What is SBAR?

SBAR stands for Situation, Background, Assessment, Recommendation. It is a structured communication framework originally developed by the US Navy and adapted for healthcare by Kaiser Permanente in the early 2000s. It is now widely adopted across the NHS and recommended by NHS England, the Royal College of Physicians, and the World Health Organisation as a best-practice tool for clinical handovers.

SBAR provides a predictable structure for conveying critical patient information between clinicians. By standardising the format of handover communication, it reduces the risk of important details being missed, misunderstood, or forgotten — a leading cause of adverse events in healthcare settings.

The Four Elements of SBAR

S — Situation

A concise statement of the current problem or reason for the handover. This answers the question: What is happening right now? For example: "Mrs Jones in Bed 4 is reporting increased pain and her observations show a rising NEWS2 score."

B — Background

The relevant clinical context. This includes the patient's diagnosis, relevant medical history, current treatment plan, and any recent changes. It answers: What led to this situation?

A — Assessment

The clinician's professional judgement of what is happening. This is where clinical reasoning is communicated: What do I think the problem is? For example: "I believe this may indicate post-operative infection."

R — Recommendation

The specific action being requested or suggested. This answers: What do I need you to do? For example: "I recommend reviewing the patient within the next 30 minutes and considering IV antibiotics."

Why SBAR Matters in the NHS

Communication failures are the most common root cause of serious incidents in healthcare. Research published in the BMJ found that poor handover communication contributes to an estimated 80% of serious medical errors.

SBAR addresses this by:

Reducing variability — Every handover follows the same predictable structure, regardless of who is communicating.
Empowering junior staff — The framework gives less experienced clinicians a clear structure for escalating concerns to senior colleagues.
Creating accountability — The Recommendation element ensures that a clear action is always requested, reducing ambiguity.
Supporting audit and governance — When SBAR handovers are digitally recorded, they create an evidence trail for CQC inspections and clinical governance reviews.