HMN 2026: How Patient safety incidents leave lasting scars on physicians

Researchers have studied the emotional and professional impact of patient safety incidents on physicians, as well as the crucial support mechanisms that can help them move on from these events.

Patient safety incidents (PSIs) are unintended or unexpected events that could have or did lead to harm for patients. While the primary focus following these events is understandably on patient well-being and recovery, PSIs can also have psychological and professional effects on health providers.

The research interviewed physicians to understand how they experience and recover from PSIs.

The research found that PSIs often had lasting emotional impacts on health providers. Participants described feelings of guilt, anxiety, self-blame, rumination and loss of confidence following incidents.

For some, these experiences contributed to defensive practice, sickness absence, changes in working arrangements and, for some, questioning their long-term future in general practice.

However, the interviews also revealed factors that supported recovery. Health providers highlighted the value of emotional support from colleagues, compassionate and open discussions about incidents, opportunities to reflect and learn, and recognizing that incidents often arise within complex systems rather than individual failings.

The findings are published today in the British Journal of General Practice.

James Tawse, lead researcher and Ph.D. student at the University of Manchester, said, “Patient safety incidents are an inevitable reality of complex health care systems, and our findings show that the impact on health providers can be profound and long-lasting.

“Recovery following incidents should not be viewed as the responsibility of individual health providers alone. Organizations, leaders and health care systems all have a role in creating compassionate, blame-free environments where clinicians feel supported to reflect, learn, recover and continue providing safe care.”

Barriers to recovery include heavy workloads, limited time and resources, fear of judgment, professional isolation, and stressful external investigations, such as referral to the General Medical Committee, which often made it more difficult for clinicians to seek support and recover following incidents.

Professor Carolyn Chew-Graham, professor of general practice research at Keele University, said, “Health providers interviewed shared very personal experiences of how patient safety incidents (PSIs) had impacted them.

“Some reflected on the importance of support from within their practice teams, which had been helpful, but most suggested that access to more formal support had been absent. Given the rising workload in general practice, it is vital that more formal support is offered to health providers, not just when a PSI occurs, but to enable them to manage everyday work.”

The findings suggest that improving recovery after patient safety incidents requires a systems-focused and blame-free approach, rather than relying on individual practitioner resilience. Researchers suggest that governing bodies have an important role in addressing structural barriers such as workload pressures and access to support, while practice leaders and teams should foster cultures based on compassion and nonpunitive support.

Professor Darren Ashcroft, director of the NIHR Greater Manchester PSRC, said, “This research highlights a critical but often overlooked aspect of patient safety—the impact of incidents on the clinicians involved.

“At the NIHR Greater Manchester Patient Safety Research Collaboration, we recognize that improving patient safety requires more than preventing harm; it also means supporting the workforce when things go wrong. These findings reinforce the need for a compassionate, systems-based approach that enables learning, supports recovery and ultimately strengthens safer care for patients.”

The researchers hope the findings will contribute to improved support for clinicians following patient safety incidents, strengthen patient safety practices, and support well-being and retention within the physician workforce.

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