Executive Overview
Clinical safety checks verify that the digital systems you rely on every day keep patients safe, staff confident, and regulators satisfied. For English GP practices, the checks demonstrate compliance with NHS England's digital clinical safety standard DCB0160 and Care Quality Commission (CQC) expectations while preventing costly incidents and rework.
Why Clinical Safety Checks Matter
- They stop small technology glitches from disrupting pathways or delaying care.
- Commissioners, PCNs, and the CQC look for proof that practices review digital risks as part of routine assurance.
- Staff and patients place more trust in systems when they know checks are happening and findings are acted on quickly. This article explains how to build a sustainable routine that delivers those benefits without adding new headcount.
What Counts as a Clinical Safety Check?
Clinical safety checks are scheduled activities that confirm:
- Hazards remain controlled: Each high-risk workflow still follows the mitigations in your hazard log and Clinical Safety Case (DCB0160 Section 2).
- Systems perform as expected: Alerts, routing, and integrations behave correctly after supplier updates or local configuration changes.
- Staff understand escalation routes: Everyone knows how to raise issues, supporting NHS Patient Safety Strategy duties of candour and learning.
- Evidence is captured: Checks create an audit trail for the CQC Safe and Well-led domains and commissioner assurance packs.
Build a Right-Sized Check Cycle
Follow these steps to embed checks without overwhelming the rota.
1. Inventory and Prioritise Your Systems
- List every clinical system (Electronic Patient Record (EPR), online consultation, prescribing, messaging, decision support, shared care records).
- Note the safety-critical workflows each supports and assign a risk score using likelihood versus impact.
- Map supplier update schedules so checks happen close to change windows.
2. Assign Responsibility and Time
- Nominate the Clinical Safety Officer (CSO) as accountable lead with 0.1-0.2 whole-time equivalent (roughly half a day a week) backed by an admin or digital champion.
- Schedule 45-60 minute monthly reviews for high-risk systems and quarterly deep dives for lower-risk tools.
- Integrate the check summary into existing governance meetings or your Primary Care Network (PCN) forum to avoid duplicate sessions.
3. Prepare Supporting Templates
Create three lightweight documents:
- Check Plan - lists systems, owners, frequency, and triggers for additional reviews.
- Safety Check Log - records date, people involved, observations, actions, and target completion dates.
- Issue Escalation Guide - highlights urgent versus routine escalation, with supplier and commissioner contacts. These templates satisfy DCB0160 documentation expectations and can be reused across the network.
What to Examine During Each Check
Focus on tangible signals that indicate drift from safe operation.
| Area | Questions to Ask | Evidence to Capture |
|---|---|---|
| Clinical workflows | Are red-flag symptoms routed correctly? Are urgent tasks picked up within agreed Service Level Agreements (SLAs)? | Test submissions, audit trail screenshots |
| Decision support | Do alerts fire at the right point? Has any override threshold changed? | Alert logs, sample patient records (anonymised) |
| Integrations and data flows | Are messages reaching shared care records? Are remote monitoring feeds updating? | Interface logs, supplier change notes |
| User access and training | Have new starters or locums received access and training? Are permissions still appropriate? | Access reports, training logs |
| Incident and feedback loops | Have staff or patients raised concerns since the last check? Were they resolved on time? | Incident log references, patient feedback summaries |
Metrics That Prove the Checks Are Working
Track a small set of measures to demonstrate impact without extra software:
- Volume and severity of technology-related incidents or near misses.
- Time from issue detection to resolution and outstanding actions.
- Percentage of checks completed on schedule and follow-up tasks closed.
- Staff confidence scores from brief pulse surveys and the number of proactive concerns raised. Use the same measures in quarterly summaries for leadership, commissioners, or PCN partners.
90-Day Implementation Roadmap
Use this roadmap to establish checks quickly.
Month 1 - Foundation
- Confirm CSO responsibility and deputy cover.
- Build your system inventory and risk scores.
- Draft the check plan, log, and escalation guide.
- Brief the wider team on why checks matter and how to report issues.
Month 2 - Pilot and Refine
- Run checks on the two highest-risk systems (often online consultations and repeat prescribing).
- Capture findings in the log and review with the practice manager and CSO.
- Adjust checklists and timings based on effort required and gaps discovered.
Month 3 - Scale and Embed
- Extend checks to remaining high-risk systems.
- Integrate summaries into monthly governance agendas and PCN safety forums.
- Share emerging metrics with commissioners or digital leads to evidence progress.
- Plan quarterly deep dives and annual audit alignment (CQC, NHS England).
Case Study: Meadowbrook Surgery
Meadowbrook Surgery introduced structured checks after repeated online triage issues. By pairing the CSO with a senior receptionist for a 45-minute monthly review, the practice spotted configuration drift soon after supplier releases, fixed routing rules before incidents reached patients, and demonstrated proactive assurance during a commissioner visit.
Common Pitfalls and How to Avoid Them
- Irregular scheduling: If checks stop during busy periods, risks accumulate. Lock check times in rotas and delegate when staff are on leave.
- Paper logs without follow-up: Capture actions with dates and owners; review progress in governance meetings.
- Supplier dependency: Challenge vendors for assurance evidence under the DCB0129 supplier clinical risk management standard and record their responses.
- Limited staff awareness: Refresh training quarterly, especially for locums and remote staff, so issues surface early.
Resources to Reference
- NHS England - Clinical Safety Guidance for GP Electronic Patient Records (2024)
- Digital NHS - Clinical Risk Management Templates
- NHS Patient Safety Strategy - Primary Care Implementation Framework (2024)
- CQC - Expectations for Monitoring National Patient Safety Alerts (2025)
Action Checklist
- Confirm CSO accountability and diary time for checks.
- Build or update your clinical systems inventory with risk scores.
- Launch the safety check log and capture the next review.
- Share outcomes and agreed actions with your governance forum and suppliers.
Key Takeaways
Structured, evidence-backed clinical safety checks reduce technology surprises, strengthen CQC and commissioner confidence, and keep busy primary care teams aligned. Treat them as a practical habit rather than an extra project, and the benefits compound month after month.