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

James Tawse; Christopher J Armitage; Carolyn A Chew-Graham; Maria Panagioti

doi:10.3399/BJGP.2026.0190

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.

How this fits in

Patient safety incidents can affect GPs’ wellbeing, confidence, and decision making. Previous research has focused on workload, uncertainty, and organisational pressures, whereas our study highlights the central role of psychologically safe practice cultures and peer support in enabling recovery. Barriers to moving on include time and workload constraints, stressful investigation processes, professional isolation, and stigma around seeking mental health support. Regular structured reflection, alongside system-level interventions, can protect clinicians while helping translate incidents into meaningful learning and safer care, and should be reinforced through GP training programmes and professional bodies.

Introduction

Patient safety incidents (PSIs) are unintended or unexpected events that could have, or did, lead to patient harm.¹ Although the primary concern is the impact on patients and their families, PSIs can also have adverse consequences for healthcare professionals and organisations. They may reduce trust between patients and clinicians, disrupt therapeutic relationships, and affect the personal and professional wellbeing of staff.^2–4

Healthcare professionals commonly report stress, anxiety, guilt, shame, and loss of confidence after being involved in a PSI.^5,6 These reactions can be stronger when harm has occurred or when complaints and investigations follow, sometimes leading to prolonged distress.^7–9 PSIs may also influence professional practice. Some clinicians adopt more defensive approaches, feel less confident in decision making, may take time off work, or question their future in the profession.^10,11 Feelings of isolation and fear of judgement can further weaken team communication and cohesion.¹² Together, these findings highlight that clinician wellbeing and the quality of patient care are interconnected,¹³ underlining the need for effective and accessible support. However, access to support following a PSI varies widely.^14,15

Most existing research on the impact of PSIs has focused on hospital settings,^4,16 where team structures and formal support systems differ from those in primary care. Much less is known about GPs, who often work in smaller teams and more isolated contexts, while maintaining ongoing relationships with patients.¹⁷ Although broader literature suggests that informal peer support may be helpful, evidence on how GPs actually access and experience both informal and formal support remains limited.¹⁸ In particular, little is known about how contextual factors, such as workload pressures, continuity of care, professional identity, and concerns about regulation, shape recovery and help seeking in primary care.¹⁹

At a time of increasing workload pressures, workforce shortages, and a growing emphasis on community-based care, it is essential to understand how PSIs affect GPs and how they can be better supported.^20,21 Qualitative research is well suited to this purpose, as it allows in-depth exploration of experiences, emotions, and social contexts.²²

This study aims to explore how GPs experience PSIs, how they recover or ‘move on’ from these events, and how they perceive and use available support. By capturing these experiences, the study seeks to inform the development of compassionate, practical interventions that strengthen GP wellbeing, promote psychological safety, and support a positive patient safety culture in primary care.

Method

Study design

This qualitative study adopted a phenomenological approach to explore how GPs experienced and made sense of PSIs.²³ The study was informed by a constructivist and interpretivist orientation, recognising that experiences are shaped by social and professional contexts.^24,25 Reflexivity was maintained through a reflexive diary and regular team discussions.

Participants and recruitment

Participants were GPs in England who had experienced a PSI. There was no restriction on severity, with experiences ranging from near misses to incidents resulting in harm, and no time limit on when the event occurred. GPs who had retired or left practice within the previous 5 years were also eligible to participate.

Recruitment was supported by the National Institute for Health and Care Research (NIHR) Research Delivery Networks (RDNs) in the North West and North East and North Cumbria, England, which circulated study information to general practices in their respective regions. Study information was also disseminated via the researcher’s social media, enabling self-referral from participants beyond these regions. Participants self-selected and confirmed eligibility, including PSI involvement, via a tick-box at sign-up to the study. No purposive sampling was used. Exclusion criteria were GPs with no prior PSI involvement, inability to provide informed consent, or inability to participate in an English-language qualitative interview.

Data collection

Data were collected through one-to-one interviews conducted either online via Microsoft Teams or face-to-face at a professional location, depending on participant preference. Data collection took place between February and November 2025. Consent was obtained before interviews, and participants completed a brief demographic form. A semi-structured topic guide (see Supplementary Information S1) explored experiences of specific incidents, and included questions on perceived contributory factors, emotional and professional responses, coping and recovery, support accessed, and any resulting learning or changes in practice. The guide was refined as interviews progressed and data were analysed.

Interviews were audio-recorded, transcribed verbatim, anonymised, and stored securely. Participants were offered a £30 voucher in recognition of their time. A distress protocol was in place to protect participants’ wellbeing. Participants were able to withdraw their data within 2 weeks of the interview, before analysis began.

Data analysis

Data were analysed using reflexive thematic analysis, following Braun and Clarke’s six-step framework.^26,27 Analysis was iterative and involved constant comparison across interviews. The lead researcher (the first author) conducted coding using NVivo (version 15) and Microsoft Excel, and a coding framework was reviewed and refined through regular discussions with the research team.

Following inductive coding, themes were mapped to the theoretical domains framework (TDF) to identify cognitive, social, and environmental influences on participants’ experiences.²⁸ The TDF provided a structured interpretation of the multilevel factors shaping GPs’ experiences of PSIs, recognising that behaviour is influenced by both individual and system-level conditions. This mapping supported identification of behavioural targets for intervention and informed recommendations for organisational learning and professional support.

Reflexivity

Interviews and initial analysis were conducted by a PhD student (the first author) with previous experience as an assistant psychologist in NHS staff support. To reduce potential bias, analysis involved regular group discussions and collaborative theme development with a multidisciplinary research team, including clinical academics with expertise in general practice, psychology, and NHS staff support.

Ethical considerations

Data management followed General Data Protection Regulation requirements. Audio-recordings were deleted after transcription, and anonymised transcripts were stored securely. All findings are reported in a way that protects participant anonymity.

Public involvement

Findings were shared with a patient and public involvement (PPI) group formed through an existing network linked to an ongoing, NIHR School for Primary Care Research-funded study synthesising evidence on interventions to improve workforce retention and wellbeing in primary care. In total, 10–15 members participated, including primary care clinicians, practice managers, and patients. Participants were presented with a summary of study findings and engaged in discussion around interpretation, relevance, and potential intervention mechanisms to support primary care clinicians. The group contributed feedback on practical implications and helped refine thinking on how findings could inform future support strategies in primary care. Participants were compensated in line with NIHR guidance for their involvement.

Results

Twenty-two GPs were interviewed. Interviews lasted an average of 41 min (ranging from 31 to 59 min). Demographic details and information about participants’ practices are presented in Table 1.

View this table:

Table 1. Participant and practice characteristics (N = 22)

Thematic analysis generated three overarching themes that reflect how GPs experience and move on from PSIs:

personal and professional consequences;
recovery and learning processes; and
barriers to healing.

