Open Disclosure Training in Irish Healthcare: What It Is and Why It's Mandatory

Open disclosure is the practice of communicating honestly with a patient or their family after something has gone wrong in their care – explaining what happened, what it means for them, and what's being done about it. In Ireland, training on open disclosure is required because the rules changed: since the Patient Safety (Notifiable Incidents and Open Disclosure) Act 2023 commenced in September 2024, disclosing certain serious incidents to patients is no longer just good practice – for a defined list of "notifiable incidents", it's a legal duty with a criminal penalty attached for non-compliance. That shift is why the HSE now treats open disclosure training as mandatory for staff, not an optional extra.

What open disclosure means in a healthcare setting

At its simplest, open disclosure is an open, honest, and timely conversation with a patient (or their family) when a patient safety incident has happened during their care. That covers everything from near misses and no-harm events through to incidents that caused serious harm or death. The HSE's own framing is direct: it commits to communicating "in an open, honest, timely and transparent manner if something goes wrong with your care," keeping the patient informed of the facts and involved in decisions about their ongoing treatment.

Done well, open disclosure isn't a single conversation but a process – acknowledging the incident, explaining what's known (and admitting what isn't yet known), apologising where appropriate, and setting out what will change as a result. It sits alongside, but is legally distinct from, the separate process of investigating and reviewing what happened.

The legal basis: voluntary and mandatory open disclosure

This is the part that trips people up, so it's worth being precise about it. Ireland actually has two layers of open disclosure law, introduced five years apart.

The Civil Liability (Amendment) Act 2017 came first. It established a voluntary open disclosure process that applied to patient safety incidents generally, including near misses. Providers could choose to make a disclosure, and if they did, the Act gave them real legal protection for doing so: an apology or disclosure made under the Act is not an admission of fault or liability, isn't admissible as evidence in court, and doesn't affect professional indemnity cover. The idea was to remove the fear of legal consequences that was putting clinicians off having these conversations – but it didn't compel anyone to disclose.

The Patient Safety (Notifiable Incidents and Open Disclosure) Act 2023, which commenced on 26 September 2024, changed that. It amends Part 4 of the 2017 Act and introduces genuinely mandatory open disclosure – but only for a specific, defined list of "notifiable incidents" set out in the Act's schedules. Those are serious events, almost all involving a patient death or a very severe outcome: things like wrong-site or wrong-procedure surgery leading to unanticipated death, retained surgical instruments causing death, death from a medication error or an ABO-incompatible blood transfusion, unanticipated maternal death, unexpected stillbirth or perinatal death, and certain cases requiring therapeutic hypothermia in infants. For those specific incidents, the health service provider must hold an in-person open disclosure meeting, generally led by the practitioner principally involved in the patient's care, and must notify HIQA (or the Mental Health Commission, for approved centres) within seven days. Failing to do so without reasonable excuse is a criminal offence.

So the honest summary is: all patient safety incidents should be openly disclosed as good practice, and the 2017 Act protects you when you do it – but only the defined list of notifiable incidents under the 2023 Act carries a legal requirement to disclose, with reporting duties and penalties attached. Training exists to make sure staff know which situation they're in and what's expected of them in each.

Who needs open disclosure training

The HSE lists Open Disclosure – formally titled "Communicating Effectively through Open Disclosure" – as one of the mandatory e-learning modules on its mandatory training page, alongside modules like Children First, Hand Hygiene, Dignity at Work, and Cyber Security Awareness. According to the HSE's own open disclosure pages, this base module is required of all staff working in the HSE and HSE-funded services, clinical and non-clinical alike, because anyone can find themselves involved in or told about a patient safety incident.

Beyond that baseline, extra layers of training apply to people with a more direct role in managing disclosure. Staff who are likely to lead or take part in formal disclosure meetings – senior clinicians, service managers, and quality and patient safety (QPS) staff – are expected to complete additional modules that go deeper into running those conversations, including the process required for notifiable incidents specifically. If your role could put you at the table when a serious incident needs to be disclosed, the training expectation is higher than the general staff module.

