What Open Disclosure Is

Honest, timely communication after something goes wrong in your care. Open disclosure is the process by which a hospital or health service tells you, openly and promptly, what happened when an incident occurred in your care: what is known, what it means for your health, what will be done about it and, where appropriate, an apology. The National Open Disclosure Framework^[6] (Department of Health, October 2023) applies this expectation across public and private health and social care in Ireland; other jurisdictions, including England with its statutory “duty of candour”, impose similar obligations under different names.

The duty is not confined to hospitals. It applies to health services providers and practitioners across the system, public and private: doctors, dentists, pharmacists, nurses and midwives all fall within the Act’s definitions, so the same expectations follow you from a hospital ward to a GP surgery or a community pharmacy^[1].

Open disclosure is about information and accountability. It sits alongside, and does not replace, a medical negligence claim: a category of personal injury claim that proceeds directly to the Irish courts. Understanding the difference between the two is the single most useful thing this guide can give you, and it runs through every section below. It also helps to be clear about what open disclosure is not:

• It is not a complaint: you do not have to raise anything for the duty to arise.
• It is not compensation: no payment or settlement flows from the meeting itself.
• It is not an admission: section 10 protects what is said.
• It is not an inquest: a coroner’s inquiry is a separate process with its own rules.

From Voluntary to Mandatory: What Changed in September 2024

Disclosure of the most serious incidents is now a legal duty. Since 26 September 2024, health services providers in Ireland must disclose a defined list of the most serious patient-safety incidents under the Patient Safety Act 2023. Before that date, open disclosure was encouraged and legally protected, but voluntary.

The voluntary framework remains part of Irish law. Part 4 of the Civil Liability (Amendment) Act 2017^[5], commenced in September 2018, supports open disclosure of all patient-safety incidents, including near misses and incidents that caused no harm, and attaches statutory protections to what is said. Its weakness was that no provider was ever obliged to use it.

That gap became impossible to ignore. Women affected by the CervicalCheck controversy learned that audit results relevant to their care had not been shared with them, and the 2018 scoping inquiry led by Dr Gabriel Scally was sharply critical of how open disclosure operated in practice. In Morrissey v HSE [2020] IESC 6, the Supreme Court case at the centre of that controversy, the HSE admitted it had breached its duty by failing to tell Ms Morrissey the results of the audit of her earlier smear tests^[8].

The legislative answer was the Patient Safety (Notifiable Incidents and Open Disclosure) Act 2023^[1] (No. 10 of 2023), signed into law on 2 May 2023 and commenced in the main on 26 September 2024 by S.I. No. 482/2024^[4]. The 2023 Act also amended the 2017 Act, so the two now operate as one two-layer system: mandatory disclosure for the defined “notifiable incidents”, and voluntary, protected disclosure for everything else.

What changed on 26 September 2024 is easy to state and easy to see side by side: for Schedule 1 incidents, disclosure stopped being a choice.

How the law evolved: 2017 to 2026

What Counts as a Notifiable Incident

A short statutory list of the most serious outcomes. A notifiable incident is one of thirteen categories of patient-safety incident listed in Schedule 1 of Ireland’s Patient Safety Act 2023, almost all involving an unintended and unanticipated death.

In plain terms, Schedule 1^[2] covers deaths connected with surgery performed on the wrong patient, the wrong site or the wrong procedure; a foreign object unintentionally left behind after surgery; the death of an otherwise well patient during or after elective surgery, related to the operation or anaesthesia; deaths associated with a medication error or an incompatible blood transfusion; the unanticipated death of a woman during pregnancy or within 42 days of its end, related to its management; certain stillbirths and perinatal deaths; the suicide of a patient while receiving care in a health service facility; and specified circumstances involving therapeutic hypothermia treatment for babies. Regulations made in 2024 (S.I. No. 501/2024) refine the maternity and neonatal definitions^[12], and section 8 allows the Minister for Health to add further incidents over time.

Practitioners typically encounter Schedule 1 when a family asks whether a death “counts”. The honest answer is that the list is narrow and its definitions precise, which is why the exact wording matters: for the statutory text of each category, the commencement detail and the defining regulations, see our companion guide to the Patient Safety Act 2023 explained.

Separately, Part 5 of the 2023 Act gives patients the right to request a review of a cancer screening they received through BreastCheck, CervicalCheck or BowelScreen, with mandatory open disclosure of the completed review. This is a direct legislative response to the screening controversy, it applies whether or not any notifiable incident has occurred, and our guide to CervicalCheck audit and open-disclosure failures covers the scheme-specific history.

