Learn from Patient Safety Events (LFPSE) Service – frequently asked questions for launch July 2021

We update the LFPSE page on the NHS website with the most up-to-date information on all major project developments.

For those on Twitter, following @ptSafetyNHS, @LucieNHSSafety, @HughNHSSafety will also provide you with ad hoc updates.

Further communications for specific audiences are disseminated via existing NHS England and NHS Improvement channels, such as our various bulletins.

Patient safety event recording is voluntary, except where reporting to NHS England fulfils duties for other statutory and mandatory requirements, such as reporting notifiable incidents to the Care Quality Commission (CQC) (we share data routinely with CQC to avoid the need for providers to have to duplicate). However, we encourage providers of all types to participate in national sharing and learning, to support both national safety interventions, and as the basis for a positive safety culture and enabler of safety improvement locally.

Any provider with an Organisation Data Service (ODS) code can record patient safety events to LFPSE, irrespective of which service type they are delivering.

The LFPSE taxonomy has been redesigned to make it more focused on learning. There is a core mandatory dataset, which must be completed to create a record. There are further non-mandatory fields where additional details can be added as they become available, and these will be automatically updated in the LFPSE record, ensuring we keep a single consistent record version between all systems, and improve timeliness of data.

Much of the new taxonomy will be very similar to NRLS, with some enhancements to make it more user-friendly, and some more innovative changes in other areas. These include the ability to capture different information based on the kind of patient safety event in question; moving away from the old list of incident types to a more responsive, nuanced question set that seeks to understand the ways in which things go wrong to support learning and making the data collection less acute-centric to support recording from a wider range of delivery settings.

You can submit anonymously on the online LFPSE Service. However, you will not have the benefit of saving drafts, retrieving or updating submitted records without a LFPSE account. The record may also not be visible to your organisation, in order for them to take further action. If you have access to a local risk management system, you are encouraged to record it there if you feel able, to support local response.

The DPSIMS was the working title for the project to develop LFPSE. The LFPSE service is the output of the DPSIMS work. Read more about this name change.

Participation in national learning and sharing activities, including use of LFPSE, is not mandatory, though it is very much encouraged, therefore we’re keen to see independent providers sign up. However, individual organisations should make their own assessments in relation to contracts they may have in place with individual commissioners.

If you have a local risk management system (LRMS), the first step is to ask your vendor when they plan to roll out LFPSE-compliant software to you. A list of approved software is available on our website.

Please continue to upload via the NRLS until your LRMS has moved over to the new LFPSE data set.

If you do not have LRMS, you are encouraged to sign up for the online service as soon as possible.

A LFPSE module to support the roll-out of the new Patient safety incident response framework (PSIRF) is currently in its alpha phase, being developed with input from the PSIRF early adopters. It will be made available in time for the wider roll-out of PSIRF. Until then, providers should continue to follow the Serious incident framework and record their serious incidents on StEIS.

The public beta phase of LFPSE went live on 19 July 2021. Organisations who have upgraded their LRMS to a LFPSE- compliant system can now start uploading safety events to 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. Staff previously using the NRLS e-forms will now be redirected to the new online LFPSE service.

Both LFPSE data and NRLS uploads via an LRMS will be available during the transition, with the view to decommissioning NRLS and archiving its data once all providers have transitioned to LFPSE. We anticipate this will be a 12 to 18 month period, depending on the roll-out of LFPSE-compliant software by the vendors.

The new Data Access app will go online shortly. Through this, providers can view quantitative data about the records submitted within their organisation. As data amasses, we will consider the best ways to present national LFPSE data alongside our existing NRLS outputs.

We recognise how important it is for patients and families to be able to be able to share their concerns about unsafe care. LFPSE aims to include this facility, and to do so in a way that makes sense to people navigating the complexities of healthcare delivery. We want to create a recording tool that sits appropriately amongst other well-established feedback channels, such as complaints processes, without requiring patients and carers to do a lot of work to establish what is feedback for national learning, and what is better aimed at their provider(s), so that they get the responses they deserve. This will take time, as the complaints process is enshrined in law, so cannot be altered quickly.

We have work planned for later in 2021 to explore this further, and in the meantime, patients and families can continue to use the NRLS e-form, which is looked at by the national Patient Safety team regularly.

Yes, in line with agile principles, we want to work with users to ensure that all LFPSE capabilities are helping improve the way healthcare is delivered. If you have ideas for enhancements to the service, or wish to be involved in the development of any of the forthcoming modules, please contact the IT Helpdesk.

To ensure strong information governance, in order to view any records you haven’t created, you need to request enhanced access permissions. Further information about the different account types is available on our website.

We are currently working on a solution to automatically map practices to commissioners via the use of hierarchies in ODS codes. This work should be completed during September.

In the meantime, as a temporary solution we have requested that all GPs submitting to the LFPSE online service forward you an email copy of each event, so you are kept informed of all patient safety events in your area.

If you have a LFPSE account, you can access and edit your previously submitted patient safety events. Nominated patient safety leads in your organisation will also have enhanced access to view and edit any patient safety events submitted from your organisation.

