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J Eval Clin Pract. 2018 Apr;24(2):362-368. doi: 10.1111/jep.12849. Epub 2017 Nov 17.

Incident reporting behaviours following the Francis report: A cross-sectional survey.

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ST5 Cardiology and Clinical Research Fellow, Sheffield Teaching Hospital NHS Foundation Trust, Sheffield, UK.
ST7 Anaesthetics, Sheffield Teaching Hospital NHS Foundation Trust, Sheffield, UK.



Previous studies have shown a lack of engagement in the reporting process. There is limited evidence about whether attitudes and behaviours of doctors in the UK towards incident reporting have changed following the events at Mid Staffordshire National Health Service Foundation Trust and the recommendations that followed. We conducted a relatively large survey of doctors, aiming to assess whether doctors recognised incidents and reported them accordingly, along with their behaviours towards reporting and their suggestions of how incident reporting may be improved.


A cross-sectional survey of doctors was undertaken in 11 hospitals in the north of England. The participants (n = 581) were invited to take part in an electronic questionnaire. Demographics were obtained, and engagement with the incident reporting process was assessed, including an estimate of the number of incidents which were witnessed but not actually reported. Factors which influenced reporting behaviours were recorded. Free-text comments were encouraged. A mixed method analysis of the responses was performed.


Doctors do not appear to be engaging with the incident reporting process-in particular, junior doctors. The main reason given for not completing forms was not having enough time (38.2% of respondents), primarily due to the length and complexity of forms. Many doctors, 43.7%, witnessed more than 5 incidents, but only 13.3% of doctors submitted more than 5 reports. Free text comments revealed 4 themes which impact upon reporting behaviours: organisational issues, form structure, a culture of blame, and a lack of feedback. Several suggestions for improvement were made.


Little has changed in the attitudes and behaviours of doctors. Improving incident reporting form structure to make it more user-friendly and improving feedback may engage doctors and lead to an improved safety culture. The way the medical profession reports serious and other incidents still needs to be improved.


behaviour; error; governance; incident; patient safety; reporting

[Indexed for MEDLINE]

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