What is PSIRF?

PSIRF stands for Patient Safety Incident Response Framework, the new approach the NHS uses to respond to patient safety incidents. Launched in August 2022, it replaces the Serious Incident Framework, marking a significant change in how the NHS handles patient safety. Rather than focusing on investigations alone, PSIRF centres on compassion, engaging those affected, and using a system-based approach to drive learning and improvement. It ensures that responses are proportionate and supported by oversight and collaboration across the healthcare system.

What’s the Aim of the PSIRF Framework?

The main aim of PSIRF is to improve patient safety by fostering a culture of learning from incidents and using the insights to prevent future harm. It encourages a broader range of methods for investigating incidents and helps NHS providers to offer more effective responses, backed by stronger governance and oversight. Most importantly, it puts those affected—patients, families, and staff—at the centre of the process, ensuring they feel supported and involved.

Who Does PSIRF Apply To?

PSIRF is mandatory for all NHS services that fall under the NHS Standard Contract. This includes:

• Acute care
• Ambulance services
• Mental health services
• Community healthcare
• Maternity services
• Specialised services

These services must use PSIRF to respond to and learn from patient safety incidents. Although primary care providers (such as GPs and dentists) are not required to adopt PSIRF, they may choose to do so voluntarily in collaboration with their local Integrated Care Board (ICB).

The Four Pillars of PSIRF

PSIRF is built on four key principles that guide how incidents should be handled:

1. Compassionate Engagement
2. Systematic Approach
3. Proportionate Responses
4. Collaboration and Oversight

Compassionate Engagement

One of PSIRF’s central aims is to ensure that patients, families, and staff affected by incidents are meaningfully involved in the investigation process. It promotes a compassionate approach where those impacted are given opportunities to share their experiences, ask questions, and contribute to the learning process. This engagement helps create a more open and inclusive environment that encourages trust and transparency.

Systematic Approach

PSIRF uses a system-based approach to investigate incidents. Rather than focusing on a single root cause, it looks at the entire system—such as the environment, tasks, tools, and technology—that may have contributed to the incident. This approach helps prevent blame being placed on individuals and promotes learning and improvement across the healthcare system.

Proportionate Responses

Recognising that resources are limited, PSIRF promotes proportionate responses. This means that not all incidents require the same level of investigation. Instead, organisations are encouraged to focus on incidents that offer the most valuable learning, especially if other work is already underway to address the underlying issues. This approach ensures that efforts are directed where they can make the most impact.

Collaboration and Oversight

PSIRF encourages collaboration between NHS providers, Integrated Care Boards (ICBs), and regulators. While providers don’t need permission from ICBs to handle incidents, there should be open dialogue about findings and lessons learned. This collaborative approach ensures that improvements are made across the wider system, not just within individual organisations.

Implementing PSIRF – Where Should NHS Providers Be Now?

As of October 2024, all NHS providers should have fully implemented PSIRF. They should now be in the final stage of the transition, with systems in place for responding to incidents in a proportionate, system-based way. Providers should be continuously learning and improving as part of the ongoing cycle of patient safety under the PSIRF framework.

Speak with the Experts

At Delphi Care, we’re experts in healthcare and social care, with a team of former CQC inspectors and registered managers who bring over 200 years of combined experience. We also have in-depth knowledge of PSIRF and are an approved supplier for NHS independent investigations, including domestic homicide reviews and .

Got questions about PSIRF or need advice on implementation? Get in touch with us today at 0330 133 3002 or email us at customer-care@delphi.care.