Learning From Incidents, Near Misses and Safeguarding Events in NHS Services
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Incidents and safeguarding events are signals, not failures. In NHS-commissioned services, commissioners expect providers to use incidents and near misses as opportunities to strengthen safety and reduce future risk.
How providers respond to incidents is often more important than the incident itself.
This approach aligns closely with learning from incidents and continuous improvement.
Why near misses matter
Near misses often reveal:
- Gaps in communication
- Weaknesses in controls
- System pressures affecting practice
They provide early warning without harm.
Creating a learning-focused response
Effective providers ensure that incident reviews:
- Focus on systems, not blame
- Include frontline perspectives
- Identify contributory factors
This encourages honest reporting.
Linking incidents to safeguarding learning
Safeguarding learning should explore:
- Whether risks were foreseeable
- How escalation operated in practice
- What barriers staff faced
This strengthens future decision-making.
Turning learning into action
Commissioners expect providers to:
- Translate learning into practical changes
- Review whether actions are effective
- Share learning with staff
Learning must be visible and sustained.
Governance oversight of learning
Strong governance ensures:
- Trends are reviewed at senior level
- Recurring issues are escalated
- System risks are addressed
This closes the learning loop.
Sharing learning across systems
In NHS systems, providers are expected to:
- Contribute to shared learning forums
- Engage with commissioner-led reviews
- Support system-wide improvement
This reflects collective responsibility.
What commissioners look for
Commissioners are reassured when providers can:
- Evidence learning over time
- Show how practice has changed
- Demonstrate openness and transparency
This builds long-term confidence.
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