Personal and professional consequences

PSIs were experienced as emotionally and professionally significant events, with the impact varying according to the level of patient harm and whether the incident triggered external scrutiny.

Psychological impacts

Participants described immediate emotional responses, including stress, guilt, fear, and anxiety, often driven by uncertainty and concern about potential harm and consequences for themselves. Where harm was minimal, these emotions were intense but contained, and participants viewed incidents as opportunities for reflection and learning to strengthen future practice:

‘Immediately the reaction is one of stress, one of — “Oh, how is this going to go? Is this going to escalate further?” — but then I think once that initial feeling has subsided, it’s an opportunity to learn.’ (Participant [P]21, GP partner, 16–24 years of experience)

Where patients experienced harm, GPs described incidents lingering in their minds, with some reflecting on them repeatedly and finding it difficult to move forward:

‘These incidents that I’m describing, I’ll never forget them, and they’re not the only ones and anyone who’s [age redacted], who’s worked in the busy settings that I’ve worked in will have incidents notched up against them.’ (P6, GP partner, 16–24 years of experience)

If incidents were escalated to an external investigation process, such as referral to the General Medical Council, NHS England, or the Coroner’s court, the impact on GPs intensified as they faced significant stress and uncertainty with concerns about reputational damage and losing their licence to practice. Participants described feeling anxious and frustrated during investigations:

‘Where it becomes problematic is if patients are unhappy and patients do complain or say they’re going to refer you to the General Medical Council and that’s where it just takes on a completely different complexion and becomes incredibly stressful.’ (P11, GP partner, ≥25 years of experience)

Work-related and occupational impacts

Participants described a range of consequences following involvement in PSIs, including reduced confidence, increased indecision, and a tendency towards more defensive practice:

‘It just made me really wary afterwards of any sort of patient reporting those symptoms. I brought everybody in, you know, I wasn’t prepared to do anything on the phone.’ (P20, GP partner, 16–24 years of experience)

For some, these responses led to changes in clinical behaviour, such as longer consultations, more detailed documentation, and increased referrals or investigations:

‘I think with experience and with a couple of complaints that I have caught, not significant events but complaints, I’ve just felt that, if they’ve [the patient] requested it [a treatment or test] and it’s not very unreasonable, just go ahead and do it.’ (P18, salaried GP, 10–15 years of experience)

In some cases, PSIs contributed to sickness absence, as clinicians felt unable to work effectively, and prompted reflection on their career. Some participants described considering alternative roles perceived as less stressful:

‘You always think, oh my God, I’m a terrible doctor. I’m rubbish at my job. Why am I doing this job? It’s not worth it. I’ll go and do, you know I’ll do something else.’ (P19, GP partner, 5–9 years of experience)

Recovery and learning processes

Participants described recovery as a reflective process involving acknowledgement of the incident and its personal and professional impact. Support from colleagues, family, and friends was often helpful, and incidents were viewed as opportunities for learning and improvement. Some participants accessed mental health support to process and recover from incidents.

Acknowledging and accepting errors

Participants described healing as beginning with acceptance of the incident and acknowledgement of its impact, alongside honest reflection and open discussion with colleagues to develop a shared understanding. At the same time, they emphasised avoiding excessive self-criticism and recognised incidents as an inherent part of clinical practice:

‘Although it may feel painful and emotionally charged now, we [will] all make more mistakes in the future, it’s part of being human. So, you can embrace it and there’s things to learn from it, but don’t let it affect your life.’ (P3, salaried GP, 5–9 years of experience)

Participants described communication with the affected patient after a PSI as more than a procedural requirement; it formed an important part of how they understood and processed the incident. Duty of candour was viewed as both a regulatory obligation and a professional responsibility. When conversations were constructive they helped repair relationships, rebuild trust, and restore professional confidence, whereas negative or uncertain responses could prolong distress and influence GPs’ ability to move forward:

‘I think in the vast majority of these situations, if you can communicate and discuss things and explain and apologise, if apologising is necessary, then it goes a long way to helping resolve or improve outcomes.’ (P7, GP partner, 16–24 years of experience)

Despite this, GPs described regulatory processes that could obstruct open acknowledgement of errors, particularly where there was concern that discussion of incidents might trigger escalation, investigation, or increased scrutiny for individuals and organisations:

‘The risk is, though, if you keep talking about your mistakes and you keep highlighting them are the CQC [Care Quality Commission] going to find out about all these mistakes? Is it going to come back and punish us in that respect?’ (P22, GP partner, 5–9 years of experience)

Accessing emotional support

Opening up to peers was identified as a key avenue for accessing emotional and work-related support. Participants described selectively approaching trusted colleagues with whom they felt comfortable and often had established informal networks of peer support. For some, consulting doctors outside their own practice was deemed preferable:

‘Being able to chat through it with other more experienced GPs or even less experienced GPs, just being able to chat through it with someone else I think is just ever so helpful, even if they’ve got nothing to add.’ (P3, salaried GP, 5–9 years of experience)

Participants emphasised the importance of being open with friends and family about the emotional impact of clinical incidents, while maintaining patient confidentiality. Support networks outside of work were considered essential for detaching from professional pressures:

‘The support network that you’ve got — family, friends, you know — confidentiality is important, but also discussing how you’re feeling is very important and different people have different groups that they want to speak to.’ (P7, GP partner, 16–24 years of experience)

Some GPs accessed further support to recover from incidents, including counselling, coaching, Balint groups (facilitated peer groups for reflecting on difficult clinical experiences), peer support, and mentoring. These interventions focused less on clinical problem solving and more on addressing the personal impact of incidents, providing compassionate support to aid emotional recovery:

‘At a Balint group, you get that kind of deep listening and discussion around emotions that I find that I always found sort of therapeutic and settling.’ (P14, GP partner, 10–15 years of experience)

Learning and reflection

Although incidents caused stress and anxiety, most participants saw them as opportunities for learning and improvement. Team-based reflection, particularly through significant event analysis (SEA) conducted during practice meetings, supported a systems-focused approach that shifted attention away from individual blame and towards wider contextual factors influencing care:

‘From all the different things I’ve done, it’s never down to one thing. It’s so often a process, a system, a number of things that have led to that point in time.’ (P20, GP partner, 16–24 years of experience)

GPs emphasised the importance of non-judgemental, empathetic environments for discussing incidents, enabling open dialogue and system-focused learning. Some identified themselves as practice leaders and took responsibility for fostering psychological safety within their teams:

‘What I try and do as the lead GP within the practice is hold my hands up and say — look I’ve done it myself — and show that — yeah I’ve done it, we’re not all perfect, but this is what we’re going to do to stop this from happening again.’ (P13, GP partner, 5–9 years of experience)

Where learning processes and peer support were experienced positively, participants reported strengthened connections within teams. In these instances, PSIs were viewed as opportunities to enhance team cohesion, which in turn increased clinicians’ willingness to engage openly with colleagues:

‘[Regarding positive experiences following safety incidents] I guess for the positive, yeah, positive reactions from my colleagues, and I know that’s reinforced how willing I am to take things to them which has been helpful even for the smaller problems.’ (P3, salaried GP, 5–9 years of experience)

Barriers to healing

Participants reported several factors that hindered access to support and the ability to move on from incidents. These included systemic pressures such as workload, limited time, and resource constraints, interpersonal barriers within general practice teams, and the uncertainty associated with external investigation processes.

