Challenges in further implementing PSIRF

While there have been clear benefits for independent healthcare providers – and most critically, for patients – in implementing PSIRF, for smaller providers particularly and those with low incident volumes, there are key challenges around successfully embedding PSIRF in their organisations.

This can be found most notably around training capacity with access to national training remaining uneven, often prioritised for NHS organisations, which is slowing the development of investigator capability in the independent sector.

Delays and uncertainty in ICB sign-off persist, particularly where commissioning relationships are unclear or capacity is limited, as Integrated Care Boards (ICBs) are responsible for approving provider PSIRF plans and overseeing system-level safety learning. Providers also continue to seek clearer and more consistent guidance on proportionality decisions, determining the appropriate level of response based on the harm, complexity, and potential for learning from an incident to avoid unnecessary escalation into investigation heavy approaches and to support timely, learning-focused responses.