When something goes wrong with a patient’s care, NHS providers are expected to report these incidents and consider if they meet the definition of a Serious Incident. When Serious Incidents are reported an investigation, which follows guidance set out in the Serious Incident framework (2015), must be undertaken to enable organisations to understand how and why incidents occur, so that changes can be made to prevent recurrence.
Between March and June 2018, we held a range of engagement activities, including an online survey, asking people to share their views on how and when the healthcare system should investigate and respond to Serious Incidents.
The responses we received are informing the review of the Serious Incident framework in order to provide national guidance on the systems, processes and behaviours providers, commissioners and oversight bodies are expected to adopt to ensure we respond appropriately when things go wrong.
Summary of engagement feedback
This document summarises the feedback received through our The future of NHS patient safety engagement activity.
Engagement questionnaire and supporting documents
Our survey closed on 12 June 2018, thank you to all those that took the time to share their views.
Please read this information before you start the survey.
Recorded webex presentation
Watch our 30 minute webex video to learn more about Serious Incident investigation and the five key factors contributing to poor investigation we identify in the discussion booklet.
Events and social media
As part of our engagement programme we hosted four workshops to bring together people associated with patient safety, from a variety of roles and backgrounds, to further explore how and when the NHS should investigate patient safety incidents:
#WeNurses tweet chat
On Thursday 24 May we hosted a #WeNurses Tweetchat as a further way to engage and seek your views about how and when the healthcare system should investigate serious incidents. View a summary of the chat and transcript of the posted comments.
We are now in the process of designing and drafting the next Serious Incident Framework using the feedback we received, and we are continuing to work with partners and stakeholders to develop this. We aim to publish in Spring 2019.