Summary
Despite growing recognition of the moral, practical, and quality-based arguments for involving patients and families in learning responses after safety incidents, their voices remain largely absent from the After Action Review (AAR) process in healthcare settings across England. This guidance aims to change that by offering a clear, structured approach to patient and family involvement in AARs—one of the most widely used tools under the NHS Patient Safety Incident Response Framework (PSIRF).
Content
Drawing on over 15 years of experience in facilitating AARs and training hundreds of healthcare professionals, this document outlines four distinct 'Routes to Involvement', each tailored to different levels of patient engagement and organisational readiness. It also provides a detailed 'Process for Involvement', including the roles, resources, and activities required to ensure safe, meaningful, and effective participation.
The guidance acknowledges the tensions between staff psychological safety, organisational learning needs, and the emotional and informational needs of patients and families. It offers practical strategies to manage these tensions, mitigate risks such as re-traumatisation or tokenism, and maximise the benefits of involvement—including improved learning, restored trust, and enhanced recovery.
Key success factors include:
- Adequate resourcing to support involvement activities.
- Skilled facilitation by trained AAR Conductors.
- Engaged leadership to embed patient involvement into organisational culture.
The report acknowledge participants of the Patient Safety Partners Network, hosted by Patient Safety Learning who gave feedback on this publication and shared valuable insights about this context. In particular it would like to acknowledge Irum Rela, Patient Safety Partner at East London Foundation Trust who reviewed and contributed to its development.
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