Time and resources

GPs described how time and workload pressures made it difficult to access support or offer it to colleagues during the working day. Consequently, opportunities to discuss PSIs and their impacts were limited, and participants reported reluctance to burden colleagues with additional conversations. Some GPs suggested that their practices lacked suitable time and space for informal catch-ups with colleagues:

‘Our practice doesn’t even have a staff room. You know, it’s so small, we eat our lunch at our desk, and you never really properly chat to people you’re just darting in and out of people’s rooms.’ (P17, salaried GP, 10–15 years of experience)

SEA conducted during practice meetings provided a forum for discussing incidents, although the frequency and time allocated for meetings varied. Participants noted that SEAs often focused on severe incidents, potentially overlooking opportunities to learn from less serious events. To address this, participants described alternative strategies for sharing patient safety updates, such as summarising key lessons and disseminating information to the wider practice team in accessible ways:

‘I think just a bulletin or included in a clinical update or newsletter, just something you know just key learning points, I think that’d be really helpful. I think we should all do that and I’m not sure that’s always brilliantly done.’ (P15, salaried GP, 16–24 years of experience)

Participants suggested that allocating more time and resources for peer support and shared learning mechanisms could strengthen team connections, improve psychological safety, enhance GP wellbeing, and contribute to safer systems of care:

‘If there was somehow a resource for a touch point, even just to chat to someone else in a more organised fashion, regularly even just once a month. To chat through some difficult cases and to have that protected time, it would be so useful.’ (P3, salaried GP, 5–9 years of experience)

Interpersonal barriers

Participants described the GP role as potentially isolating, with long periods of back-to-back patient consultations and limited opportunities to build connections with colleagues:

‘I mean, GP [general practice] itself is very isolated work, to be very honest, we are eight partners, but honestly speaking, the work is isolated.’ (P16, GP partner, ≥25 years of experience)

Participants noted that building supportive relationships within practices takes time, and less experienced clinicians may find it harder to speak openly because of limited trust and familiarity with colleagues. They may also experience incidents more acutely given their relative inexperience and uncertainty about processes:

‘I think the longer you’ve been somewhere, the easier it probably is because you’ve already established yourself there and you know people who will support you … I think if you’re a newly qualified or new in a practice, I think that makes it probably much harder.’ (P15, salaried GP, 16–24 years of experience)

Some GPs reported reluctance to access mental health support services or admit they were struggling to colleagues following an incident. Participants described concerns about being judged by colleagues or perceived as unable to cope with the demands of the role:

‘Maybe there’s some fear of judgement that you’re saying you can’t cope and the implications of that, that maybe people say, “well, you need to be off work” or maybe the embarrassment of maybe making a mountain out of a molehill.’ (P14, GP partner, 10–15 years of experience)

External investigation processes

Participants described that external escalation processes around PSIs represented a significant barrier to GPs moving on from incidents. These included investigations by NHS England, the General Medical Council, the Coroner’s court, and litigation. The emotional toll was considerable for affected clinicians and could last several months before any resolution:

‘The whole thing took around seven months and at the end it was cleared with no case for me to answer, completely cleared and I was told there’s nothing more needs to be done. The patient made a full recovery, they are now fine, which is good. I went through seven or eight months of absolute hell. I can’t say that I’ve still fully come to terms with it.’ (P10, salaried GP, 16–24 years of experience)

Participants reported that investigation processes could feel unsupportive and generate significant anxiety and uncertainty. Some suggested that external investigation processes could be less adversarial to reduce the psychological burden on GPs under review, alongside stronger dedicated support for GPs during investigations:

‘I know in some countries, and I believe New Zealand’s an example, there’s no fault compensation, which means if something goes wrong, the person gets adequately compensated without any law case.’ (P5, GP partner, ≥25 years of experience)
‘There should be a dedicated support line for any clinician who’s had a complaint, and it shouldn’t require you to raise a flag and say I need this help, it should be automatic.’ (P6, GP partner, 16–24 years of experience)

Mapping findings to the theoretical domains framework

Themes were identified inductively from transcripts and mapped to the TDF, highlighting cognitive, social, emotional, and environmental influences on behaviour. Box 1 summarises key findings, corresponding TDF domains, and potential interventions, linking experiential insights to strategies that support clinician wellbeing and safer practice. Potential interventions were refined using interview data, existing literature, and input from PPI contributors.

Recovery, learning, and help seeking after PSIs are shaped by interacting emotional, social, cognitive, and organisational factors. Peer support, mentoring, psychologically safe team cultures, and structured reflection facilitate recovery, while workload and limited protected time highlight the need for interventions at individual, team, and system levels. Interventions are further categorised by their primary and secondary level of operation (individual, team, organisational, and system), reflecting the multilevel nature of influences on clinician behaviour and recovery; organisational-level factors refer to structures and processes within GP practices or employing organisations, whereas system-level factors capture external influences such as policy, regulation, and the wider medicolegal context.

View this table:

Box 1. Theoretical domains framework (TDF) mapping of GPs’ recovery and support needs after patient safety incidents (PSIs)

Discussion

Summary

GPs described the psychological and professional consequences of PSIs, with experiences shaped by incident severity, perceived harm, and available support. Common emotional responses included stress, guilt, and anxiety, particularly when patient harm was involved. In more serious cases, incidents were described as persistent and difficult to move on from, with formal complaints or regulatory investigations intensifying distress through prolonged uncertainty and concerns about reputation and fitness to practise. GPs reported reduced confidence, increased indecision, and more defensive practice, with some requiring sickness absence or reconsidering their future in medicine.

Recovery involved reflection, acceptance, and open discussion with colleagues. Constructing timelines, engaging in duty of candour conversations, and accessing emotional support from peers, family, or formal services (such as counselling, Balint groups, and mentoring) helped GPs process events. Incidents were later viewed as opportunities for learning, particularly within non-judgemental, empathetic, and systems-focused team cultures. Barriers included high workload, limited time, lack of protected space, isolation, and fears of judgement, while external investigations were often burdensome and adversarial.

