At London Ambulance Service NHS Trust, patient safety is central to everything we do. Every day, our staff make thousands of decisions and provide care in fast-moving, complex and often challenging environments. We are committed to providing safe, effective and compassionate care, while continually learning and improving from the care we provide.
Our Approach to patient safety
We believe that keeping patients safe is dependent on strong systems, supportive leadership, skilled staff, effective teamwork and listening to the people who use our services. Patient safety is not only about responding when something goes wrong, it is about designing services that reduce risk, support good care and help staff do the right thing.
We aim to:
- Learn from incidents, concerns, complaints, compliments and feedback
- Identify patterns and themes across our services
- Improve the systems, processes and environments in which care is delivered
- Support our staff to speak up, report concerns and share learning
- Work openly with patients, families, carers and partner organisations
- Continually strengthen the quality and safety of our services
A learning culture
We are committed to creating a just and learning culture. This means we seek to understand what happened, how it happened and why it made sense at the time, rather than focusing on blame.
Healthcare is complex, and when things go wrong there are often multiple contributing factors. These can include communication, workload, equipment, training, technology, processes or wider system pressures.
Our focus is to learn and improve so that care becomes safer for everyone.
Systems thinking
We recognise that patient safety incidents rarely happen because of one individual action alone. They usually arise from a combination of factors within the wider system.
This is known as systems thinking. It helps us look beyond immediate events to understand the conditions that influenced them. By taking this approach, we can make stronger and more sustainable improvements.
Patient Safety Incident Response Framework (PSIRF)
We follow the NHS England Patient Safety Incident Response Framework (PSIRF), the national approach to improving how NHS organisations respond to patient safety incidents.
PSIRF supports organisations to move away from a one-size-fits-all investigation model and instead use a range of learning responses that are proportionate and focused on improvement.
This means that when incidents happen, we consider the most appropriate way to respond. This may include:
- Patient Safety Incident Investigations
- After Action Reviews
- Swarm Huddles
- Multi-disciplinary Reviews
- Thematic reviews of recurring issues
Our aim is always to understand what happened and how care can be improved.
You can download a copy of our 2026/27 Patient Safety Incident Response Plan below.
Being open and honest – Duty of Candour
We are committed to being open and honest when something goes wrong with a patient’s care.
Under the statutory Duty of Candour, NHS organisations must inform patients and families when care has resulted in certain levels of harm, provide an apology, explain what is known, and keep people updated.
There may be occasions where it is appropriate to embrace openness beyond the statutory duty of candour definitions. We believe openness is the right thing to do. We aim to communicate with compassion, honesty and respect, and to support those affected.
Involving patients, families and carers
We know that patients, families and carers can provide valuable insight into what happened and how services can improve.
Where appropriate, we will offer people the opportunity to be involved in patient safety learning responses. This may include:
- Sharing concerns or questions they would like considered
- Providing their account or experience
- Receiving updates during the process
- Discussing findings and learning
- Receiving a summary of the outcome where appropriate
We will always aim to involve people in a sensitive and supportive way.
Partnership and collaboration
Patient safety is strongest when organisations work together. We regularly work with hospitals, community providers, mental health services, commissioners, regulators, and other emergency services to understand incidents and improve care pathways.
Some safety issues cross organisational boundaries, and shared learning is essential to improving patient outcomes.
If you are a healthcare professional and would like to collaborate on a learning response, please contact our Patient Safety Team via email.
Our Commitment
We are committed to building a safer service through learning, openness, compassion and continuous improvement. By listening, reflecting and working together, we can continue to improve the care we provide to the people of London.