Patient Safety Incident Reporting Framework (PSIRF) Standards: CoProduction of Adaptations for the Care Home Sector to Improve Cross-System Integration

Abstract

Context: The National Health Service (NHS) in England has introduced the Patient Safety Incident Response Framework (PSIRF) which seeks to guide learning from safety incidents, including those that occur across different health and social care services. At the foundation of PSIRF are standards that stress a set of minimum expectations of patient safety incident reporting and learning, however, their development has sidestepped social care and the care home sector. Objectives: This study aimed to co-produce recommendations for adapting PSIRF standards for care homes. Methods: Nominal Group Technique workshops were conducted with key stakeholders. Participants generated and developed a consensus on recommendations for adapting PSIRF standards, with data analysed inductively and conceptually mapped. Findings: People (n = 17) from senior roles in care homes, external organisations and public involvement representatives participated. There was high agreement that PSIRF standards insufficiently represented care homes. Required revisions to PSIRF included addressing the use of NHS-centric language, approaches to training, resource provision, oversight and implementation support. Limitations: Almost all participants were at senior levels, which may impact on whether adaptations to PSIRF standards would result in standards that could be implemented. Implications: Resources in care homes to support cross-system learning are currently lacking, and PSIRF standards do not sufficiently link care and communication across boundaries. Once identified issues are addressed, PSIRF is promising for integrating safety incident responses between NHS and care home sectors. Care home sector should be involved at the outset of future patient safety policy developments that aim to improve integrated and cross-sector working.