Consistent with these findings, the TDF mapping highlights clear points for intervention at individual and organisational levels. These include access to emotional and peer support, structured reflection and debriefing, communication skills training, protected time for learning, and more supportive investigation processes.

Strengths and limitations

The use of semi-structured interviews to explore GPs’ experiences of PSIs generated rich, contextualised accounts of their emotional and professional impacts. The design enabled in-depth exploration of recovery, wellbeing, and learning following incidents, as well as the broader organisational and systemic conditions shaping these experiences. The findings are timely within the UK context, where general practice is facing sustained workload pressures, workforce shortages, and high levels of burnout, alongside policy shifts towards community-based and integrated models of care.^20,21

Limitations include self-selecting participants, which may overrepresent those with strong experiences or views, and reliance on self-reported data, which can be affected by recall or social desirability bias. The sample was mostly from the North West of England, which may limit transferability of findings. Most GPs were partners, therefore the study may not have captured experiences of recently qualified GPs or locum GPs in detail. Wider primary care team and patient perspectives on PSI management and staff support were not captured in the qualitative interviews. Although these perspectives were incorporated through PPI when reviewing the findings, future research should explore them directly and examine how organisational context shapes recovery and learning over time, addressing the limitations of single-profession and cross-sectional designs.

As the interviewer (the first author) did not have a background in general practice, this may have influenced how participants described their experiences. Although this may have reduced shared clinical understanding and required more contextual explanation, it may also have facilitated openness by reducing perceived judgement when discussing errors or emotional impacts.

Comparison with existing literature

There is limited research specifically examining GPs’ or primary care practitioners’ reactions to PSIs, and comparisons are therefore drawn from studies conducted in hospital settings or across mixed professional groups. The emotional and professional impacts described by participants align with wider evidence showing that clinicians may experience stress, guilt, anxiety, loss of confidence, and changes in clinical practice following adverse events.^2–4 Distress was particularly pronounced when patient harm occurred or when incidents were formally investigated, supporting evidence that regulatory scrutiny and prolonged uncertainty intensify psychological burden.^7,9,29

The findings also align with research emphasising the importance of supportive patient safety cultures, including psychological safety, team reflection, and openness to learning.^30–32 Participants highlighted the value of peer supports including mentoring, reflective forums, and Balint groups as mechanisms for processing events, reducing isolation, and strengthening professional resilience.^16,33 Similarly, engaging with patients and families after incidents was viewed as an important step and has been shown to facilitate resolution, rebuild trust, and contribute to improvements in quality and safety.³⁴

However, this study also highlights features that are more specific to general practice. Clinical uncertainty was described as routine, with decisions often made at an early stage of illness and with limited information, including uncertainty about diagnosis, prognosis, and management. Professional isolation and limited opportunities for shared reflection constrained recovery,¹² while continuity of care meant GPs often maintained relationships with patients after incidents, shaping both the emotional impact and resolution.¹⁹ Primary care research on structured incident-reporting systems found that locally embedded reporting processes increased identification of near misses and supported practice-level learning, particularly where organisational engagement was strong.³⁵ These findings extend existing literature by situating PSIs within the organisational and relational context of general practice.

Barriers to recovery identified in this study reflect challenges that may be particularly acute in general practice. Time and workload pressures often limit opportunities for shared reflection.^36,37 Qualitative studies have shown that GPs may delay seeking support because of norms of self-reliance, stigma surrounding vulnerability, and the relative isolation of general practice.^17,18,38 Consequently, there have been calls for more compassionate and connected workplace cultures that destigmatise mental ill health and enable timely access to support.¹⁹ The participants’ accounts of investigation processes as being stressful and uncertain reinforce recommendations for systems that are transparent, proportionate, and oriented towards learning rather than blame.³⁹

Implications for practice

PSIs are an inevitable feature of general practice and can have profound effects on GPs’ wellbeing, confidence, and decision making, especially when patients are harmed or external investigations arise. Reflecting the interventions identified in Box 1, the following implications for practice highlight key areas where support and system-level changes are needed to reduce harm and improve recovery following PSIs.

Effective management requires a multifaceted approach addressing emotional- and system-level factors. Opportunities for learning and peer support through regular practice meetings, safety huddles, and informal gatherings can help GPs build trust, strengthen team cohesion, and enhance resilience. Leaders should model transparency, curiosity, and respectful communication, reinforcing a shared commitment to clinician wellbeing and patient safety. Easy access to confidential support services is essential, allowing GPs to seek help without fear of judgement or professional repercussion. Less punitive, transparent, and proportionate investigation processes are critical to protect GP wellbeing while maintaining accountability and learning.

At the same time, upstream barriers must be addressed. High workloads, administrative pressures, and staffing constraints increase the risk of errors and limit time for reflection, team discussion, and learning from incidents. Without adequate capacity, GPs may struggle to process events, implement improvements, or support colleagues, perpetuating stress and safety risks. Addressing these systemic pressures is critical to enable recovery and ensure lessons from PSIs translate into safer care.

Notes

Funding

This study is funded by the National Institute for Health and Care Research (NIHR) School for Primary Care Research (Project 597) and the NIHR Greater Manchester Patient Safety Research Collaboration (reference: NIHR204295). Carolyn A Chew-Graham is part-funded by the NIHR Applied Research Collaboration West Midlands (reference: NIHR200165). Christopher J Armitage is supported by the NIHR Biomedical Research Centre Manchester. The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.

Ethical approval

Ethical approval was granted by the University of Manchester Research Ethics Committee (reference: 2024-21215-38614). All participants provided informed consent.

Provenance

Freely submitted; externally peer reviewed.

Acknowledgements

The authors would like to sincerely thank the 22 GPs who generously gave their time and shared their experiences for this study. Their insights were invaluable in helping us understand the factors influencing patient safety incidents and recovery in general practice. We also extend our thanks to the patient and public involvement contributors for their valuable input in interpreting the findings and helping to shape the practical implications of this research.

Competing interests

The authors have declared no competing interests.

Received March 19, 2026.
Revision received April 13, 2026.
Accepted May 13, 2026.

http://creativecommons.org/licenses/by/4.0/

This article is Open Access: CC BY 4.0 licence (http://creativecommons.org/licenses/by/4.0/).

