Moving on from patient safety incidents: a qualitative study exploring GP perspectives in England.

Abstract

Background: Patient safety incidents (PSIs), defined as unintended or unexpected events that could have or did lead to patient harm, can have profound effects on GPs. Understanding how GPs experience and recover from PSIs is important for workforce wellbeing and patient safety in primary care.

Aim: To explore how GPs experience PSIs, how they move on, and how they use available support.

Design and setting: Qualitative study with GPs in England.

Method: Semi-structured interviews were conducted with 22 GPs. Data were analysed using thematic analysis. Participants were eligible if they had been involved in a PSI in general practice, spanning near misses to events resulting in patient harm. Themes were developed inductively and mapped onto the theoretical domains framework to identify cognitive, social, and environmental influences on learning, help seeking, and recovery.

Results: Three themes were generated: personal and professional consequences; recovery and learning processes; and barriers to healing. GPs described emotional responses, including guilt, self-doubt, and fear of reputational or regulatory consequences. Peer support was valued, but access to structured support was limited. Formal investigations were experienced as distressing and compounded the emotional impact. Recovery and learning were facilitated by empathetic, systems-focused cultures, protected time for reflection, and structured opportunities to learn from incidents.

Conclusion: GPs rely on informal and self-directed strategies to recover from PSIs, with variable access to formal support. Recovery is shaped by individual and organisational factors. Findings highlight the importance of compassionate, non-punitive support systems and psychologically safe environments to enable recovery and promote learning.