What You Must Be Told, and When

A formal meeting, specific information, and a record of it. Under the 2023 Act, once a health services provider in Ireland is satisfied that a notifiable incident has occurred, it must hold an open disclosure meeting with you, or with a “relevant person”. A relevant person steps in where the patient cannot take part, has died, or has asked for the disclosure to be made to someone they nominate: in a fatal incident, that usually means the family^[1].

The Act structures what that meeting must contain. Under section 18, the meeting must give you^[1]:

• the date and a description of the incident;
• when it came to the provider’s attention;
• the physical and psychological consequences for you; and
• an apology, where appropriate.

Disclosure is to happen promptly, once the provider is satisfied the incident has occurred, rather than at the end of a lengthy internal process.

The duty does not stop at your meeting. The provider must also notify the relevant regulator, whether that is HIQA, the Chief Inspector of Social Services or the Mental Health Commission, as soon as practicable and no later than 7 days after it is satisfied the incident occurred, through the National Incident Management System^[10]. That external notification matters to you for a practical reason: the incident is formally on record with an independent body, not only inside the hospital’s own files. The regime is operating in practice as well as on paper: HIQA’s 2024 annual report records more than 30 notifiable-incident notifications in the first months after commencement, including from private facilities^[11].

What to Expect in a Disclosure Meeting

In person, led by a senior clinician, with support built in. The disclosure meeting is held in person, unless you ask for a different arrangement, and led by the principal health practitioner responsible for your care, unless the circumstances of the incident make that inappropriate.

You are not expected to navigate the process alone. The provider appoints a designated person to act as your point of contact, to help arrange the meeting, and to deal with any request for clarification you make afterwards under section 23. You are entitled to bring a support person, to take notes, and to ask questions. You do not have to respond to anything on the spot.

In practice, disclosure meetings turn on preparation: who attends with you, what you ask, and what gets recorded.

Not every fact is available on day one, and the Act recognises this. Where further relevant information emerges after the first meeting, additional information must be given to you, so disclosure can involve more than one session. A written record of what was disclosed must follow, and it is required to reach you within 5 calendar days of the meeting: keep it, and show it to anyone advising you.

Within the HSE and HSE-funded services, the meeting is run under the HSE Open Disclosure Policy 2025, “Communicating with Patients Following Patient Safety or Notifiable Incidents”, launched on 17 June 2025 to replace the 2019 policy^[7]. Its emphasis is on preventing the additional harm that poor communication after an incident causes families, which is precisely the failure the older voluntary system allowed. If you decline a disclosure meeting, that is your right under section 19, and you can change your mind: the provider must give you contact details so you can request the disclosure at any time within the next 5 years^[7]; where you cannot be contacted despite reasonable attempts, section 20 sets out what the provider must do.

A short checklist for the meeting

Does an Apology Admit Liability? Section 10 Explained

No. The apology is legally protected, by design. Under section 10^[3] of the 2023 Act, information and any apology given at an open disclosure meeting do not constitute an express or implied admission of fault or liability.

Section 10 does three things^[3]. The information and apology given at the meeting:

• “shall not constitute an express or implied admission of fault or liability”;
• are not “admissible as evidence of fault or liability” in proceedings arising from the incident; and
• do not invalidate the provider’s insurance or indemnity.

The 2017 Act contains equivalent protections for voluntary disclosures made under its framework.

Section 10 is often misunderstood as a shield against claims. Its actual effect is narrower, and worth understanding rather than resenting: the old culture of silence was driven by fear that an honest explanation or a sincere apology would be treated in court as a confession. Section 10 removes that fear so that you get the truth, and an apology, early. It protects the conversation, not the conduct.

What section 10 does not do is erase the facts. Your medical records, test results, and the events themselves remain exactly as they were, fully available to be examined. Nothing in the Act prevents a court deciding a negligence claim on that independent evidence.

How Does Open Disclosure Affect a Medical Negligence Claim?

Two separate tracks: information first, liability proven independently. Open disclosure and a medical negligence claim run on separate tracks. Disclosure gives you information and, where appropriate, an apology; a claim must be proven independently, through your medical records and expert evidence.

