If you’ve been invited to an HSE open disclosure meeting following a traumatic birth or neonatal incident, you may feel anxious about what will be said and what the meeting could mean for your child’s future.
Our advice is simple: do not attend without preparation.
Speak to a specialist medical negligence solicitor first. Ask for your solicitor to attend with you. If the hospital will not facilitate this, get legal advice before deciding how to proceed.
An open disclosure meeting may provide important answers. It may also be the first formal account of what happened during your baby’s birth. You should approach it carefully, with someone on your side who understands both the medical and legal issues.
What is an HSE open disclosure meeting?
Open disclosure is the process through which a healthcare provider tells a patient or family that something went wrong during care.
The meeting should give you an opportunity to:
- Hear what the hospital knows about the incident.
- Understand when and how the incident was identified.
- Ask questions about your baby’s care.
- Discuss any known or possible future harm.
- Learn what treatment or support is planned.
- Hear what the hospital is doing to investigate the incident.
- Discuss changes intended to prevent something similar happening again.
The hospital should appoint a designated person to act as your point of contact. Notes will be taken. You should also receive a written account after the meeting.
The Patient Safety (Notifiable Incidents and Open Disclosure) Act 2023 came into operation on 26 September 2024. It made open disclosure legally mandatory for a defined group of serious events known as “notifiable incidents”. The HSE’s current guidance also applies open disclosure procedures to other patient safety incidents.
What does “notifiable incident” mean?
A notifiable incident is one of the serious patient safety events specifically listed in the 2023 Act.
In maternity and neonatal care, the list includes certain:
- Maternal deaths during pregnancy or within 42 days after pregnancy.
- Unanticipated and unintended stillbirths that meet the legal criteria.
- Unanticipated and unintended perinatal deaths that meet the legal criteria.
- Cases where a baby requires or is referred for therapeutic hypothermia, sometimes called cooling treatment.
- Cases where therapeutic hypothermia was considered but could not be given because of the severity of the baby’s condition.
For stillbirth and perinatal death cases, the legislation contains detailed requirements concerning gestational age, birthweight and underlying medical conditions. The 2024 regulations define the relevant thresholds as a birthweight of at least 2,500 grammes and a gestational age of at least 37 weeks. A perinatal death means a death within seven days of birth. The full definitions are set out in the 2024 Regulations.
Not every poor birth outcome is automatically a notifiable incident. Other birth injuries may still require open disclosure under HSE policy and the Civil Liability (Amendment) Act 2017.
Equally, being told that an event is notifiable does not prove medical negligence. A successful claim normally requires independent expert evidence showing that the care fell below an acceptable standard and that this caused or materially contributed to the injury.
The classification still matters. It means the hospital has identified the event as falling within a category serious enough to trigger mandatory disclosure and regulatory reporting.
What should happen at the meeting?
You should be told who will attend and why they are there. The meeting will usually involve the clinician leading the disclosure, another healthcare professional, the designated person and a note-taker.
The hospital should explain:
- What happened, based on the facts currently available.
- When the incident occurred and when it came to the hospital’s attention.
- How it was discovered.
- The known physical or psychological consequences.
- Any possible future consequences.
- Your baby’s current or proposed care.
- What reviews or investigations have started.
- What action has been taken or is planned.
The hospital may not yet have every answer. Open disclosure should begin as soon as practicable, sometimes before the incident review is complete. If information is unavailable, ask why, when it is expected and how it will be shared with you.
For a notifiable incident, the hospital must provide a written statement recording the information disclosed. This should generally be provided within five calendar days. The hospital must also keep prescribed records relating to the process. Section 18 of the Act sets out the information that must be provided.
Is an apology an admission of liability?
No.
An apology may be deeply important to a family. However, under section 10 of the 2023 Act, information and an apology provided through a compliant open disclosure process do not:
- Constitute an admission of legal liability or fault.
- Invalidate the healthcare provider’s insurance.
- Automatically become admissible evidence in court.
This means you should listen carefully to the facts, not only the wording of the apology.
An apology might acknowledge the harm your family has suffered without accepting that anyone was negligent. It may also refer to an “error” or “failing”, but the legal effect still depends on the full circumstances and the evidence available outside the protected disclosure process.
Your child’s medical records, CTG traces, medication records, neonatal notes, staff statements, internal review documents and independent expert evidence may all have separate legal significance.
