NHS England and NHS Improvement manage the national learn from patient safety events (LFPSE) service (previously called PSIMS), a centralised system to record information and offer data and analysis about patient safety events to support safety improvement across all care settings.

All healthcare staff in England, including those working in primary care, are encouraged to use the system to record any events where:

• a patient was harmed, or could have been harmed
• there has been a poor outcome but it is not yet clear whether an incident contributed or not
• risks to patient safety in the future have been identified
• good care has been delivered that could be learned from to improve patient safety.

LFPSE is a new system being rolled out from July 2021, as the successor to the previous National Reporting and Learning System (NRLS). The NRLS e-forms for general practice are no longer in use and will now redirect to the LFPSE log in page.

Recording primary care patient safety events on LFPSE

One of the major objectives of LFPSE was to make it more suitable for use across all healthcare settings, and it has been designed with this in mind. Its predecessor system, the NRLS, was originally designed for use primarily within secondary care, where local risk management system (LRMS) software is common, which created a barrier to primary care participation.

To record safety events on LFPSE, in most cases primary care staff and organisations without a LRMS will input information directly via an online account.

This new online service has been designed for use by staff anywhere healthcare is delivered by organisations registered with an ODS code. This includes general practice, community dentistry and community optometry. However, some larger organisations may have an existing LRMS and staff should continue to record safety events via that route, which will in turn connect to LFPSE (see below).

Healthcare staff can register for a LFPSE account via the web-based service. Details of patient safety events can then be submitted to LFPSE by completing a responsive online form.

To help you request the right type of LFPSE account after registering, we have created an additional webpage, listing the key features of each account type and who they are for.

LFPSE has been extensively tested to make it accessible and user-friendly. There is also a national helpdesk to support you with any technical queries around using the online service.

Access to the LFPSE service for primary care providers using LRMS software

Providers with a LRMS will have a different way to connect to LFPSE via their desktop software. For more information about how LFPSE is being rolled out to organisations with a LRMS, please see the main project webpage.

Access to LFPSE data for commissioners

All CCGs should sign up for a LFPSE online account now so that they can maintain visibility of any patient safety events being recorded within their catchment areas.

How the LFPSE supports safety improvement

When things go wrong in care, or even when they go right, it is vital patient safety events are recorded to ensure learning can take place to support local and national patient safety improvement.

By recording safety events on LFPSE, you are participating in an NHS-wide effort to share patient safety data that is vital to our national safety improvement work, while also supporting local responses to safety events.

Having a national incident management system for the NHS allows patterns and trends that are not visible locally to be picked up more effectively as part of the national picture, enabling our National Patient Safety Team to identify new or under recognised issues, and to take NHS-wide action such as issuing an urgent alerts to protect patients. The team also work with partners on a range of other responses to identified risks, and share data to support ongoing programmes tackling more common safety issues.

You can find our more on our ‘Using patient safety events data to keep patients safe‘ webpages.

Using LFPSE to support safety improvement in primary care

LFPSE has been developed to be more suitable for use across all healthcare settings.

This change is important as less than 1% of the 2.2 million reports received by the NRLS each year were from primary care, despite this being where most patient interactions take place. At a national level, this provided only limited information about patient safety events occurring in primary care, limiting our effectiveness to support improvement in these settings.

Through LFPSE, the data collected is structured in a way that directly supports our understanding of the state of safety within all areas of healthcare delivery. The National Patient Safety Team analyse this data for maximum learning benefit, and to generate insights that can change the way we work to improve the safety of care for all our patients.

Enabling local safety culture in primary care

Equally as important to supporting national patient safety work, primary care providers can use their own data from LFPSE to support local response and governance around patient safety events. The LFPSE online service contains a number of new features specifically designed to support a positive patient safety culture in primary care and other non-trust providers.

With a LFPSE account, users can log in to review and update records they have previously drafted or shared, and can use an easy summary-print option to keep copies to support CPD and personal reflection.

Graded account permissions mean that different staff can access different levels of data to support good governance and data quality. This includes using a filterable dashboard of all events recorded within their organisation.

Those holding an administration account are in control of their organisation’s LFPSE permissions, so you can be assured that the right people within your teams are able to fulfil oversight and governance responsibilities appropriately, and that the service can be used to fit your locally-established processes.

Find out more about the different LFPSE accounts.

Access to LFPSE for patients

New tools for patients and families to participate in safety learning via LFPSE will be developed later this year. For now, patients can still use the NRLS patient eForm to provide information on patient safety incidents.