This form is to be used to record details of medication safety incidents that are related to errors and near misses that occur within the pharmacy.
It should not be sent to NHS England or the National Reporting and Learning System (NRLS).
This form does not count as formal notification of a dispensing error to the NPA as your indemnity provider; this should be done separately by telephone if appropriate.
Patient information should not be included in this electronic form and should be added after printing.
Read our guidance on completing this form.
The Patient Safety Incident Reporting Service is currently available as a separate pilot service to NPA members in Scotland using the specific Scotland Reporting Form for 'near miss' and 'error' patient safety incidents and will be evaluated every months.