Why the meeting creates an important investigative trail
A mandatory disclosure can create a structured record of the incident. This may include:
- Notification to the relevant regulator.
- Appointment of a designated contact person.
- A formal description of the incident.
- The date the hospital became aware of it.
- A written account of information disclosed.
- Records of your questions and requests for clarification.
- An incident review and later review findings.
- Details of actions proposed in response.
Some open disclosure communications receive statutory legal protection and may not themselves be used as evidence. That does not make the process unimportant. It helps a solicitor identify the records that should exist, the questions that remain unanswered and the independent evidence that may need to be preserved.
What to do before attending
1. Speak to a specialist solicitor
Contact a birth injury or medical negligence solicitor before the meeting. Early advice can help you understand what the invitation means and protect important evidence.
Your solicitor can prepare questions, request information and seek to attend with you. Legal advice at this stage is sensible protection during a formal process. It is not an accusation or an overreaction.
Tell the designated person in writing that you want your solicitor present. Ask the hospital to confirm the arrangements before the meeting.
2. Ask for information in advance
Request:
- Written confirmation of whether the event is a notifiable incident.
- The date, time and proposed length of the meeting.
- The names, roles and departments of everyone attending.
- The purpose and planned scope of the meeting.
- Confirmation of any ongoing internal or external review.
- The name and contact details of your designated person.
- Details of any documents the hospital intends to discuss.
You can also ask for an interpreter, accessibility arrangements, an independent advocate or a different meeting format if required. HSE guidance says families should be encouraged to bring a support person.
3. Prepare your questions
Write your questions down. For a birth or neonatal incident, they may include:
- When did staff first identify signs that the baby was in difficulty?
- What did the CTG or other monitoring show?
- When was a senior obstetrician called?
- When was the decision to deliver made?
- Was there any delay in carrying out that decision?
- What happened during resuscitation?
- What were the cord blood results and Apgar scores?
- Why was therapeutic hypothermia required or considered?
- What do MRI, EEG or other test results show?
- What is known about the baby’s prognosis?
- What investigation is taking place, and when will we receive its findings?
Ask for technical terms to be explained in plain language. If a question cannot be answered, ask for that to be recorded and answered later in writing.
4. Keep your own record
Bring a notebook and someone who can take notes. Record the names and roles of everyone present, the facts given, documents mentioned and questions left unanswered.
Do not secretly record the meeting. Ask in advance whether an audio recording can be agreed.
Afterwards, write down anything important while it is still fresh. When the hospital’s written summary arrives, compare it with your notes. If it is incomplete or inaccurate, respond in writing and keep a copy.
5. Do not sign documents without advice
Do not sign a settlement, confidentiality agreement, release or document confirming your agreement with the hospital’s account without legal advice.
You are entitled to take time to consider what you have heard. You do not need to reach conclusions during the meeting.
Frequently asked questions
Do I have to attend the meeting immediately?
You can ask for time to obtain advice and prepare. HSE guidance recognises that families may not be emotionally ready to participate straight away. Ask for any postponement or alternative date in writing.
Can I bring a solicitor?
You should ask to do so. A solicitor is not automatically treated as the child’s statutory “relevant person”, so arrangements should be confirmed with the hospital beforehand. Even if your solicitor does not attend, get advice before the meeting and arrange a prompt debrief afterwards.
Does a notifiable incident mean my child has a medical negligence claim?
No. It means the event falls within a defined statutory category. An independent medical expert must usually assess whether negligent care caused or contributed to the injury.
What if the hospital cannot answer my questions?
Ask for each unanswered question to be recorded. Request a written response and a date for a further meeting. The designated person should remain your contact throughout the process.
Talk to our medical negligence team before the meeting
You do not have to face an HSE open disclosure meeting alone.
HOMS Assist can review your invitation, explain your rights, help you prepare the right questions and seek to attend with you. We’ll listen carefully to what happened and give you clear, practical advice about the next steps.
Contact our specialist medical negligence team to book a confidential consultation before your meeting. We’re here to help protect your child’s interests and make sure your family’s questions are properly heard.
About the author: Áine McSweeney is a seasoned solicitor at HOMS Assist, specialising in medical negligence claims. With over two decades of experience and a diploma in healthcare law, Áine combines her legal expertise and deep understanding of healthcare standards to advocate for clients affected by medical errors.
