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Patient Safety Incident Response Framework (PSIRF)

The NHS is changing the way we learn from those occasions when things don't go to plan, and where patients may be harmed as a result.

These are known as patient safety incidents.

A new approach, called the Patient Safety Incident Review Framework (PSIRF) is being introduced and will focus on:

  • compassionate engagement and involvement of patients, their loved ones and staff
  • new approaches to learning that look for all the complicated issues that are combining to cause risks
  • considered and proportionate responses when things go wrong
  • continuing to learn and evolve over future years.

NHS England video

Policy and Plan

We are required to publish two key documents to explain how we will meet the requirements of PSIRF - a PSIRF Policy and Plan.

PSIRF Policy (pdf, 661 KB)

PSIRF Plan (pdf, 468 KB)

These documents describe how the Trust will oversee the process of learning from incidents and making improvements, and which areas of patient safety we will focus on in the first 12-18 months.

We will initially focus on proactively improving safety in the following four areas.

  1. Handovers, including communication and documentation
  2. Referral and multidisciplinary team processes and pathways
  3. Reporting and pathology and/or imaging endorsement
  4. Care of vulnerable people (safeguarding, learning difficulties and disabilities and mental health issues)


Should you have reached this section of our website because you have suffered harm whilst in the care of Oxford University Hospitals, we are sorry.

We undertake to be honest and open with you in our words and actions as we respond to this. We will also support you as necessary.

Making sure patients, families, carers and staff are supported and involved when incidents occur, is a priority for Oxford University Hospitals.

If you need support, or wish to discuss the care you or your loved one received from us, please contact our Patient Advice and Liaison Service (PALS):

Patient Advice and Liaison Service (PALS)

There are also other ways you can give us your feedback on our services:

Patient feedback

Learning from incidents

There are a number of different ways of learning from patient safety incidents - ranging from an immediate debrief, a multidisciplinary meeting and a detailed investigation which may be submitted to external organisations.

If you are, or someone you care for is, involved in a patient safety incident, you will be able to speak to someone who will:

  • listen to you
  • understand what questions you have
  • explain the different types of learning methods that may be used; and
  • explore what your needs are in any learning response that is undertaken.

If you would like to speak to someone, and have not already been introduced to one, please contact PALS who can direct you to the most appropriate person.

Contact us

If you have any queries, please contact us for more information.


Last reviewed:29 September 2023