A Significant Adverse Incident (SAI) is an internal but formal investigation by the Health and Social Care Trust into a particular event, treatment or medical emergency which occurred in a Health and Social Care Setting and which has the potential to cause a ‘significant’ or ‘adverse’ loss or injury to the patient or medical team, or Trust involved.

Once the SAI investigation is finalised, an SAI Report is published and provided to the injured parties, involved clinicians and relevant Trust departments.

The type of incident that is reportable under SAI doesn’t necessarily have to involve grave medical mistakes which cause immediate and/or obvious loss, it can also include near misses, lack of medical intervention, review of a patient’s previous care or wider patient safety concerns.

The purpose behind the SAI is to essentially identify:

What happened:

The SAI investigation will involve a review into the patient’s circumstances, medical history, health conditions and any relevant procedures in an attempt to create a timeline of events and timeline of clinician/department involvement to identify which decisions were made in the patient’s care.

What went wrong:

Following a detailed review of the medical notes and interviews with relevant clinicians, the SAI report will then confirm whether any errors, omissions, delay and/or failures arose, by who and when. In our experience, this is arguably the most important information for the patient/family of the patient.

What happened to the patient as a result:

The report will likely confirm how the patient and/or their care was affected as a result, whether and how the patient potentially deteriorated, whether further treatment/medical intervention was required, and whether transfer to another ward or trust facility was indicated.

Most importantly, what learning outcomes and/or steps might be taken to ensure that such an incident does not happen again:

The main purpose of the SAI investigation is to determine whether any failing arose on behalf of the relevant Health and Social Care Trust on that occasion which was a breach in the duty of care to the patient.

Examples of this include whether there is a need for formal disciplinary steps to be taken in relation to individual clinicians, whether training is required to certain departments/wards, whether a change in Trust policy should be warranted and whether face to face meetings with the patient and/or their family should be undertaken.

Does an SAI mean medical negligence has occurred?

An SAI report will not always conclude that failings have arisen, and an SAI is not raised in every case where ultimately medical treatment is found to be negligent or to have caused a loss.

However, where an SAI has identified failings on behalf of the Trust, those findings may be relevant when considering whether the treatment provided fell below the standard expected of a reasonably competent healthcare professional in that speciality.

Why is an SAI important for a medical negligence claim?

An SAI is usually undertaken within weeks or months of the incident in question and you will be contacted at the outset and upon completion. If you are considering obtaining legal advice upon the findings in an SAI report, it is important to inform your solicitor as soon as possible that an SAI investigation is taking place. The SAI investigation does not determine a legal breach of duty itself, and it is always recommended to seek legal advice for guidance in this respect, as the findings and recommendations may be valuable to your legal team when investigating a potential medical negligence action.  

Every case will turn on its own facts ultimately, but where the SAI confirms failings in care provided by the Trust, then this may support pursuit of formal legal action to recover compensation for injuries attributable to the failings identified in the SAI report..  

We can help you:

If you or your family member have received a Significant Adverse Incident Report,   Notification of an SAI investigation or a Significant Event Audit (SEA), which is an audit of a healthcare trust or GP’s practices to review unexpected, adverse or near miss incidents), our specialist medical negligence solicitors will be happy to advise you on your legal options and next steps. Email [email protected] or via telephone on 028 9043 4015 or 028 9181 1538.