When did PSIRF become mandatory?
NHS England published PSIRF on 16 August 2022 and expected providers to complete the transition within twelve months, so PSIRF became the operating framework for NHS-contracted care by autumn 2023. It replaced the Serious Incident Framework (2015).
Does PSIRF apply to independent or private providers?
Yes, where they deliver care under the NHS Standard Contract. Fully private activity is out of scope, though many independent providers apply the framework across all their work for consistency.
Does PSIRF apply to GP practices?
Not yet as a requirement. Adoption in primary care is optional at this stage. The framework applies to NHS-funded secondary care: acute, ambulance, mental health, community healthcare, maternity and specialised services.
What replaced root cause analysis?
A range of proportionate learning responses: the patient safety incident investigation (PSII), after action review, swarm huddle and multidisciplinary team review. The response is chosen to fit the incident's learning potential rather than applied by default.
What is a PSIRP?
The patient safety incident response plan: the published document describing an organisation's incident profile and how it intends to respond to incidents, including its chosen methods and the rationale. It is paired with a patient safety incident response policy.
Who has to agree the PSIRP?
The plan goes through the organisation's own governance to board level and is then reviewed and agreed with the lead or coordinating integrated care board, before being published on the organisation's website.
Which incidents still require a full investigation?
Incidents with a nationally required response, most prominently deaths thought more likely than not due to problems in care, always receive a PSII. Beyond those, the organisation's own plan decides which incident types are investigated.
How long does a PSII take?
There is no fixed deadline. Timeframes are agreed with those affected at the start, with investigations expected to average around three months and not exceed six except in exceptional agreed circumstances. The old 60 working day rule ended with the Serious Incident Framework.
What is an after action review?
A facilitated team discussion built on four questions: what was expected to happen, what actually happened, why was there a difference, and what can we learn? It is the most used learning response for contained incidents with an intact team.
Do ICBs sign off investigation reports?
No. Providers are not required to seek ICB sign-off for incident response reports. ICBs oversee the effectiveness of the provider's response system as a whole, which PSIRF calls supportive oversight.
What training does PSIRF require?
All staff are encouraged to complete level 1 of the NHS patient safety syllabus. Learning response leads, engagement leads and oversight roles need levels 1 and 2 plus role-specific training, with ongoing professional development and annual peer networking.
What is LFPSE?
Learn from Patient Safety Events: the national NHS service for recording patient safety events. Incidents are recorded through LFPSE, and the organisation's learning responses run alongside that record.