Private healthcare providers are drawn into this too, since the 2023 Act's mandatory disclosure and HIQA reporting duties for notifiable incidents apply across both public and private settings, not just the HSE.

What the training actually covers

The HSE's open disclosure training is structured in stages, each building on the last:

• Module 1 – Communicating Effectively through Open Disclosure: the foundation module for all staff, covering what open disclosure is, why it matters, and the basic principles of an honest, respectful conversation after a patient safety incident.
• Module 2 – Open Disclosure: Applying Principles to Practice: a step up for staff more likely to be involved in the process, working through how the principles apply in real situations.
• Module 3 – Face-to-Face Skills Workshop: a three-hour, in-person workshop for senior clinical and management staff who may need to lead a disclosure meeting, focusing on the practical, human skills of managing that conversation well – including with families in the aftermath of a serious incident.

Across the modules, the recurring themes are: how to communicate clearly and compassionately without minimising or over-promising; what needs to be documented and how (including recording disclosures on the National Incident Management System, NIMS); the legal protections and obligations that apply, so staff aren't disclosing in fear of it being used against them, or unaware that a notifiable incident carries a mandatory reporting clock; and the difference between disclosure and a full clinical review or investigation, which is a separate process.

How it's delivered, and how long it takes

Delivery follows the standard HSE pattern for mandatory training: the foundation modules are self-paced e-learning delivered through HSELanD, the HSE's online learning platform, and can be completed on a work computer or device during working hours. The more advanced Module 3 is delivered as an in-person, facilitator-led workshop, typically arranged by contacting a local Open Disclosure Lead, and runs for around three hours. Some organisations report the modules also carry CPD points and CEUs, which can be useful for professionals tracking their own continuing development alongside their statutory Medical Council or professional body requirements – worth checking against your own Medical Council CPD category if that applies to you.

On renewal: HSE guidance states that refresher training should be completed by all staff on a periodic basis, so open disclosure training isn't a one-off, box-ticking exercise – it's meant to be kept current, particularly given how recently the legal framework changed. If you're checking your own or your team's due date, the safest approach is to confirm the current interval directly on HSELanD or with your local training and development office, since mandatory training policies are reviewed and can be updated.

Like several other HSE mandatory modules, Open Disclosure sits in the same bracket of "everyone completes the base version, some staff need more." It's a similar pattern to other statutory training staff are expected to keep current, such as Children First training for anyone working with children, or Hand Hygiene training for infection prevention and control.

Frequently asked questions

Is open disclosure the same as admitting fault?
No. Under the Civil Liability (Amendment) Act 2017, information and apologies given as part of an open disclosure are specifically not an admission of fault or liability, and are not admissible as evidence of fault in court proceedings. The protection exists precisely so that staff can be honest with patients without it being used against them or the organisation later.

Do I have to disclose every patient safety incident by law?
Not every one. Voluntary open disclosure is encouraged for all patient safety incidents, including near misses, as good practice and it carries legal protection when you do it. Mandatory disclosure, with a statutory duty to hold a meeting and report to HIQA within seven days, applies only to the specific "notifiable incidents" listed in the Patient Safety (Notifiable Incidents and Open Disclosure) Act 2023 – mostly incidents involving death or very serious harm.

Who is expected to complete Open Disclosure training?
The base e-learning module is mandatory for all HSE staff and staff in HSE-funded services. Staff more likely to be directly involved in leading or managing a disclosure – senior clinicians, managers, and QPS staff – are expected to complete additional modules, including the in-person Module 3 workshop.

How often does the training need to be renewed?
The HSE requires periodic refresher training for open disclosure, but the exact interval is set out in HSE mandatory training policy and can change, so it's worth confirming the current requirement directly via HSELanD or your local training office rather than assuming a fixed number of years applies indefinitely.

Open disclosure training exists to close the gap between "we know we should tell patients the truth" and "we know exactly how, when, and under what legal framework to do it." With mandatory disclosure for notifiable incidents now in force, that clarity matters more than ever for anyone working in an Irish healthcare setting.

This guide is part of Learnsignal's ongoing coverage of professional qualifications and training routes.