Open disclosure with women and families after unexpected harm in NHS maternity care
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4 May 2020 — adopted November 2019 • completed June 2021
Open disclosure with women and families after unexpected harm in NHS maternity care
This study identifies the key factors, systems and processes which enable some maternity units or networks to achieve significant improvements in disclosure practices — and examines the consequences of disclosure for women, families and staff.
Besides a legal duty of candour, international studies suggest that the disclosure and discussion of harm with those affected can benefit them. Such discussions may also improve patient safety and reduce prolonged and costly legal claims.
However, doing this well is difficult for individual professionals, healthcare teams and healthcare organisations. Some maternity services are strengthening and embedding improvements — and this study examines whether this can be achieved by other services.
The DISCERN study examines: “What works, for whom, in what situations, in what ways and why?” — using in-depth interviews and observation in up to four selected NHS maternity units or networks in England.
The research team
The co-investigators and study team include:
Four national charities or associations representing women and family interests; a senior obstetrician; two midwives and social scientists; and a senior and international specialist in this safety improvement field.
The co-investigator team is supported by:
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A project advisory group including seven women who have directly experienced harm in maternity care; senior NHS organisational representatives; clinicians and legal specialists
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A study steering team of senior social science and clinical academics and a parent representative, which monitors and advises on study progress
Benefits and impact of the study
From the research findings, the team will co-design with invited stakeholders — including women and family representatives — filmed and written guidance for:
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Frontline staff on how to conduct open and compassionate disclosure conversations
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Women and families on what to expect when harm occurs and what support is available
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Briefings for service and organisational leads on embedding improvement in disclosure practice
Immediate benefit: co-produced guidance for those involved in harm.
Longer-term benefit: to re-energise and sustain a conversation in NHS maternity care about the need for consistent structures and processes of support for families, women, patients and healthcare professionals affected by critical healthcare incidents.
Meet the team
 Prof Jane Sandall CBE Professor of social science and women’s health, KCL; midwife and NIHR Senior Investigator (co-lead) |
MA
Senior research fellow, KCL; social and medical anthropologist; clinical background in nursing and midwifery (co-lead) |
RI
Professor Rick Iedema Professor and director, Centre for Team-based Practice & Learning in Health Care, KCL |
AH
Professor Alex Heazell Professor of obstetrics, University of Manchester; director, Tommy’s Stillbirth Research Centre |
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JH
Dr Julie Hartley Research associate, KCL; social anthropologist |
Related content
- →
DISCERN study website - →
The experiences of parents who suffer pregnancy loss and whose babies die during the pandemic (PUDDLES) - →
Informing national policy on perinatal mental health and maternity care - →
Maternity and perinatal mental health research at ARC South London
Original source: arc-sl.nihr.ac.uk — NIHR ARC South London legacy content archived May 2026.