question marks.jpg

Can we look into your concern?

Find out how we decide to take a national investigation forward.

Every contact we receive is valuable to us. Each one is logged on our database and helps us to identify patterns. This way we can build up a broad picture of safety issues over time.

We investigate concerns based on the way they impact people and services, how widespread the concern might be and whether it is likely to produce safety recommendations that we can share at the widest level across the NHS.

How we decide to investigate


We look at how badly a safety issue has affected the people involved, both physically and emotionally. We usually discuss this with patients, families or carers during our preliminary investigations.

Through these interviews, we're able to build a full picture of how severe the incident is. They also help us to identify the most serious issues as they’ve often had the most impact.

We also look at the impact on services - whether the safety issues have, for example, reduced the ability to deliver safe and reliable care.


We always look at the wider risk associated with the safety issue – how common or widespread a patient safety concern is and whether it spans different areas of healthcare and locations.

Some of the areas we consider include:

  • do various care settings or organisations change the way they work to address a safety issue?
  • have the issues taken a while to be recognised and are they recognised at the right level?
  • has the issue existed over a long period of time and are concerns about that issue consistently raised?
  • will it get worse or spread into different areas of the healthcare system if not addressed?

Learning potential

We always look at whether we have a new perspective so that we can develop meaningful, influential and effective safety recommendations that benefit all of those being cared for by the health service.

What we cannot investigate

Often, we’re unable to investigate patient safety concerns. We know this might be disappointing and frustrating to families, patients and carers who have had a bad experience.

We cannot investigate issues that happened within NHS-funded care in England before April 2017.

We cannot attribute blame or liability to individuals or organisations. Our sole focus is to find out what went wrong in an investigation so we can reduce the risk of it happening again. We investigate the system in which care is given and the way care is organised, but we do not investigate any of the individuals concerned. If you have concerns about individual staff members or particular trusts then we will not be able to help you.

We cannot conduct second opinion investigations for people who are unhappy with a previous one or who have had an unsatisfactory response to a concern. It is also especially difficult for us to investigate an incident previously or currently being investigated by another regulators such as the General Medical Council or by the police.

We have no legal powers. We cannot force NHS trusts to co-operate with us. They need to collaborate with us voluntarily.

If we cannot help

We can only investigate a small number of investigations each year, even if they fit our directions and meet our criteria. However, if we can’t take your patient safety concern forward, or simply aren’t the right people to talk to, there are organisations which may be able to help you.

Get help and support