Patient Safety Incident Response Framework (PSIRF)
Overview and policy change
From 1 April 2024 the Patient Safety Incident Response Framework (PSIRF) replaced the Serious Incident Framework (SIF) as the NHS approach to recognising, responding to and learning from patient safety incidents (GOV.UK).
PSIRF removes the binary “serious incident” threshold and requires proportionate, system‑based responses across all NHS‑funded care. Emergency clinicians should understand the PSIRF mindset (learning, not blame), the range of response methods, and the immediate actions to take at the bedside.
What PSIRF aims to achieve PSIRF was introduced to:
- Detect system weaknesses earlier by investigating incidents with high learning potential as well as high consequence.
- Allocate investigative resources proportionately.
- Prioritise system‑based learning over individual blame.
- Ensure compassionate, transparent engagement with patients, families and staff (GOV.UK; NICE).
Core principles PSIRF is structured around four interdependent principles:
- Compassionate engagement - meaningful, timely involvement and communication with patients, families and staff affected by incidents; signposting to support services.
- System‑based learning - analyse contributory factors across systems (processes, teams, environment) rather than attributing fault to individuals.
- Proportionate response - match the investigation method and effort to the incident’s severity, recurrence risk and learning potential.
- Supportive oversight and collaboration - local providers, Integrated Care Boards (ICBs) and national partners share oversight and learning to reduce system‑wide risks.