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Never Events in UK General Practice

A Survey of the Views of General Practitioners on Their Frequency and Acceptability as a Safety Improvement Approach

Stocks, Susan J. PhD*; Alam, Rahul PhD*†; Bowie, Paul PhD‡§; Campbell, Stephen PhD*†∥; de Wet, Carl MRCGP, MFPHM; Esmail, Aneez PhD, MRCGP, MFPHM*†; Cheraghi-Sohi, Sudeh PhD*†

doi: 10.1097/PTS.0000000000000380
Original Article: PDF Only

Background Never events (NEs) are serious preventable patient safety incidents and are a component of formal quality and safety improvement (Q&SI) policies in the United Kingdom and elsewhere. A preliminary list of NEs for UK general practice has been developed, but the frequency of these events, or their acceptability to general practitioner (GPs) as a Q&SI approach, is currently unknown. The study aims to estimate (1) the frequency of 10 NEs occurring within GPs' own practices and (2) the extent to which the NE approach is perceived as acceptable for use.

Methods General practitioners were surveyed, and mixed-effects logistic regression models examined the relationship between GP opinions of NE, estimates of NE frequency, and the characteristics of the GPs and their practices.

Results Responses from 556 GPs in 412 practices were analyzed. Most participants (70%–88%, depending on the NE) agreed that the described incident should be designated as a NE. Three NEs were estimated to have occurred in less than 4% of practices in the last year; however, two NEs were estimated to have occurred in 45% to 61% of the practices. General practitioners reporting that a NE had occurred in their practice in the last year were significantly less likely to agree with the designation as a NE compared with GPs not reporting a NE (odds ratio, 0.42; 95% CI = 0.36–0.49).

Conclusions The NE approach may have Q&SI potential for general practice, but further work to adapt the concept and content is required.

This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

From the *NIHR Greater Manchester Primary Care Patient Safety Translational Research Centre, University of Manchester, Manchester; †Centre for Primary Care, Institute of Population Health, University of Manchester, Williamson Building, Manchester; ‡NHS Education for Scotland, Glasgow; §Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom; ∥Centre for Research and Action in Public Health (CeRAPH), University of Canberra, Bruce, Australian Capital Territory; and ¶School of Medicine, Gold Coast Campus, Griffith University, Nathan, Queensland, Australia.

Correspondence: Susan J. Stocks, PhD, GM PSTRC, Suite 10, 7th Floor Williamson Bldg, University of Manchester, Oxford Road, Manchester, M13 9PL (e-mail:

The National Institute for Health Research Greater Manchester Primary Care Patient Safety Translational Research Centre (NIHR GM PSTRC) and NHS Education for Scotland funded this study. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR, or the Department of Health.

The authors disclose no conflict of interest.

University of Manchester Ethics Committee 2 Approval 14027.

Raw data (numerical only) is available from

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