Serious Incidents & Never Events
Serious incidents requiring investigation in healthcare are rare, but when they do occur, everyone must make sure that there are systematic measures in place to respond to them. These measures must protect patients and ensure that robust investigations are carried out, which result in organisations learning from serious incidents to minimise the risk of the incident happening again. When an incident occurs it must be reported to all relevant bodies such as CQC, Local Authority - Safeguarding, NHS Commissioners and the Health Protection Agency.
What is a serious incident?
Serious incidents requiring investigation are defined in the NPSA’s 2010 National Framework for Reporting and Learning from Serious Incidents Requiring Investigation. In summary, this definition describes a serious incident as an incident that occurred during NHS funded healthcare (including in the community), which resulted in one or more of the following;
- unexpected or avoidable death or severe harm of one or more patients, staff or members of the public;
- a never event - all never events are defined as serious incidents although not all never events necessarily result in severe harm or death.
- a scenario that prevents, or threatens to prevent, an organisation’s ability to continue to deliver healthcare services, including data loss, property damage or incidents in population programmes like screening and immunisation where harm potentially may extend to a large population;
- allegations, or incidents, of physical abuse and sexual assault or abuse; and/or
- loss of confidence in the service, adverse media coverage or public concern about healthcare or an organisation.
Serious incidents occuring in care homes should be reported via the Dashboard: www.ardencareportal.nhs.uk
Links