Conclusion

Three years on from its introduction, PSIRF is embedded as a core element of patient safety governance for most organisations in the independent healthcare sector, while others continue to work towards full implementation. What began as a significant cultural and operational shift has evolved into a sustained movement towards learning-focused, system-based safety practice.

However, PSIRF implementation remains a journey rather than a destination. Challenges persist around equitable access to training, the availability of investigative expertise—particularly for smaller providers—and variability in engagement from Integrated Care Boards. Some organisations continue to face delays or uncertainty due to complex or unclear commissioning relationships, while others are still developing the capability needed to apply PSIRF methodologies consistently. Addressing these challenges will require continued partnership working between independent providers, IHPN, NHSE, regulators, and other system partners.

Despite these pressures, the independent sector has demonstrated resilience, adaptability, and a strong commitment to embedding PSIRF in a meaningful, sustainable way. The progress achieved so far provides a strong foundation for continued improvement. As the sector moves into a more mature phase of PSIRF delivery—strengthening thematic review capability, embedding PSIRF metrics, expanding access to human-factors-informed training, and deepening patient involvement—there is a clear opportunity to build on this momentum, with the sector well-positioned not only to sustain this progress but to lead by example in shaping the future of patient safety.

IHPN will continue to support progress by bringing providers together through Communities of Practice and Reference Groups, sharing practical tools and examples of good practice, supporting the development of Patient Safety Specialists and recruitment of Patient Safety Partners, and working with key stakeholders to improve the development and sharing of national resources. This will help the sector maintain momentum and continue strengthening patient safety across independent healthcare.