Introduction to PSIRF

What is the Patient Safety Incident Response Framework (PSIRF)?

‍The Patient Safety Incident Response Framework (PSIRF) is a national NHS initiative designed to improve how healthcare organisations in England respond to patient safety incidents. Introduced by NHS England, PSIRF replaces the Serious Incident Framework (SIF) and marks a fundamental shift towards a more compassionate, learning-focused approach.

At its core, PSIRF helps healthcare providers investigate and respond to incidents in a way that prioritises learning, systems thinking, and meaningful involvement of patients, families, and staff. It ensures that safety investigations are focused not just on what happened, but why it happened, so that changes can be made to reduce future risks.

‍Why Was PSIRF Introduced?

‍The PSIRF was developed to address the limitations of the previous Serious Incident Framework, which often relied heavily on root cause analysis and placed undue focus on blame and individual error. Feedback from patients, staff, and healthcare leaders called for a more proportionate and compassionate response system – one that genuinely supports improvement.

Key reasons for the shift include:
• The need for more consistent and fair investigations into patient safety incidents.
• A desire to focus on systemic learning, rather than isolated individual actions.
• Evidence that engaging affected individuals more meaningfully leads to better outcomes and trust.
• Alignment with the NHS’s broader patient safety strategy and Just culture principles.

‍When Was PSIRF Introduced?

‍The Patient Safety Incident Response Framework was formally introduced by NHS England in August 2022 as part of the national strategy to improve patient safety and promote a culture of continuous learning. It became the mandatory framework for NHS trusts from Autumn 2023, with all relevant healthcare providers expected to fully transition by that date.

The rollout followed extensive piloting and consultation with healthcare organisations across England, ensuring the framework was informed by real-world challenges and best practices in patient safety investigations.

‍Key milestones in PSIRF’s introduction include:

• 2020–2021: Initial pilot programmes across multiple NHS sites.

• August 2022: Official publication of PSIRF and supporting guidance by NHS England.

• Autumn 2023: Full implementation deadline for all NHS Trusts.

By replacing the Serious Incident Framework, PSIRF signalled a significant evolution in the NHS's approach to safety incidents, with a focus on proportionate responses, systemic learning, and building safer care environments.
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Who Does PSIRF Apply To?

‍The Patient Safety Incident Response Framework applies to all NHS-funded healthcare providers in England. This includes:

• NHS Trusts and Foundation Trusts
• Integrated Care Systems (ICSs)
• Independent healthcare providers delivering NHS-funded care
• Mental health, ambulance, and community services
• Primary care organisations (where locally adopted or integrated)

Secondary care providers are required to implement PSIRF, but it is currently only encouraged for primary care providers.

While primarily targeted at NHS organisations, PSIRF principles are relevant to any healthcare provider aiming to strengthen safety culture and improve how they learn from patient safety events.