Annual Reporting Under the National Open Disclosure Framework

Concerns about medical negligence often raise difficult questions for patients and families about what went wrong, why it happened, and whether lessons have been learned. In recent years, there has been a growing public and legal focus on transparency in healthcare, particularly when adverse incidents occur.

Against this background, open disclosure and how it is monitored have taken on increased importance. Recent changes to annual reporting under Ireland’s National Open Disclosure Framework represent a significant step in how healthcare providers account for patient safety incidents, and how information about those incidents is shared at a national level.

What is open disclosure?

It is the practice of communicating openly and honestly with patients, and where appropriate, their families, when something goes wrong during healthcare that has caused, or may have caused, harm. It is centred on transparency, respect, and learning, rather than blame.

In practical terms, open disclosure involves healthcare providers explaining what is known about an incident, acknowledging the impact on the patient, and outlining what steps are being taken in response. This conversation should take place as soon as possible after the event, and it should be conducted in a compassionate and supportive manner.

Open disclosure usually includes the following elements:

1. A clear explanation of what happened, based on the information available at the time.
2. An acknowledgement of the harm or potential harm experienced by the patient.
3. An apology or expression of regret, where appropriate, without this being treated as an admission of legal liability.
4. Information about what reviews or investigations will take place, and how the patient will be kept informed.
5. Details of any supports available to the patient and their family.

From a patient safety and medical negligence perspective, open disclosure is intended to help patients understand their care, reduce feelings of uncertainty or mistrust, and ensure that lessons are learned to prevent similar incidents from occurring again.

The National Open Disclosure Framework

The National Open Disclosure Framework is a national policy developed by the Department of Health to support a consistent and transparent approach to open disclosure across Ireland’s health and social care system. Launched in October 2023, it reflects growing recognition of the importance of openness and accountability when patient safety incidents occur.

The Framework applies across public and private healthcare settings and is designed to make open disclosure a routine part of clinical practice rather than an exceptional response. It places responsibility on healthcare organisations to have appropriate policies, training, and support in place so that staff can engage in open disclosure with confidence and consistency.

By introducing national standards and oversight, including formal annual reporting requirements, the Framework also strengthens accountability at a system level. It aligns with wider patient safety reforms, including legislation providing for mandatory open disclosure in certain serious cases, and is intended to support learning and improvement across the healthcare system as a whole.

Annual reporting requirements

One of the most significant developments under the National Open Disclosure Framework is the introduction of formal annual reporting requirements. These requirements are designed to ensure that open disclosure is not only encouraged in principle but also monitored and reviewed in a structured and transparent way, at national level.

Under the Framework, a wide range of stakeholders are expected to submit an annual report to the Department of Health outlining how they are implementing open disclosure. This includes public and private healthcare providers, regulators, professional bodies, and education and training organisations. The reports are intended to give a clear picture of how open disclosure is being embedded across the healthcare system.

Annual reports are expected to cover matters such as:

• The organisation’s open disclosure policies and governance arrangements.
• Training provided to staff, including clinical and non-clinical personnel.
• Supports in place for staff involved in open disclosure.
• The number of open disclosures initiated and completed during the reporting period.
• Any challenges identified, and steps being taken to address them.

The Department of Health, through the National Patient Safety Office, compiles this information into an aggregated national report, which is published and provided to the Minister for Health.

The first Stakeholders Annual Report (2025)

In 2025, the Minister for Health published the first national Stakeholders Annual Report under the National Open Disclosure Framework. This marked the first time that information on open disclosure implementation across the health and social care system was brought together and reported at a national level.

The report summarised how the initial annual reporting cycle operated, including submissions from the HSE and other healthcare stakeholders, and highlighted early progress in areas such as policy development, training, and governance. It also noted variation in engagement levels across sectors, indicating that further work is needed to embed consistent reporting practices.

Although the report is largely descriptive, its publication represents an important milestone. It establishes a baseline for future reporting and signals that open disclosure is now subject to ongoing national monitoring, rather than being addressed on an ad-hoc or informal basis.

What this means for patients and families

For patients and families affected by adverse medical events, these developments place a stronger emphasis on openness and accountability within the healthcare system. The expectation that open disclosure will be recorded, reviewed, and reported at national level increases the likelihood that patients will receive clear explanations about what happened and what steps are being taken in response.

Improved reporting also supports a more consistent approach to patient communication across different healthcare settings. While annual reporting does not replace the legal avenues available to those affected by medical negligence, it does signal a shift towards greater transparency and learning, which many patients and families have long called for when serious incidents occur.

Require assistance with a medical negligence issue?

If you or a family member has been affected by a medical negligence issue, understanding your rights and the obligations placed on healthcare providers can be complex. Recent developments in open disclosure and reporting may raise important questions, but they do not remove the need for clear, independent legal advice tailored to your individual circumstances. For assistance with any medical negligence matter, the experienced team at McCarthy + Co Solicitors LLP can be contacted through our quick and confidential online enquiry form.