References

1.↵
1. World Health Organization
(2009) Conceptual framework for the international classification for patient safety. accessed. https://iris.who.int/server/api/core/bitstreams/fc68f57e-3cf6-4fbf-a95d-2686593ea392/content. 16 Sep 2026.
2.↵
1. Wu AW
(2000) Medical error: the second victim. BMJ 320(7237):726–727, doi:10.1136/bmj.320.7237.726.
OpenUrl FREE Full Text
3.
1. Harrison R,
2. Lawton R,
3. Stewart K
(2014) Doctors’ experiences of adverse events in secondary care: the professional and personal impact. Clin Med 14(6):585–590, doi:10.7861/clinmedicine.14-6-585, pmid:25468840.
OpenUrl Abstract/FREE Full Text
4.↵
1. Jukarainen L,
2. Mahat S,
3. Koskiniemi S,
4. et al.
(2026) The symptoms and impacts experienced by healthcare professionals as second victims after a safety incident: a scoping review. J Adv Nurs 82(5):4538–4592, doi:10.1111/jan.70196, pmid:41029346.
OpenUrl CrossRef PubMed
5.↵
1. Seys D,
2. Wu AW,
3. Van Gerven E,
4. et al.
(2013) Health care professionals as second victims after adverse events: a systematic review. Eval Health Prof 36(2):135–162, doi:10.1177/0163278712458918.
OpenUrl CrossRef PubMed
6.↵
1. Ozeke O,
2. Ozeke V,
3. Coskun O,
4. Budakoglu II
(2019) Second victims in health care: current perspectives. Adv Med Educ Pract 10:593–603, doi:10.2147/AMEP.S185912, pmid:31496861.
OpenUrl CrossRef PubMed
7.↵
1. Zeeman G,
2. Schouten L,
3. Seys D,
4. et al.
(2020) Prolonged mental health sequelae among doctors and nurses involved in patient safety incidents with formal complaints and lawsuits. Eur J Public Health 30(4):777–779, doi:10.1093/eurpub/ckz138, pmid:31365062.
OpenUrl CrossRef PubMed
8.
1. Biggar S,
2. van der Gaag A,
3. Maher P,
4. et al.
(2023) ‘Virtually daily grief’ — understanding distress in health practitioners involved in a regulatory complaints process: a qualitative study in Australia. Int J Qual Health Care 35(4), doi:10.1093/intqhc/mzad076, pmid:37751386. mzad076.
OpenUrl CrossRef PubMed
9.↵
1. Morrison R,
2. Yeter E,
3. Syed-Sabir H,
4. et al.
(2024) ‘It’s been years and it still hurts’: paediatric critical care staff experiences of being involved in serious investigations at work: a qualitative study. Intensive Care Med Paediatr Neonatal 2, doi:10.1007/s44253-024-00039-0. 17.
OpenUrl CrossRef
10.↵
1. Scott SD,
2. Hirschinger LE,
3. Cox KR,
4. et al.
(2009) The natural history of recovery for the healthcare provider ‘second victim’ after adverse patient events. Qual Saf Health Care 18(5):325–330, doi:10.1136/qshc.2009.032870, pmid:19812092.
OpenUrl Abstract/FREE Full Text
11.↵
1. Hall LH,
2. Johnson J,
3. Watt I,
4. et al.
(2017) Healthcare staff wellbeing, burnout, and patient safety: a systematic review. PLoS One 11(7), doi:10.1371/journal.pone.0159015. e0159015.
OpenUrl CrossRef
12.↵
1. Sirriyeh R,
2. Lawton R,
3. Gardner P,
4. Armitage G
(2010) Coping with medical error: a systematic review of papers to assess the effects of involvement in medical errors on healthcare professionals’ psychological well-being. Qual Saf Health Care 19(6), doi:10.1136/qshc.2009.035253. e43.
OpenUrl Abstract/FREE Full Text
13.↵
1. Hodkinson A,
2. Zhou A,
3. Johnson J,
4. et al.
(2022) Associations of physician burnout with career engagement and quality of patient care: systematic review and meta-analysis. BMJ 378, doi:10.1136/bmj-2022-070442, pmid:36104064. e070442.
OpenUrl Abstract/FREE Full Text
14.↵
1. Chan ST,
2. Khong PCB,
3. Wang W
(2017) Psychological responses, coping and supporting needs of healthcare professionals as second victims. Int Nurs Rev 64(2):242–262, doi:10.1111/inr.12317, pmid:27679402.
OpenUrl CrossRef PubMed
15.↵
1. Robertson JJ,
2. Long B
(2018) Suffering in silence: medical error and second victim syndrome. J Emerg Med 54(4):402–409, doi:10.1016/j.jemermed.2017.12.001.
OpenUrl CrossRef PubMed
16.↵
1. Simms-Ellis R,
2. Harrison R,
3. Sattar R,
4. et al.
(2025) Avoiding ‘second victims’ in healthcare: what support do staff want for coping with patient safety incidents, what do they get and is it effective? A systematic review. BMJ Open 15(2), doi:10.1136/bmjopen-2024-087512, pmid:39929502. e087512.
OpenUrl Abstract/FREE Full Text
17.↵
1. Riley R,
2. Spiers J,
3. Buszewicz M,
4. et al.
(2018) What are the sources of stress and distress for general practitioners working in England? A qualitative study. BMJ Open 8(1), doi:10.1136/bmjopen-2017-017361, pmid:29326181. e017361.
OpenUrl Abstract/FREE Full Text
18.↵
1. Hussan A,
2. Satheeskaran M,
3. Dho H,
4. et al.
(2024) GP perceptions of informal peer support in primary care: a qualitative study. BJGP Open doi:10.3399/BJGPO.2023.0151.
OpenUrl Abstract/FREE Full Text
19.↵
1. Spiers J,
2. Buszewicz M,
3. Chew-Graham CA,
4. et al.
(2017) Barriers, facilitators, and survival strategies for GPs seeking treatment for distress: a qualitative study. Br J Gen Pract doi:10.3399/bjgp17X692573, pmid:28893766.
OpenUrl Abstract/FREE Full Text
20.↵
1. Royal College of General Practitioners
(2025) Nearly three quarters of GPs say patient safety is being compromised by their workload, as concerns are raised over new reforms. accessed. https://www.rcgp.org.uk/news/workload-concerns-polling. 16 Sep 2026.
21.↵
1. Department of Health and Social Care,
2. Prime Minister’s Office 10 Downing Street
(2025) Fit for the future: 10 year health plan for England — executive summary. accessed. https://www.gov.uk/government/publications/10-year-health-plan-for-england-fit-for-the-future/fit-for-the-future-10-year-health-plan-for-england-executive-summary. 16 Sep 2026.
22.↵
1. Braun V,
2. Clarke V
(2021) Thematic analysis: a practical guide to understanding and doing (SAGE Publications Ltd, London).
23.↵
1. Neubauer BE,
2. Witkop CT,
3. Varpio L
(2019) How phenomenology can help us learn from the experiences of others. Perspect Med Educ 8(2):90–97, doi:10.1007/s40037-019-0509-2, pmid:30953335.
OpenUrl CrossRef PubMed
24.↵
1. Bryman A
(2008) Social research methods. (Oxford University Press, Oxford), 3rd edn.
25.↵
1. Dodgson JE
(2019) Reflexivity in qualitative research. J Hum Lact 35(2):220–222, doi:10.1177/0890334419830990.
OpenUrl CrossRef PubMed
26.↵
1. Braun V,
2. Clarke V
(2006) Using thematic analysis in psychology. Qual Res Psychol 3(2):77–101, doi:10.1191/1478088706qp063oa.
OpenUrl CrossRef
27.↵
1. Braun V,
2. Clarke V
(2023) Toward good practice in thematic analysis: avoiding common problems and be(com)ing a knowing researcher. Int J Transgend Health 24(1):1–6, doi:10.1080/26895269.2022.2129597, pmid:36713144.
OpenUrl CrossRef PubMed
28.↵
1. Michie S,
2. Atkins L,
3. West R
(2014) The behaviour change wheel: a guide to designing interventions (Silverback Publishing, London).
29.↵
1. Tazzyman A,
2. Bryce M,
3. Walshe K,
4. Boyd A
(2019) Identifying and managing concerns about GPs in England: an interview study and case-series analysis. Br J Gen Pract doi:10.3399/bjgp19X703733, pmid:31064744.
OpenUrl Abstract/FREE Full Text
30.↵
1. Wailling J,
2. Kooijman A,
3. Hughes J,
4. O’Hara JK
(2022) Humanizing harm: using a restorative approach to heal and learn from adverse events. Health Expect 25(4):1192–1199, doi:10.1111/hex.13478, pmid:35322513.
OpenUrl CrossRef PubMed
31.
1. Raja S,
2. Litle VR
(2021) The critical role of learning from investigating and debriefing adverse events. J Thorac Dis 13(Suppl 1):S3–S7, doi:10.21037/jtd-2020-epts-01, pmid:34447586.
OpenUrl CrossRef PubMed
32.↵
1. Liukka M,
2. Steven A,
3. Moreno MFV,
4. et al.
(2020) Action after adverse events in healthcare: an integrative literature review. Int J Environ Res Public Health 17(13), doi:10.3390/ijerph17134717, pmid:32630041. 4717.
OpenUrl CrossRef PubMed
33.↵
1. Lane MA,
2. Newman BM,
3. Taylor MZ,
4. et al.
(2018) Supporting clinicians after adverse events: development of a clinician peer support program. J Patient Saf 14(3):e56–e60, doi:10.1097/PTS.0000000000000508, pmid:29878948.
OpenUrl CrossRef PubMed
34.↵
1. Aubin DL,
2. Soprovich A,
3. Diaz Carvallo F,
4. et al.
(2022) Support for healthcare workers and patients after medical error through mutual healing: another step towards patient safety. BMJ Open Qual 11(4), doi:10.1136/bmjoq-2022-002004, pmid:36588324. e002004.
OpenUrl Abstract/FREE Full Text
35.↵
1. Zwart DLM,
2. Steerneman AHM,
3. van Rensen ELJ,
4. et al.
(2011) Feasibility of centre-based incident reporting in primary healthcare: the SPIEGEL study. BMJ Qual Saf 20(2):121–127, doi:10.1136/bmjqs.2009.033472, pmid:21209136.
OpenUrl Abstract/FREE Full Text
36.↵
1. Rea D,
2. Griffiths S
(2016) Patient safety in primary care: incident reporting and significant event reviews in British general practice. Health Soc Care Community 24(4):411–419, doi:10.1111/hsc.12221.
OpenUrl CrossRef PubMed
37.↵
1. Cooper AJ,
2. Behrens DA,
3. Jones SE,
4. et al.
(2025) Understanding the impact of employee investigations on those who lead them: a case study from NHS Wales. Adm Sci 15(6):211, doi:10.3390/admsci15060211.
OpenUrl CrossRef
38.↵
1. McAnee G,
2. Norwood K,
3. Leavey G
(2024) Qualitative study investigating the professional and personal effects of patient suicide on general practitioners in Northern Ireland. BMJ Open 14(2), doi:10.1136/bmjopen-2023-077940, pmid:38341208. e077940.
OpenUrl Abstract/FREE Full Text
39.↵
1. Bourne T,
2. De Cock B,
3. Wynants L,
4. et al.
(2017) Doctors’ perception of support and the processes involved in complaints investigations and how these relate to welfare and defensive practice: a cross-sectional survey of the UK physicians. BMJ Open 7(11), doi:10.1136/bmjopen-2017-017856, pmid:29162574. e017856.
OpenUrl Abstract/FREE Full Text

