Introducing LFPSE

The Learn from Patient Safety Events (LFPSE) service is a new national NHS service for the recording and analysis of patient safety events that occur in healthcare. The service introduces a range of innovations to support the NHS to improve learning from the over 2.5 million patient safety events recorded each year, to help make care safer (see ‘How LFPSE will improve patient safety learning’).

LFPSE is currently being introduced across the NHS as organisations switch to recording patient safety events onto the new LFPSE service, rather than the National Reporting and Learning System (NRLS) and Strategic Executive Information System (StEIS) it is replacing.

Some organisations have already upgraded their Local Risk Management System (LRMS) to a LFPSE-compliant system and are now uploading all safety events recorded by their staff to LFPSE; while other organisations are still recording onto the NRLS as they prepare to make the switch. Organisations are asked to complete this by Autumn 2023 (see ‘Preparing for LFPSE’).

Organisations without an LRMS (typically independent primary care providers, such as GP, dental and optometry practices and community pharmacies) are asked to record patient safety events directly onto LFPSE by registering for an account and using the online Learn From Patient Safety Events service. Also see our ‘Primary care information on the new national learn from patient safety events service’ webpage.

What services does LFPSE provide

LFPSE initially provides two main services:

Record a patient safety event – organisations, staff and patients will be able to record the details of patient safety events, contributing to a national NHS wide data source to support learning and improvement.

Access data about recorded patient safety events – providers can access data that has been submitted by their teams, in order to better understand their local recording practices and culture, and to support local safety improvement work.

• Use the data access app

The LFPSE service is currently in a public-beta stage and will continue to grow and evolve in response to user feedback. More tools will be added over time.

How recording safety events supports patient safety

Recording patient safety events, whether they result in harm or not, provides vital insight into what can go wrong in healthcare and the reasons why.

At a national level, this allows for new or under-recognised safety issues to be quickly identified and acted upon on an NHS-wide scale, ensuring providers across the country take action to reduce the risk (find out more about how we use patient safety incident recording at a national level).

It also provides a wealth of data offering essential insight to support ongoing national patient safety improvement programmes, as well as improvement work at a more local or speciality-specific level.

Roll-out of LFPSE

LFPSE began its public beta stage in summer 2021. This is a final extended piloting stage where organisations transition to using the system, instead of the NRLS.

During this stage:

• Organisations that have upgraded their Local Risk Management System (LRMS) to a LFPSE compliant system can now start uploading safety events to LFPSE (see details below on ‘preparing for LFPSE’). All other organisations with an LRMS should continue to upload to the NRLS.
• Organisations without an LRMS, and their staff, can now register for an account and use the online Learn from patient safety events service to record safety events.
• All NRLS users should have made the switch to LFPSE by the end of September 2023. Once the transitional period is over, NRLS will be decommissioned.

This webpage provides details of which organisations have now connected their LRMS to the LFPSE service.

How LFPSE will improve patient safety learning 

The new LFPSE service is a major upgrade, creating a single national NHS system for recording patient safety events. It introduces improved capabilities for the analysis of patient safety events occurring across healthcare, and enables better use of the latest technology, such as machine learning, to create outputs that offer a greater depth of insight and learning that are more relevant to the current NHS environment.

When fully functional, LFPSE will:

• make it easier for staff across all healthcare settings to record safety events, with automated uploads from local systems to save time and effort, and introducing new tools for non-hospital care where reporting levels have historically been lower
• collect information that is better suited to learning for improvement than what is currently gathered by existing systems
• make data on safety events easier to access, to support local and specialty-specific improvement work
• utilise new technology to support higher quality and more timely data, machine learning, and provide better feedback for staff and organisations.

Around three quarters of reporting to the NRLS and StEIS was from the hospital sector. LFPSE will make recording safety events easier in other care settings, including primary care, through the introduction of simple online forms, and a multi-functional online service to access, review and update previously recorded incidents. This supports good incident response practice, by allowing smaller organisations to see all their safety events through one dashboard, and to continuously improve their data quality over time.

Lucie Mussett, product owner for LFPSE, describes what the new system will do and how it will benefit patient safety.

Developing the LFPSE service

LFPSE has been developed with staff from all health and care settings, following best-practice agile development methodology, and adheres to the Government Digital Service Standard. This means that design decisions are made around how best to meet specific user needs. It also means the service is developed one step at a time, so different functions will become available at different points, and the roll-out process will be a gradual one.

Upcoming additional functionality

To continue to meet identified user needs, throughout the roll-out period new functionality will be added to the service as it is developed. This will include:

• enhanced tools for accessing and visualising data, for the public, providers and national bodies
• new feedback mechanisms and enhanced learning outputs
• work to understand how best to ensure patients, carers and families can contribute to national learning (the NRLS Patient eForm will remain available for use until the new service is fully developed).

Ongoing user research will take place throughout, to also identify any new needs for future developments.

Preparing for LFPSE

Larger NHS organisations, such as trusts and foundation trusts, usually have a dedicated local risk management system (LRMS) for reporting incidents. Incident data is then uploaded onto the national NHS system (the NRLS or LFPSE).

LRMS suppliers are rolling out a programme of upgrades to move organisations onto products that are compatible and compliant with the LFPSE service, supporting two-way communication between local and national systems, and allowing automated data sharing. Providers should contact their LRMS supplier for further details.

We have a web page providing a list of LRMS vendors who have achieved LFPSE compliance who are able to offer LFPSE-compatible products. Further information and resources to support organisations with a LRMS to prepare to transition to LFPSE are available in the LFPSE section of the Patient Safety FutureNHS workspace.

Smaller organisations, such as general practice, independent dental surgeries, community pharmacies and optometry practices, may not have their own LRMS. In these organisations, staff can now record patient safety events directly to LFPSE online. Further information can be found on our LFPSE primary care webpage. We encourage all individuals in these organisations to sign up for an account, though there remains the option to record anonymously.

To support local safety governance, response and improvement, LFPSE also offers organisations without an LRMS the ability to assign relevant individuals access to data on all safety events recorded within their organisation, and to complete statutory and national policy requirements as necessary.

This web page provides information on the different types of LFPSE accounts, and who should use them.

LFPSE podcasts

To provide further information about LFPSE  and support organisations to transition and start recording patient safety events onto the service, we are producing a series of podcasts.

You can listen to our latest LFPSE podcasts via the links below:

• LFPSE and the NHS Patient Safety Strategy – in discussion with national director of patient safety
• Steps to getting connected to LFPSE – in discussion with the NHS England reporting leads
• Learning from transitioned providers – adopting the LFPSE service in a mental health trust
• Learning from transitioned providers – adopting the LFPSE service in an acute trust
• Machine learning and LFPSE – revolutionising how we learn from patient safety events

Accessing data recorded to the LFPSE service

Providers sharing details of patient safety events with LFPSE can access their own data at record level, through their LRMS or the online service. There is also a data access function for viewing you own organisation’s aggregate data in line with current NRLS data access. This includes tools for simple online visualisations of the data, and will be developed with any other needs identified in our ongoing research. We will also continue to publish national aggregated data for both NRLS and LFPSE while they exist in parallel.

Over time, we will develop self-service tools to support routine and ad hoc analysis of national LFPSE data, in line with our agenda of transparency, and to facilitate more opportunities to derive improvement insight from the information we hold, and to share learning outputs across the NHS.

Find out more

More information about the project is available in our frequently asked questions.

For further information about LFPSE and the Beta service you can also view a PSIMS show and tell video recorded in July 2020,  or access more detailed information and documentation on the LFPSE pages of the FutureNHS platform.