Bowtie Analysis as a prospective risk assessment technique in primary healthcare

Despite repeated calls for the use of proactive assessment of serious significant events in primary healthcare, GP teams in the UK rarely apply the kind of formal methods of prospective risk assessment that are commonly used in high-hazard industries. NHS Education for Scotland (NES) conducted an exploratory workshop to assess the potential value of Bowtie Analysis (BTA) as a means of proactively identifying and assessing the controls relied on to protect against the risk of a potential primary care ‘never event’. It was concluded that BTA could provide a straightforward approach to engage frontline care practitioners and managers in proactively assessing risk. However, concerns remain about the level of training, support and resources that would be required for the healthcare community to be capable of conducting BTA to an adequate quality standard without having to rely on external facilitators.