Published on Monday 11th February 2002
Foreword
Executive
Summary
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| Foreword | ||||
| I write after my first year as Chairman of SASM at a time when this audit has been undergoing a period of change. This has predominantly been in order to streamline and unify methodology and the organisational structure of the Audit. This allows for more comprehensive staffing with better cover of the remaining offices. As many will be aware, SASM has introduced ballots for key roles in the organisation and has opened up the role of assessor to all interested clinicians. As part of the reorganisation of the office structure the Aberdeen office has already closed and we are very grateful to the local staff for their understanding of the situation. SASM is moving towards a position where before long there will be two offices, one based in the West, in Glasgow and one in the East, in Dundee. These offices will be very clearly identified with the two surgical Royal Colleges in Scotland, Glasgow and Edinburgh. This will make it apparent to all that the basis of this audit is neither governmental nor health service in origin but entirely separately organised. This will enable clear independent messages to emerge, which will then be fed to the Scottish Executive and the National Health Service in Scotland. This principle is vital for the future of SASM. Turning to the report itself, SASM continues to be very well supported by the clinicians in Scotland. There has been a slight fall in the compliance rate of cases returned during the same period due to a number of consultants not participating to the agreed standard. With the advent of clinical governance and the reliance that will be placed on accurate audit data for appraisal, clinical outcomes and even revalidation, it will be the responsibility of everyone to encourage those who, for whatever reason, are finding compliance a difficult issue. A successful Scottish audit removes the need for the National Health Service in Scotland to institute any other form of data collection of this type. We must not let SASM and its potential go to waste. That we can validate our data is without question and the depth of the scrutiny that takes place, |
| which now includes a 10% random sampling of cases without any apparent adverse event, ensures that the information produced by the Audit is very robust. I congratulate everyone on their continued enthusiasm in maintaining this standard. So many different aspects of SASM constitute unique achievements. It is very encouraging that year on year there continues to be a fall in deaths following elective admissions, both as an absolute number and as a percentage of the number of elective admissions. It is also very commendable that there is an extremely high consultant input into the clinical management of the cases reported. This includes decision-making and direct involvement of consultant surgeons and anaesthetists in patients undergoing operations. This also shows that senior supervision of those in training is a very strong facet of the National Health Service in Scotland. It is of some concern that 1 in 5 deaths following operative and "non-operative" care are recorded as having an adverse event. From 2002 SASM will be able to allocate these adverse events to specific areas of care – clinical, resource and other. The conclusions of the audit this year speak for themselves and indicate some important areas, which we will take to our discussions with the Chief Medical Officer and the Scottish Executive. We also propose to enable all clinicians to see how they compare alongside their peers so that we move to an ever more open way of conducting our audit process. Change is part of the clinical scene that keeps the Profession and the National Health Service progressive and meeting the needs of the public. This change is being managed in a positive and I believe successful way. I congratulate all involved.
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Professor John Temple President, Royal College of Surgeons of Edinburgh and Chairman of SASM Executive Group
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