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The patient safety incident response plan (PSIRP)

The PSIRP is where PSIRF stops being a philosophy and becomes commitments: which incidents your organisation will respond to, how, and why.

Last reviewed 6 July 2026 · Sources: NHS England PSIRF and supporting guidance (August 2022)

  • 2 documentsthe enduring response policy and the operational plan, agreed and published together
  • 5 core contentsincident profile, improvement priorities, intended responses, rationale, national requirements
  • Publishedon the organisation's public website, a deliberate accountability mechanism

Definition

A patient safety incident response plan (PSIRP) is the published document in which a provider of NHS-funded care describes its patient safety incident profile and how it intends to respond to incidents, including the methods it will apply and the rationale for them. The plan is agreed with the organisation's lead integrated care board and published on its website.

Source: NHS England, August 2022 · Last reviewed 6 July 2026

What a PSIRP contains

Working plans vary in format, and NHS England provides a template, but the substance is consistent:

  • The organisation's incident profile: what its incident data shows about where harm and risk actually occur.
  • Its patient safety improvement priorities, drawn from national priorities and from what the local profile shows.
  • The intended learning response for each priority incident type, from a PSII down to no individual response where improvement work already covers the risk.
  • The rationale for those choices, so the reasoning is inspectable by the board, the ICB and the public.
  • The nationally required responses the organisation is bound by regardless of local choices.
PSIRP 01 Incident profile where harm and risk actually occur 02 Improvement priorities national and local 03 Intended responses per priority incident type 04 Rationale reasoning inspectable by board, ICB and public 05 National requirements binding regardless of local choices
The substance every working plan carries, whatever its format.

Plan and policy: two documents

PSIRF asks for a pair of documents that are often confused. The patient safety incident response policy describes the organisation's enduring systems and processes for responding to incidents: governance, roles, how those affected are engaged, how responses are quality assured. The PSIRP is the operational half: the current incident profile and the response choices made against it. The policy changes rarely; the plan is expected to move as the profile moves. Transition to PSIRF was complete only once both were agreed and published.

How the plan is developed

The plan is only as good as the profile beneath it. NHS England's preparation guidance expects organisations to analyse their incident data over a meaningful period, alongside claims, complaints, staff feedback and inequalities data, before choosing priorities. The analysis is a team effort between the patient safety specialist, clinical governance and the services themselves, and it deliberately includes those affected by incidents. Choosing priorities means saying no: a plan that promises deep responses to everything recreates the old framework's problem with extra paperwork. The implementation page covers where plan development sits in the wider transition sequence.

Agreement and publication

The finished plan goes through the organisation's own governance to board level, and is then reviewed and agreed with the lead or coordinating ICB. Agreement is about the strength of the reasoning, and the ICB's oversight role stops short of case-by-case control: providers do not need ICB sign-off for individual incident response reports.

Publication is not optional. The plan is published on the organisation's public website, which is a quiet but deliberate accountability mechanism: patients, families and the public can read exactly what response the organisation has committed to for the incidents it sees most.

Keeping the plan live

The plan is a living document. NHS England describes review on a cycle of approximately every 18 months, and sooner where the incident profile shifts or improvement work changes the risk picture [VERIFY: exact review cadence wording in current NHS England guidance; trusts commonly state 18 months to 4 years]. A plan that still describes the profile of two years ago fails at its one job. Most organisations tie the review to their safety improvement plan cycle so the two documents stay coherent.