Online First

Download PDF

Email Article

Citation Tools

Keywords

More in this TOC Section

Show more Research

Cited By...

Intended for Healthcare Professionals

[1] 1.↵
World Health Organization
(2009) Conceptual framework for the international classification for patient safety. accessed. https://iris.who.int/server/api/core/bitstreams/fc68f57e-3cf6-4fbf-a95d-2686593ea392/content. 16 Sep 2026.

[2] World Health Organization

[3] 2.↵
Wu AW
(2000) Medical error: the second victim. BMJ 320(7237):726–727, doi:10.1136/bmj.320.7237.726.
OpenUrl FREE Full Text

[4] Wu AW

[5] 3.
Harrison R,
Lawton R,
Stewart K
(2014) Doctors’ experiences of adverse events in secondary care: the professional and personal impact. Clin Med 14(6):585–590, doi:10.7861/clinmedicine.14-6-585, pmid:25468840.
OpenUrl Abstract/FREE Full Text

[6] Harrison R,

[7] Lawton R,

[8] Stewart K

[9] 4.↵
Jukarainen L,
Mahat S,
Koskiniemi S,
et al.
(2026) The symptoms and impacts experienced by healthcare professionals as second victims after a safety incident: a scoping review. J Adv Nurs 82(5):4538–4592, doi:10.1111/jan.70196, pmid:41029346.
OpenUrl CrossRef PubMed

[10] Jukarainen L,

[11] Mahat S,

[12] Koskiniemi S,

[13] et al.

[14] 5.↵
Seys D,
Wu AW,
Van Gerven E,
et al.
(2013) Health care professionals as second victims after adverse events: a systematic review. Eval Health Prof 36(2):135–162, doi:10.1177/0163278712458918.
OpenUrl CrossRef PubMed

[15] Seys D,

[16] Wu AW,

[17] Van Gerven E,

[18] et al.

[19] 6.↵
Ozeke O,
Ozeke V,
Coskun O,
Budakoglu II
(2019) Second victims in health care: current perspectives. Adv Med Educ Pract 10:593–603, doi:10.2147/AMEP.S185912, pmid:31496861.
OpenUrl CrossRef PubMed

[20] Ozeke O,

[21] Ozeke V,

[22] Coskun O,

[23] Budakoglu II

[24] 7.↵
Zeeman G,
Schouten L,
Seys D,
et al.
(2020) Prolonged mental health sequelae among doctors and nurses involved in patient safety incidents with formal complaints and lawsuits. Eur J Public Health 30(4):777–779, doi:10.1093/eurpub/ckz138, pmid:31365062.
OpenUrl CrossRef PubMed

[25] Zeeman G,

[26] Schouten L,

[27] Seys D,

[28] et al.

