GP practices are being asked to sign up to national systems that allow them to record patient incidents in a bid to improve patient safety within primary care.
NHS England has proposed a number of measures to promote a safety culture as well as provide more data and insight into incidents as part of its first primary care patient safety strategy launched at the end of September.
It has warned that incident recording systems in primary care are not as well developed as in secondary care, therefore the 20,000 to 30,000 ‘incidents of avoidable significant harm identified in general practice in England per year’ may be an underrepresentation.
And it has highlighted that a single ‘significant harm episode in primary care’ is estimated to cost the NHS £5,000, a total of more than a £100m a year.
The commissioner is urging practices and other GP organisations to connect to national systems of patient safety information, including the Learn from Patient Safety Events service (LFPSE) or Patient Safety Incident Response Framework (PSIRF) for recording and analysing incidents.
This will ‘enable learning that supports local and national patient safety improvement’, it said. And it helps nurture a culture that focuses on ‘the role of systems, not individuals, when things go wrong’.
PSIRF, first launched in 2022 for acute, ambulance, mental health and community healthcare providers, is going to being piloted in general practice this year, ahead of other primary care providers. It could be implemented at practice or via PCN/GP federation-level, NHS England has said.
LFPSE replaced the National Reporting and Learning System, which closed in June this year, and which the majority of hospitals use. NHS England has created an information site specifically for primary care explaining how practices can log on to the LFPSE system and record an event and why it’s a valuable tool.
Meanwhile, ICBs are being asked to develop mechanisms that support adoption of these two systems in primary care, and how insight and learning is shared, utilising existing structures such as buddying/peer systems for practices and PCN-based patient safety groups.
The NHS England strategy document says: ‘The new approach in patient safety is that when things go wrong in care and when things go right, it is important that patient safety events are recorded so the learning will continually improve patient safety: locally, at place, across systems and nationally.
‘We know that the culture of incident recording from primary care is relatively underdeveloped and quite variable compared to secondary care, which means there will be areas of patient safety that we do not yet understand. Less than 1% of the 2.2 million incidents recorded nationally each year are from primary care, despite this being where most patient interactions take place.’
Other recommendations in the strategy for practices to take action on, include:
- Practices or PCNs to start to identify staff who can become ‘patient safety leads’. They should be encouraged to complete free online NHS patient safety syllabus training, to help them to learn from what goes well and how to respond appropriately to things that go wrong.
- Practices or PCNs to start to identify two or more lay ‘patient safety partners’, who can work with staff to improve governance and leadership of safety.
- Practices to add patient safety to their PPG agendas.
- ICBs and GP practices to pilot approaches and share good practice for patient safety improvements in the areas of diagnosis, medication and referral – the top three types of patient safety incidents in general practice.
The strategy’s aim is for some improvements to be implemented in general practice first before being rolled out to community pharmacy, optometry and dental services.
NHS England also said its plans are are best practice and not ‘a contractual requirement’, and looks to build on existing processes to avoid creating additional work, given the capacity pressures primary care faces.
It also said timeframes for work are ‘intentionally flexible.’
‘We want improved patient outcomes and experience in primary care – reduced patient reduced patient harm, fewer complaints and less litigation, staff who are less stressed, a better understanding of pressures and improved efficiency,’ it said.
