Reporting Beyond the Practice

Most patient safety issues should be reported within the practice first, because the practice can usually act fastest to make the patient safe. Some incidents also require external reporting, advice or escalation. Dental nurses are not expected to complete every external report, but they should recognise when external routes may be needed.

In England, staff are encouraged to record patient safety events through their organisation's risk management system; those records feed the Learn from Patient Safety Events (LFPSE) service for national learning. Smaller organisations and independent dental surgeries may record directly to LFPSE if they do not have a local system. LFPSE shares learning but does not investigate individual incidents.

External routes may include

• LFPSE: national patient safety learning in England, especially for NHS-related or direct primary care reports.
• Commissioners or health boards: for NHS service issues, contractual reporting or local patient safety processes.
• CQC, HIW, RQIA or Healthcare Improvement Scotland: where regulator escalation is required.
• GDC: where a dental professional's fitness to practise may endanger patients or public confidence.
• Police or safeguarding services: where abuse, serious crime or immediate protection concerns exist.

External reporting does not replace local action. If a patient is unsafe now, provide immediate clinical care and safety measures before completing any external report. If a manager resists escalation and the risk is unresolved, the nurse may need to escalate further.

UK differences

External reporting is not one single route. The correct route depends on the issue: patient safety learning, professional fitness, safeguarding, regulator notification, device failure, data breach or workplace accident.