Harm Free Care - elearning for healthcare
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This programme is in partnership with...
  • NHS Quest
  • eVTE
  • NHS

About the Harm Free Care programme

Patients are at the heart of everything we do. They are our driving force. They inspire and motivate our need for change. We are committed to improving their experience of healthcare by reducing errors which lead to harm.

elearning for Harm Free Care is an online educational resource designed to support frontline teams in delivering harm free care, as defined by an absence of four common harms: pressure ulcers, harm from falls, urine infections in patients with a catheter, and venous thromboembolism (VTE).

The curriculum is designed to help effectively deliver harm free care to patients through a unique blend of quality improvement methods, leadership, highly reliable clinical care processes and supporting infrastructure. There is a focus on the fundamental issue of care (Hourly Nursing Rounds, nutrition, hydration, equipment provision, and medication reconciliation) and the four common harms (pressure ulcers, harm from falls, urine infections in patients with a catheter and VTE).

We recognise the vast amount of quality improvement work many of you have already done in parts of an organisation, so this is not about starting again – it’s about building on what you already have in place.

So where do you start?

The curriculum has been divided into pre-work and two main sections.

More information

We know the challenge is big. But it isn’t a path we expect you to walk alone. The diagram below identifies the key drivers which will ultimately deliver success. If we focus on these core areas, we will achieve our aim of delivering harm free care.

To further explain, the driver diagram should be read from right to left. The secondary drivers feed the overall aim. So by working through each of the drivers, you will accomplish our aim of delivering harm free care to our patients.


Use the 3 primary drivers and 9 secondary drivers to focus your education. Choose from the following modules:

Safety Science informs the need for improvement

The last decade has seen an increase in the application of safety science applied to healthcare and the findings are fascinating. Under scrutiny, it has showed that the reliability of basic care processes is in need of improvement in almost all non fatal care processes; undertake the pre-work to learn more about the model for improvement.

Leadership is everyone’s responsibility

Safety leadership doesn’t just rest on the shoulders of one person, it is the role of everyone within your organisation to drive the plan forwards; undertaking the leadership module will help you to develop your personal leadership skills. More information can be found in the LeAD programme.

Hourly Nursing Rounds

Hourly Nursing Rounds bring a proactive nurse-led approach to the basics of nursing care using an agreed check of 6-8 fundamentals each hour. The nurse is able to reduce calls between visits, increase patient satisfaction and potentially avoid common harms such as falls and pressure damage. Learn how to implement rounding effectively and how to measure its impact.


Learn how to deliver good nutritional care with high levels of reliability and understand the importance of nutritional screening and how to screen properly.


Hydration is just as important as nutrition. Learn about the signs and symptoms of dehydration and practical tips to improve the hydration of your patients.


Test your knowledge and enhance your learning about VTE, how to undertake a VTE risk assessment and how to prevent and treat VTE. More information can be found in the e-VTE programme.

Meet the team

  • Maxine Power

    Maxine Power

    National Improvement Advisor and QIPP Safe Care work stream lead
  • Katherine Fenton

    Katherine Fenton

    Chief Nurse, University College London Hospitals NHS Foundation Trust
  • Ailsa Brotherton

    Ailsa Brotherton

    QIPP Safe Care work stream Programme Directory and Knowledge Management lead
  • Nicola Bell

    Nicola Bell

    Research Assistant, Quality Improvement in Patient Safety, University of Central Lancashire
  • elfh-staff-Neha-Baj-learning-profile

    Neha Baj

    Senior Project Manager, HEE elearning for healthcare
  • David Foster

    David Foster

    Deputy Chief Nursing Officer
  • Lyn McIntyre

    Lyn McIntyre

    Head of Operations: Quality and Nursing, NHS Midlands and East
  • Christine Russell

    Christine Russell

    Chair (Faculty), BAPEN

How to access

In order to access the Harm Free Care programme, you will need an elfh account. If you do not have one, then you can register by selecting the Register button below.

Register >

To view the Harm Free Care programme, select the View button below. If you already have an account with elfh, you will also be able to login and enrol on the programme from the View button.

View >

Care home or hospice staff

To register for the Harm Free Care programme, select the Register button Above. Select the option ‘I am a care home or hospice worker’ then enter your care home / hospice name or postcode and select it from the options available in the drop down list. Finally enter your care home / hospice registration code and select ‘Register’. You may need to see your employer to get this code.

If your employer does not have a code, then they need to contact the elfh Support Team. The Support Team can either give the employer the registration code or arrange a bulk upload of all staff.

Social care professionals

Access to elfh content is available to all social care professionals in England whose employers are registered with the Skills for Care National Minimum Data Set for Social Care (NMDS-SC). Every employer providing NMDS-SC workforce information to Skills for Care has been given a user registration code for their staff. This code enables you to self-register for access to Harm Free Care. Please contact your employer for more details about the registration code. For information about registering your organisation with the NMDS-SC your employer should access www.nmds-sc-online.org.uk or contact the Skills for Care Support Service on 0845 8730129.

If you have a registration code, you can register by clicking here.

NHS healthcare staff in England

The Harm Free Care programme is also available to NHS healthcare staff via the Electronic Staff Record (ESR). Accessing this elearning via ESR means that your completions will transfer with you throughout your NHS career.

Further details are available here.

Not an NHS organisation?

If you are not an NHS health or care organisation and therefore do not qualify for free access elfh Hub, you may be able to access the service by creating an OpenAthens account.

To check whether or not you qualify for free access via OpenAthens, you can view the eligibility criteria and register on the ‘OpenAthens’ portal.

Registering large numbers of users

If you are a HR, IT or Practice Manager and would like to register and enrol large numbers of staff within your organisation for access onto the Harm Free Care programme, please contact elfh directly.

Organisations wishing to use their own LMS

For HR departments wanting to know more about gaining access to courses using an existing Learning Management System please contact elfh directly to express interest.

More information

Please select the following link for more information on how to use the elfh Hub.

elfh is a NHS England programme in partnership with the NHS and professional bodies