Background and objectives: This project investigates the policies informing emotional and psychological support for healthcare staff after involvement in patient safety incidents, the support provided in practice, and the terminology used to describe those involved.

Method: In a qualitative study design, semi-structured interviews were conducted with 27 healthcare professionals in England, with management, supervisory, or policy responsibility, to answer two research questions: 1) the policies, protocols, and practices they were aware of that aim to support healthcare personnel in their organisation who have experienced unanticipated adverse or near miss medical events, and 2) their views about the term “second victim”. Thematic analysis was chosen to analyse the interview data.

Findings: Four themes were developed: 1) Severe and enduring impact; 2) Absence of policies; 3) No certainty of support; 4) Language undermines support. A notable gap exists between rhetoric about staff wellbeing, including in national and international healthcare policy reports, and the rarity of structured support after patient safety incidents (PSI). Staff are impacted both by the incidents and by the way their organisation treats them. Informal support depends upon the goodwill of close colleagues, and may not be available. There is an imbalance between the high expectations placed on staff and the support resources they can access. Routine language usage in healthcare negatively impacts support provision. The established “second victim” concept accurately reflects the feelings of staff affected by PSI, but is not a stable construct, has unwelcome connotations, and causes offence to some patient representatives.

Conclusions: There are many national and international policy recommendations to support staff emotionally and psychologically after PSI. A small number of policies require support provision, without stipulating how. Support programmes known to exist are mostly in North America. In the UK, support is lacking, and necessary components of structured support are identified