Understanding what must be disclosed, and what the statutory protections do and do not cover, shapes how compensation for injury in Ireland is pursued where the underlying facts support a negligence claim. Some patients assume an apology means the case is effectively won. It does not, and it is fairer to know that now: the protected statements cannot prove your claim, and the burden of proving breach of duty and causation stays exactly where it always was. What disclosure often does is hand you, early, the factual starting points that your solicitor and an independent medical expert then test against the records.

Breach of duty in an Irish medical negligence case is judged by the principles set out by the Supreme Court in Dunne v National Maternity Hospital [1989] IR 91 and unanimously reaffirmed in Morrissey v HSE [2020] IESC 6:

“The true test for establishing negligence in diagnosis or treatment on the part of a medical practitioner is whether he has been proved to be guilty of such failure as no medical practitioner of equal specialist or general status and skill would be guilty of if acting with ordinary care.”

per Finlay CJ in Dunne v National Maternity Hospital [1989] IR 91 at p 109, reaffirmed in Morrissey v HSE [2020] IESC 6^[8]

Two practical points follow. First, medical negligence claims in Ireland do not go through the Injuries Resolution Board; they proceed directly to court, and an independent expert report is required. Second, time limits are unforgiving: a claim must generally be brought within two years of the date of knowledge. The two-year period is set by section 7 of the Civil Liability and Courts Act 2004; the date-of-knowledge test that governs when the two years start to run comes from the Statute of Limitations (Amendment) Act 1991. What you learn at a disclosure meeting can be relevant to when that clock starts. The clock does not pause while internal processes, reviews or inquests continue, so it is sensible to take advice early even if you are still waiting on answers.

If Disclosure Does Not Happen: Your Options

Non-disclosure has consequences, and you still have routes. If a notifiable incident is not disclosed to you, the provider may be committing an offence, and you can still pursue both the information and any claim through other channels.

Start with what you control. You are entitled to request your full medical records at any time, whatever the provider has or has not told you. You can also raise the matter directly with the hospital or service and ask whether an incident review exists.

Formal routes then follow. You can make a complaint through the HSE complaints process, or the equivalent process of a private provider; our guide to complaint vs claim explains how a complaint differs from legal action and why the two are often confused. On the regulatory side, providers must notify HIQA, the Chief Inspector of Social Services or the Mental Health Commission of a notifiable incident within 7 days, and under section 77 a failure to make open disclosure of a notifiable incident without reasonable excuse is an offence, punishable on summary conviction by a Class A fine of up to €5,000^[1].

Finally, a medical negligence claim does not depend on disclosure ever having happened. The claim is built on records and independent expert evidence, and the circumstances of any non-disclosure form part of the picture your solicitor examines.

Fatal Incidents and Inquests

Most notifiable incidents are deaths, and inquests often follow. Because almost every category in Schedule 1 involves the death of a patient, many families in Ireland encounter open disclosure and a coroner’s inquest within the same painful period.

The two processes answer different questions. An inquest establishes the facts of how a death occurred; it cannot make a finding of civil liability against anyone. Open disclosure, the provider’s internal review and the incident records created around it can give a family important information before or alongside the inquest, and the same material often informs any later assessment of a civil claim. Our guide to inquests in medical negligence cases explains the coronial process itself, including how families participate.

The two processes also feed each other in practical ways. The written disclosure record and the provider’s internal review often form part of the information available around the inquest, and a family can ask the provider directly whether the incident was notified to the regulator. If a claim is being considered, the limitation clock runs independently of the coronial timetable, so families should not assume time stands still while they wait.

Support and Next Steps

You are entitled to support through every step. The Patient Advocacy Service^[9] is a free, independent, confidential service that supports patients and families through patient-safety incidents and open disclosure, and you can involve it at any stage.

Beyond advocacy, be patient with yourself about pace. You can ask for the written account of the meeting, take time to absorb it, and return with questions through the designated person. If you are considering whether what happened amounts to negligence, a solicitor experienced in medical negligence can obtain your records and instruct an independent medical expert to assess them, without any commitment on your part to proceed further.

The law itself is still settling in. Under section 80, the Act’s operation must be reviewed within two years of commencement, so a Government review falls due around September 2026, and section 8 allows the Minister to add further notifiable incidents by regulation, meaning the mandatory list can grow. The position described on this page is the position as at the last-reviewed date shown above.

Frequently Asked Questions

Direct answers to the questions patients ask most. Each answer below starts with the short version, then the context that sits behind it.

Related Questions

Short bridges to the guides most readers open next.