Overview of patient safety event recording systems

Patient safety event data is held by NHS England in three recording systems:

 

NRLS

The NRLS was the primary source of national patient safety incident data for over 20 years from October 2003, sourced primarily from provider’s local risk management systems (LRMSs) and holding a total of approximately 30 million incident records. Due to its aging infrastructure, it was decommissioned in June 2024 and replaced by the LFPSE service. 

LFPSE

The LFPSE service is currently the primary source of national patient safety incident data. Since it began operating in July 2021, approximately 3 million records annually. You can read more about the service here.

StEIS

StEIS is the system which holds Serious Incidents, as defined by the revised Serious Incident Framework (2015). Never Events, as defined by the Never Events framework, are included here. StEIS will eventually be decommissioned and its functions replaced by LFPSE. Until then, StEIS is still in use while the next version of LFPSE is rolled out – see here for specific guidance.

 

Publication of patient safety event data

Until October 2022, NHS England published official statistics using patient safety incident data from the NRLS, in the National Patient Safety Incident Reports (NaPSIR) and Organisation Patient Safety Incident Reports (OPSIR). In addition, we published monthly summary data which complemented those official reports. Publication of official statistics was paused during the transition from NRLS to LFPSE, and resumed in April 2025, using LFPSE data. In addition, monthly counts of reported Never Events are published monthly during each financial year since 2014.

All current and previous publications can be found here.

 

Differences between the datasets

Although the three systems hold patient safety event data, there are important differences worth highlighting between them, particularly regarding their scope and data structure. 

Table 1. Differences between data sets

Data set   Operational period  Scope  Data types  Mode of transfer  Degrees of harm 
NRLS From October 2003 until June 2021 Largely voluntary recording of patient safety incidents, mostly by NHS providers in secondary care. Both free text and categorical fields, with incidents mostly classified into single specific types. Generally bulk  extracted from LRMSs and uploaded to the NRLS with a lag. Incidents are gradable by an overall degree of harm.
LFPSE July 2021 – present Largely voluntary recording of patient safety incidents, with the ability to also separately record patient safety risks, outcomes, and examples of good care. Primarily via NHS providers in secondary care, with the addition of an online portal for organisations without an LRMS. Both free text and categorical fields, with less emphasis on strict categorisation of data, and more multi-select fields to acknowledge events can concern several domains. Automatic transfer from LRMSs to the LFPSE service in real-time. Incidents are gradable by physical and psychological degree of harm separately. 
StEIS April 2009 – present

Module 3: 20th May 2015 to present

Module 2: 1st April 2013 to 19th May 2015

Module 1: 1st April 2009 to 31st March 2013

 Mandatory recording of incidents “where the consequences to patients, families and carers, staff or organisations are so significant or the potential for learning is so great, that a heightened level of response is justified.” Includes Never Events. Both free text and categorical fields, with incidents mostly classified into single specific serious incident types. Data structure varies between versions (‘modules’) and fields may change or be removed accordingly. Directly into StEIS via web browser. Incidents are not categorised into degrees of harm. 

 

Taxonomies

 

Contact us

If you have any questions about patient safety event data, please contact patientsafety.analysis@nhs.net.