The core LFPSE data set must be collected as specified, in order to ensure data integrity and interoperability. Mapping of local options is not permitted, as it can lead to ambiguity in the data, and creates brittle structures which require manual updates as the national data collection evolves. However, some unequivocal fields (for example, dates) can be pre-populated from local sources – please speak to your LRMS vendor for details on where this is permitted.

Yes, provided each record meets the core mandatory LFPSE dataset to enable submission, you can configure your LRMS to capture any other fields you require locally. Speak to your LRMS supplier about the best ways to achieve this when upgrading to a LFPSE-compliant software version.

If you think there are important options missing from any drop-down menus, or that LFPSE questions need clarifying or amending, please email NHSI.patientsafetyhelpdesk@nhs.net and we can review the taxonomy for future updates.

User guides will be available shortly on the Online Incident Record landing page and within the app itself at the bottom of the page.

For further information regarding the LFPSE taxonomy and data set, please contact NHSI.patientsafetyhelpdesk@nhs.net

To support interoperability of data, LFPSE reuses existing lists wherever possible and appropriate. The specialities list used comes from the NHS data dictionary list of treatment function codes. If you feel a relevant specialty is not available on this list, please see their website for further details, and contact the Treatment Function Maintenance Group at enquiries@nhsdigital.nhs.uk.

Yes, all records of patient safety incidents require this to be completed as a mandatory field. The separation of physical and psychological harm in LFPSE has come at the request of patients and families. We have made both scales mandatory as they are equally as important, and necessary for the triaging of records for review, and enacting other related policies such as Duty of Candour. Early user feedback indicated that some non-mental health staff were anxious about having to make a judgement on this new scale, and so to reduce this barrier, we have included:

  • clarified definitions, and examples for each, to help guide decision-making
  • the ability to amend all fields, including these, should further information become available at any point.

It is important that we capture all kinds of patient safety events, both positive and negative, at the national level, to support the best possible opportunities for national learning and improvement. If examples of good practice are currently being captured within your LRMS, but not within patient safety modules, speak to your vendor about how best to integrate these at the front end.

LFPSE’s scope is specifically for the collection of data about patient safety events. Safeguarding events which meet the definition of a patient safety incident (i.e. where there is an indication that NHS staff have provided poor care leading to safeguarding concerns) should be recorded as incidents.

Safeguarding that does not involve any suspicion or acts of omission or commissions by healthcare staff, but that does require notification to adult or child protection services can be recorded via the outcomes pathway on LFPSE.

Providers who are submitting data to LFPSE will be able to access their organisation’s own data through online tools, and regions can access the data of their relevant providers when they set up an account and request appropriate permissions. National data will also be published.

  • Later this year we will be adding tools to allow more self-service national data to relevant users, such as professional organisations and specialty-specific learning groups, to support learning activities.
  • In the meantime, those wishing to access LFPSE data for patient safety learning and improvement should contact the team on patientsafety.enquiries@nhs.net.

Go to the login screen and click on need help signing in. Here you can reset your password, register (if not already registered) and/or get extra help with logging in.

This image accompanies question 26. It shows you how to rest your password: go to the login screen - the link to this is https://nhsi.okta-emea.com/ - and click on ‘need help signing in’.

Go to your NHS England Applications homepage and click my account. Here you can change your password or security question.

This image accompanies question 27. It shows you how to change your password or security question

 

If your organisation is not listed on the NHS England Application’s registration page, please send your organisation name, address and ODS code to the IT helpdesk and they will add it to the list.

If you have not received your activation email after registering with NHS England Application, please check your junk inbox in the first instance in case it has been redirected there. If not, then please contact the IT helpdesk and they will investigate this for you.

In the majority of cases, if an ODS code is supplied, access to the system will be granted automatically. However, in certain circumstances (for example, non-nhs.net email account used, organisation name not within the pre-approved list), a request will be declined. Please check the information you have provided is correct; if you are still having an issue, please contact the IT helpdesk and they will investigate this for you.

If you are accessing the LFPSE web application for the first time, you will need to connect your NHS England Applications account by clicking on the connect your NHS England Applications account within the LFPSE application. If the problem persists, please contact the IT helpdesk for assistance.

This image accompanies question 31. It shows you how to connect your NHS England Applications account to the LFPSE web application, when you are accessing this for the first time: click on the ‘Connect your NHS England Applications account within the LFPSE application’. If the problem persists, please contact the IT helpdesk itservicedesk@nhseandi.nhs.uk for assistance.

 

We encourage all users to avoid submitting PID wherever possible. However, if PID is accidentally submitted, one of the first ways we are using machine learning (ML) in LFPSE is in the anonymisation software we have developed to redact any identifiable details from the main free text fields.  This uses a ML algorithm, backed up by rules-based learning, and finally our team of data quality officers, whose feedback will continue to train the model on live data. The models have been tested on old NRLS free text and reached acceptable reliability metrics for live use.