NHSE asks GPs to record patient safety incidents on national system

GP practices are now expected to record incidents nationally as part of NHS England’s push to improve patient safety in primary care. 

A new strategy, published last week, has set out a series of improvements to be made in general practice, while stressing that these are not ‘contractual requirements’ and the timelines are ‘intentionally flexible’.

On recording incidents, the strategy said GP practices are expected to connect their local risk management systems to the Learn From Patient Safety Events (LFPSE) national NHS system.

NHS England said it wants a ‘single, simple patient safety event recording form and process, with improved quality of incident (patient safety event), near miss (sometimes called good catches), good practice events and risk recording’.

Another system used in secondary care – the Patient Safety Incident Response Framework (PSIRF) – will also be implemented in general practice from this year, starting with pilot sites.

The PSIRF ‘sets out the approach for responding’ to incidents to help healthcare professionals learn and improve patient safety. 

NHSE said: ‘While there is no intention to lift and shift PSIRF directly from secondary care into primary care, we want to implement its concepts of proportionate, flexible and contextual into the primary care response to incidents, dependent on local configurations.’

According to the strategy, the ‘culture of incident reporting’ in general practice is ‘relatively underdeveloped’ compared with secondary care. 

It highlighted that while over a fifth of new claims to NHS Resolution are from general practice, only 1% of the 2.2 million incidents recorded nationally each year are from primary care.

This is the first patient safety strategy for primary care and was based on NHSE’s recognition that the strategy for the wider NHS from 2019 ‘needs more specific interpretation’ for GP practices.

NHSE expects some improvements to be implemented first in GP practices before being rolled out more widely to other primary care providers. 

Other ‘ambitions’ laid out in the new strategy:

• Improve communications between primary care providers as well as with secondary care, mental health, ambulance, community care, and social care – as incidents are ‘more likely to occur at these points of change’;
• Implement IT systems in primary care that ‘automatically flag patient safety issues such as missed patient referral follow-ups, safeguarding, diagnoses and medical issues’;
• Develop IT which ‘consistently support clinical decisions in primary’, for example by embedding differential diagnosis decision guidance digitally; 
• Implement the general practice staff survey fully in order to provide standardised data on staff experience;
• GP practices to identify patient safety leads among staff and ‘lay patient safety partners’ in PPGs;
• Pilot approaches and share good practices for patient safety improvements around the themes of: diagnosis, medication, and referral.

NHS England also said it will ‘explore the application’ to primary care of an approach used in the nuclear power industry for managing risk, called the ‘safety management systems’ approach.

The strategy said: ‘Given the capacity pressures in primary care and ICBs, this strategy seeks to continuously improve patient safety through existing processes and structures as much as possible, rather than adding work.’

In July, NHSE was told to evaluate the patient safety risks associated with online consultation tools used by GPs after an investigation found the use of such tools has led to harm and death in a small number of cases.