[29] 8.
Biggar S,
van der Gaag A,
Maher P,
et al.
(2023) ‘Virtually daily grief’ — understanding distress in health practitioners involved in a regulatory complaints process: a qualitative study in Australia. Int J Qual Health Care 35(4), doi:10.1093/intqhc/mzad076, pmid:37751386. mzad076.
OpenUrl CrossRef PubMed

[30] Biggar S,

[31] van der Gaag A,

[32] Maher P,

[33] et al.

[34] 9.↵
Morrison R,
Yeter E,
Syed-Sabir H,
et al.
(2024) ‘It’s been years and it still hurts’: paediatric critical care staff experiences of being involved in serious investigations at work: a qualitative study. Intensive Care Med Paediatr Neonatal 2, doi:10.1007/s44253-024-00039-0. 17.
OpenUrl CrossRef

[35] Morrison R,

[36] Yeter E,

[37] Syed-Sabir H,

[38] et al.

[39] 10.↵
Scott SD,
Hirschinger LE,
Cox KR,
et al.
(2009) The natural history of recovery for the healthcare provider ‘second victim’ after adverse patient events. Qual Saf Health Care 18(5):325–330, doi:10.1136/qshc.2009.032870, pmid:19812092.
OpenUrl Abstract/FREE Full Text

[40] Scott SD,

[41] Hirschinger LE,

[42] Cox KR,

[43] et al.

[44] 11.↵
Hall LH,
Johnson J,
Watt I,
et al.
(2017) Healthcare staff wellbeing, burnout, and patient safety: a systematic review. PLoS One 11(7), doi:10.1371/journal.pone.0159015. e0159015.
OpenUrl CrossRef

[45] Hall LH,

[46] Johnson J,

[47] Watt I,

[48] et al.

[49] 12.↵
Sirriyeh R,
Lawton R,
Gardner P,
Armitage G
(2010) Coping with medical error: a systematic review of papers to assess the effects of involvement in medical errors on healthcare professionals’ psychological well-being. Qual Saf Health Care 19(6), doi:10.1136/qshc.2009.035253. e43.
OpenUrl Abstract/FREE Full Text

[50] Sirriyeh R,

[51] Lawton R,

[52] Gardner P,

[53] Armitage G

[54] 13.↵
Hodkinson A,
Zhou A,
Johnson J,
et al.
(2022) Associations of physician burnout with career engagement and quality of patient care: systematic review and meta-analysis. BMJ 378, doi:10.1136/bmj-2022-070442, pmid:36104064. e070442.
OpenUrl Abstract/FREE Full Text

[55] Hodkinson A,

[56] Zhou A,

[57] Johnson J,

[58] et al.

[59] 14.↵
Chan ST,
Khong PCB,
Wang W
(2017) Psychological responses, coping and supporting needs of healthcare professionals as second victims. Int Nurs Rev 64(2):242–262, doi:10.1111/inr.12317, pmid:27679402.
OpenUrl CrossRef PubMed

[60] Chan ST,

[61] Khong PCB,

[62] Wang W

[63] 15.↵
Robertson JJ,
Long B
(2018) Suffering in silence: medical error and second victim syndrome. J Emerg Med 54(4):402–409, doi:10.1016/j.jemermed.2017.12.001.
OpenUrl CrossRef PubMed

[64] Robertson JJ,

[65] Long B

[66] 16.↵
Simms-Ellis R,
Harrison R,
Sattar R,
et al.
(2025) Avoiding ‘second victims’ in healthcare: what support do staff want for coping with patient safety incidents, what do they get and is it effective? A systematic review. BMJ Open 15(2), doi:10.1136/bmjopen-2024-087512, pmid:39929502. e087512.
OpenUrl Abstract/FREE Full Text

[67] Simms-Ellis R,

[68] Harrison R,

[69] Sattar R,

[70] et al.

[71] 17.↵
Riley R,
Spiers J,
Buszewicz M,
et al.
(2018) What are the sources of stress and distress for general practitioners working in England? A qualitative study. BMJ Open 8(1), doi:10.1136/bmjopen-2017-017361, pmid:29326181. e017361.
OpenUrl Abstract/FREE Full Text

[72] Riley R,

[73] Spiers J,

[74] Buszewicz M,

[75] et al.

[76] 18.↵
Hussan A,
Satheeskaran M,
Dho H,
et al.
(2024) GP perceptions of informal peer support in primary care: a qualitative study. BJGP Open doi:10.3399/BJGPO.2023.0151.
OpenUrl Abstract/FREE Full Text

[77] Hussan A,

[78] Satheeskaran M,

[79] Dho H,

[80] et al.

[81] 19.↵
Spiers J,
Buszewicz M,
Chew-Graham CA,
et al.
(2017) Barriers, facilitators, and survival strategies for GPs seeking treatment for distress: a qualitative study. Br J Gen Pract doi:10.3399/bjgp17X692573, pmid:28893766.
OpenUrl Abstract/FREE Full Text

[82] Spiers J,

[83] Buszewicz M,

[84] Chew-Graham CA,

[85] et al.

[86] 20.↵
Royal College of General Practitioners
(2025) Nearly three quarters of GPs say patient safety is being compromised by their workload, as concerns are raised over new reforms. accessed. https://www.rcgp.org.uk/news/workload-concerns-polling. 16 Sep 2026.

[87] Royal College of General Practitioners

[88] 21.↵
Department of Health and Social Care,
Prime Minister’s Office 10 Downing Street
(2025) Fit for the future: 10 year health plan for England — executive summary. accessed. https://www.gov.uk/government/publications/10-year-health-plan-for-england-fit-for-the-future/fit-for-the-future-10-year-health-plan-for-england-executive-summary. 16 Sep 2026.

[89] Department of Health and Social Care,

[90] Prime Minister’s Office 10 Downing Street

[91] 22.↵
Braun V,
Clarke V
(2021) Thematic analysis: a practical guide to understanding and doing (SAGE Publications Ltd, London).

[92] Braun V,

[93] Clarke V

[94] 23.↵
Neubauer BE,
Witkop CT,
Varpio L
(2019) How phenomenology can help us learn from the experiences of others. Perspect Med Educ 8(2):90–97, doi:10.1007/s40037-019-0509-2, pmid:30953335.
OpenUrl CrossRef PubMed

[95] Neubauer BE,

[96] Witkop CT,

[97] Varpio L

[98] 24.↵
Bryman A
(2008) Social research methods. (Oxford University Press, Oxford), 3rd edn.

