PSIRF Frequently Asked Questions

General Questions About PSIRF

1. What is the Patient Safety Incident Response Framework (PSIRF)?
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PSIRF is a national NHS England framework that replaces the Serious Incident Framework. It promotes a systems-based approach to learning from patient safety incidents, focusing on improvement rather than blame.

‍2. Why was PSIRF introduced?
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PSIRF was introduced to address the limitations of the previous framework (SIF) by fostering a just culture, supporting proportionate investigations, and improving learning outcomes from incidents.

‍3. When did PSIRF become mandatory?
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PSIRF became the mandatory patient safety incident response framework for services provided under the NHS Standard Contract in England as of Autumn 2023. Preparation guidance was issued in August 2022.

‍Implementation and Timelines

4. What steps are involved in implementing PSIRF?
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Implementation involves several stages: orientation, diagnostic assessment, stakeholder engagement, governance updates, development of a Patient Safety Incident Response Plan (PSIRP), and final preparations.

‍5. How long does it take to implement PSIRF?
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Implementation timelines vary by organisation, depending on readiness, resource availability, and complexity of services.

‍6. Are all NHS organisations required to implement PSIRF?
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All secondary care providers and services providers under the NHS Standard contract must implement PSIRF. Integrated Care Boards (ICBs), mental health, community, and ambulance services are all included.

‍Reportable Incidents and Investigation Types

7. Does PSIRF still require “serious incidents” to be reported?
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PSIRF removes the requirement to label incidents as “serious” and instead focuses on local prioritisation for learning. Only specific categories – such as Never Events or nationally reportable events – must still be escalated externally.

‍8. What types of investigation methods can be used under PSIRF?
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Organisations can choose from a range of methods including After Action Reviews, Learning Responses, Thematic Reviews, and Case-based Reflections. Traditional RCA is no longer a default method.

‍9. What is a Learning Response?
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A Learning Response is a tailored, proportionate investigative process designed to uncover contributory factors and generate system-level insights for improvement.

‍Patient, Family and Staff Involvement

10. How are patients and families involved in PSIRF?
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Organisations must engage patients, families, and carers in incident responses through transparent communication, involvement in setting investigation terms, and support using trauma-informed principles.

‍11. How does PSIRF support staff wellbeing?
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By promoting a just culture and reducing blame, PSIRF helps create a psychologically safe environment where staff are more willing to report and learn from incidents.

‍Training and Capacity Building

12. What training is required to support PSIRF?
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Staff involved in investigations should receive training in systems thinking, human factors, trauma-informed communication, and proportional response methods. NHS England offers webinars and resources.

‍13. Do we need dedicated investigation teams for PSIRF?
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Not necessarily. Organisations can build internal capacity by training multidisciplinary staff and aligning investigation responsibilities within governance or quality teams.

‍Governance and Oversight

14. How does PSIRF align with existing risk management systems?
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PSIRF is designed to integrate with governance platforms. It complements rather than replaces existing digital systems.

‍15. How often should a Patient Safety Incident Response Plan (PSIRP) be reviewed?
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At least once per year, or sooner if there are significant changes to services, risk profiles, or emerging trends in incident reporting.

‍16. Who is responsible for overseeing PSIRF within an organisation?
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PSIRF implementation should be led at an executive level, typically by the Director of Nursing or Medical Director, supported by clinical governance and patient safety leads.