Being Open Framework for Health and Social Care Northern Ireland (19 February 2026)

Summary

The Department of Health's Being Open Framework for Health and Social Care Northern Ireland is aimed at supporting a culture of openness, honesty, and transparency across health and social care in Northern Ireland. The Framework provides a standardised, yet flexible, regional approach to help create the conditions where a culture of openness and trust can flourish between those who use our services, their families and carers, health and social care staff and leaders and organisations.

Content

Purpose of the framework

The Framework aims to promote and support a culture of openness, transparency and accountability reflected through compassionate communication with staff, patients, service users and their families and carers, and where ongoing learning enhances and improves patient safety and quality of care.

The Framework will help ensure that all staff understand the expectations and responsibilities upon them to operate in an open, just and learning culture, and that they are supported to do so by health and social care organisations, leaders and managers. It is designed not only to guide staff when things go wrong, but also to promote openness, transparency and honesty as part of everyday practice and patient care, and to create a supportive and psychologically safe environment for all. By supporting an open, just and learning culture, patient safety, public confidence and support for staff will be improved. 

Aims of the Framework

• Improve patient safety and quality of care by supporting an open, just and learning culture.
• Normalise openness as a valued everyday behaviour rather than something that is only important in certain circumstances.
• Position and frame openness as part of mainstream business, not as an optional add-on.
• Ensure those who use services, their families, carers and staff are listened to and are treated openly, fairly and with compassion and respect; and their experiences and views are recognised as having a valuable contribution to learning and improvement.
• Ensure HSC staff experience visible, engaged and inclusive leadership at all levels that demonstrates and promotes an open, just and learning culture – including from those in the most senior leadership positions.
• Enable leaders at all levels of the organisation to drive cultural improvements.
• Create psychologically safe spaces for all staff to speak up and to learn.
• Support a move from blame to balanced accountability, and a focus on system-based learning when an event or incident has occurred or where concerns are raised.
• Support open and prompt sharing of learning across the organisation and beyond as appropriate, both when things go wrong and when they go well.
• Ensure that all staff understand the expectations and responsibilities upon them to operate in an open, just and learning culture, and that they are supported to do so.
• Achieve a sustained focus by leaders at all levels, including senior leaders, on embedding an open culture that is informed by both qualitative and quantitative data.

Related reading

‘Being Open’ Framework and Duty of Candour in Northern Ireland: Consultation response (Patient Safety Learning, 28 March 2025)