Scottish Audit of Surgical Mortality
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The SASM Process – a legal opinion.

SASM requested an opinion from the Central Legal Office concerning the legal standing of the SASM process and its implications for both participants and assessors. The legal opinion received can be summarised as follows –

  1. The basic structure of SASM and its process is legally sound but the audit cycle would be best served if it were seen to be completed by each participant presenting his/her yearly SASM data at an appraisal meeting.

  1. The participant him/herself is at liberty to disclose any SASM assessment to any third party, but normally no other third party could gain access to that information without the consent of the participant.  The exception to this position would arise if a Trust could provide evidence of poor performance by a SASM participant and a formal investigation was underway with the documented knowledge of the participant.  SASM’s duty of care regarding patient safety would oblige SASM to release audit data without the consent of the participant.

  1. Assessor anonymity must be respected unless the assessor agrees to waive it.  If an assessor were to be named on a SASM document he/she could be drawn into any subsequent legal proceedings relating to the reviewed case as a potential witness.

  1. A SASM participant should always have a right of appeal following any SASM assessment.  If the appeal cannot be resolved “in house” then the appellant should name three or four experts outside their region in the relevant field.  SASM will request a case note review from one of these experts who shall remain anonymous. 

  1. The SASM Board has a duty of care to protect public safety.  If SASM identifies such issues concerning a participant the SASM Board are required to seek further clarification / confirmation.  The participant would be informed of these concerns and his/her co-operation would be sought to investigate the matter further.  If the participant refused to co-operate or further investigation confirmed the safety concerns, the Board would have no option but to inform an appropriate authority (Trust / GMC).