[99] Bryman A

[100] 25.↵
Dodgson JE
(2019) Reflexivity in qualitative research. J Hum Lact 35(2):220–222, doi:10.1177/0890334419830990.
OpenUrl CrossRef PubMed

[101] Dodgson JE

[102] 26.↵
Braun V,
Clarke V
(2006) Using thematic analysis in psychology. Qual Res Psychol 3(2):77–101, doi:10.1191/1478088706qp063oa.
OpenUrl CrossRef

[103] Braun V,

[104] Clarke V

[105] 27.↵
Braun V,
Clarke V
(2023) Toward good practice in thematic analysis: avoiding common problems and be(com)ing a knowing researcher. Int J Transgend Health 24(1):1–6, doi:10.1080/26895269.2022.2129597, pmid:36713144.
OpenUrl CrossRef PubMed

[106] Braun V,

[107] Clarke V

[108] 28.↵
Michie S,
Atkins L,
West R
(2014) The behaviour change wheel: a guide to designing interventions (Silverback Publishing, London).

[109] Michie S,

[110] Atkins L,

[111] West R

[112] 29.↵
Tazzyman A,
Bryce M,
Walshe K,
Boyd A
(2019) Identifying and managing concerns about GPs in England: an interview study and case-series analysis. Br J Gen Pract doi:10.3399/bjgp19X703733, pmid:31064744.
OpenUrl Abstract/FREE Full Text

[113] Tazzyman A,

[114] Bryce M,

[115] Walshe K,

[116] Boyd A

[117] 30.↵
Wailling J,
Kooijman A,
Hughes J,
O’Hara JK
(2022) Humanizing harm: using a restorative approach to heal and learn from adverse events. Health Expect 25(4):1192–1199, doi:10.1111/hex.13478, pmid:35322513.
OpenUrl CrossRef PubMed

[118] Wailling J,

[119] Kooijman A,

[120] Hughes J,

[121] O’Hara JK

[122] 31.
Raja S,
Litle VR
(2021) The critical role of learning from investigating and debriefing adverse events. J Thorac Dis 13(Suppl 1):S3–S7, doi:10.21037/jtd-2020-epts-01, pmid:34447586.
OpenUrl CrossRef PubMed

[123] Raja S,

[124] Litle VR

[125] 32.↵
Liukka M,
Steven A,
Moreno MFV,
et al.
(2020) Action after adverse events in healthcare: an integrative literature review. Int J Environ Res Public Health 17(13), doi:10.3390/ijerph17134717, pmid:32630041. 4717.
OpenUrl CrossRef PubMed

[126] Liukka M,

[127] Steven A,

[128] Moreno MFV,

[129] et al.

[130] 33.↵
Lane MA,
Newman BM,
Taylor MZ,
et al.
(2018) Supporting clinicians after adverse events: development of a clinician peer support program. J Patient Saf 14(3):e56–e60, doi:10.1097/PTS.0000000000000508, pmid:29878948.
OpenUrl CrossRef PubMed

[131] Lane MA,

[132] Newman BM,

[133] Taylor MZ,

[134] et al.

[135] 34.↵
Aubin DL,
Soprovich A,
Diaz Carvallo F,
et al.
(2022) Support for healthcare workers and patients after medical error through mutual healing: another step towards patient safety. BMJ Open Qual 11(4), doi:10.1136/bmjoq-2022-002004, pmid:36588324. e002004.
OpenUrl Abstract/FREE Full Text

[136] Aubin DL,

[137] Soprovich A,

[138] Diaz Carvallo F,

[139] et al.

[140] 35.↵
Zwart DLM,
Steerneman AHM,
van Rensen ELJ,
et al.
(2011) Feasibility of centre-based incident reporting in primary healthcare: the SPIEGEL study. BMJ Qual Saf 20(2):121–127, doi:10.1136/bmjqs.2009.033472, pmid:21209136.
OpenUrl Abstract/FREE Full Text

[141] Zwart DLM,

[142] Steerneman AHM,

[143] van Rensen ELJ,

[144] et al.

[145] 36.↵
Rea D,
Griffiths S
(2016) Patient safety in primary care: incident reporting and significant event reviews in British general practice. Health Soc Care Community 24(4):411–419, doi:10.1111/hsc.12221.
OpenUrl CrossRef PubMed

[146] Rea D,

[147] Griffiths S

[148] 37.↵
Cooper AJ,
Behrens DA,
Jones SE,
et al.
(2025) Understanding the impact of employee investigations on those who lead them: a case study from NHS Wales. Adm Sci 15(6):211, doi:10.3390/admsci15060211.
OpenUrl CrossRef

[149] Cooper AJ,

[150] Behrens DA,

[151] Jones SE,

[152] et al.

[153] 38.↵
McAnee G,
Norwood K,
Leavey G
(2024) Qualitative study investigating the professional and personal effects of patient suicide on general practitioners in Northern Ireland. BMJ Open 14(2), doi:10.1136/bmjopen-2023-077940, pmid:38341208. e077940.
OpenUrl Abstract/FREE Full Text

[154] McAnee G,

[155] Norwood K,

[156] Leavey G

[157] 39.↵
Bourne T,
De Cock B,
Wynants L,
et al.
(2017) Doctors’ perception of support and the processes involved in complaints investigations and how these relate to welfare and defensive practice: a cross-sectional survey of the UK physicians. BMJ Open 7(11), doi:10.1136/bmjopen-2017-017856, pmid:29162574. e017856.
OpenUrl Abstract/FREE Full Text

[158] Bourne T,

[159] De Cock B,

[160] Wynants L,

[161] et al.

Main menu

User menu

Search

Moving on from patient safety incidents

a qualitative study exploring GP perspectives in England

Abstract

How this fits in

Introduction

Method

Study design

Participants and recruitment

Data collection

Data analysis

Reflexivity

Ethical considerations

Public involvement

Results

Personal and professional consequences

Psychological impacts

Work-related and occupational impacts

Recovery and learning processes

Acknowledging and accepting errors

Accessing emotional support

Learning and reflection

Barriers to healing

Time and resources

Interpersonal barriers

External investigation processes

Mapping findings to the theoretical domains framework

Discussion

Summary

Strengths and limitations

Comparison with existing literature

Implications for practice

Notes

Funding

Ethical approval

Provenance

Acknowledgements

Competing interests

References

Citation Manager Formats

Jump to section

Keywords

More in this TOC Section

Related Articles

Cited By...

NAVIGATE

RCGP

MY ACCOUNT

NEWS AND UPDATES

AUTHORS & REVIEWERS

CUSTOMER SERVICES

CONTRIBUTE

CONTACT US