Patient Safety Incident report form – England


Step 1 of 3

  • This form is to be used to record details of medication safety incidents that are related to errors 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 by hand after printing. Read our guidance on completing this form.