The Future is Collaborative: ADR in Clinical Negligence

The Bar of Ireland has recently published its first alternative dispute resolution survey. Our Medical Law team examines the key findings from the survey. They also look at how mediation and alternative dispute resolution continue to play a pivotal role in the management and resolution of clinical negligence disputes.

Alternative Dispute Resolution (ADR), particularly mediation, is playing an increasingly prominent role in resolving disputes outside the traditional court process. In the area of healthcare, clinical claims are often complex, time-sensitive and emotionally charged. As a result, mediation has emerged as a particularly effective and empathetic method of resolution.

Reflecting this growing importance, the Bar of Ireland has published its first dedicated ADR survey: “The State of ADR in 2025: Insights into the Irish Alternative Dispute Resolution Landscape.” Conducted in February 2025, this inaugural survey captures perspectives from legal practitioners across a wide range of practice areas. It also provides timely insight into the usage, effectiveness and evolving perception of ADR in Ireland, including in the context of negligence claims.

Key survey findings

• 61% of those surveyed expected increased demand for ADR processes, including mediation, over the coming years
• 83% reported that ADR produced a successful outcome in over half of their cases
• 85.5% of respondents had engaged in ADR in the previous 12 months
• 88% confirmed that ADR led to cost savings in their cases
• Out of all forms of ADR, mediation was by far the most commonly practiced. 96% of those surveyed had experience in mediation, making it the standout preferred method of ADR, likely due to its flexible nature and the growing use of Court-directed mediation processes.

These figures highlight that legal practitioners throughout Ireland are actively participating in ADR and recognise its value as a reliable and efficient dispute resolution mechanism.

In clinical negligence claims, ADR provides several important benefits, including:

• Direct dialogue between patients and healthcare professionals
• Greater opportunity for emotional closure
• Faster, more efficient resolution of claims
• Significant cost savings
• Reduced adversarial stress
• More personalised and flexible outcomes

Mediation allows acknowledgment, responsibility and understanding to be addressed in a constructive and non-adversarial environment to the benefit of all parties.

Mediation as the primary ADR mechanism

Mediation continues to be one of the most utilised ADR methods in negligence disputes. It provides flexibility, reduces delays, and from our experience, very often avoids the high emotional and financial costs of court proceedings.

The survey results do not provide a sector-by-sector breakdown. However, there are suggestions from various practice groups that ADR may be less utilised in professional negligence and clinical negligence claims compared to areas like employment or construction disputes. While the reasons for this are not entirely clear, it is likely due to the fact that commercial entities are bound by contracts requiring the use of ADR. In contrast, healthcare providers typically operate under public liability frameworks without any contractual ADR processes in place with patients. As a result, litigation is often the only option.

A recurring theme in survey responses is the urgent call for the establishment of the Mediation Council, as outlined in the Mediation Act 2017. This body would have responsibility for setting and maintaining standards, and accrediting mediators who are crucial to the process. Specific training for mediators in specialised areas like healthcare and clinical disputes will be required. The Mediation Act 2017 provides the Courts with a statutory framework to invite or direct parties to consider mediation. The Courts may also make adverse costs orders where parties unreasonably refuse to mediate.

Practice Directions No. 131 and 132

The President of the High Court issued Practice Direction No. 131 and Practice Direction No. 132 in April 2025. Both of these mark a significant step forward in advancing ADR use in the Irish court system.

Practice Direction 131 deals specifically with the use of mediation in clinical negligence proceedings. There is a mandatory requirement to offer mediation within three weeks of a trial date being set and engage constructively with that offer. However, the Court strongly encourages parties to consider mediation at all stages, particularly early in the litigation process. Parties now need to confirm to the Court whether mediation has been considered or satisfy the Court that there is good reason why mediation will not assist. While there are no specific cost implications for failing to engage in mediation, the direction points to cost orders and sanctions being imposed for general non-compliance.

Practice Direction 132 formally establishes a dedicated Clinical Negligence List, aimed at streamlining the management of clinical claims through early intervention and proactive oversight by judges. This structured approach allows the Court to identify cases suited to mediation at an earlier stage, reducing unnecessary litigation delays and enabling parties to focus on resolution sooner.

These directions are not just procedural refinements, they reflect a cultural shift within the judiciary toward embedding ADR as a central feature of dispute resolution in healthcare litigation.

Conclusion

The Bar of Ireland’s ADR survey signals a growing and welcome shift towards mediation and court-supported dispute resolution, particularly in the field of clinical negligence. The advantages of ADR are clear and wide-ranging.

With the introduction of Practice Directions 131 and 132, the Courts have signalled a new era in case management, where ADR is increasingly seen as an essential step in clinical claims.

While mediation remains voluntary, it is strongly encouraged by the judiciary to resolve or narrow disputes. The establishment of the Mediation Council, long anticipated under the 2017 Act, would further strengthen this framework.

As ADR continues to become mainstream in Irish legal practice, particularly in clinical negligence, it presents a timely opportunity for stakeholders to rethink how complex, sensitive disputes are resolved to the benefit of all those involved.

For more information and expert advice, please contact a member of our Medical Law team.

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