The Scottish Audit of Surgical Mortality (SASM) is unique in the United Kingdom. It encompasses nearly all the surgical specialties and all except two eligible Consultant Surgeons and Anaesthetists in Scotland have agreed to participate. SASM identifies all deaths that occur in hospital under the care of a surgeon, whether an operation has taken place or not. SASM forms are completed by the relevant Surgeon and where appropriate Anaesthetist. The forms then undergo a peer review process carried out by virtually
every practising clinician within the audited specialties on behalf of their colleagues. Over 1100 consultants participate and approximately 4,500 deaths are reviewed per year.

The single greatest achievement of SASM is that routine objective peer review of surgical deaths takes place in Scotland. This unique feat is all the more remarkable as current participation in SASM is entirely voluntary. The success of SASM depends totally on the profession's sense of ownership, which is reflected by the very high compliance rates. This in turn is a testament to the commitment of the surgical and anaesthetic clinicians involved to continuous audit in clinical practice