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WHAT ARE SINGLE CLINICAL INCIDENCES?

 

This module focuses on single clinical incidences (SCI) which are unplanned events which either cause - or have the potential to cause a patient harm. This term is used by the General Medical Council:

A single clinical incident is an allegation of poor clinical care involving a single consultation or procedure.

An SCI usually relates to the care of a single patient and involves a single consultation or clinical procedure. An SCI may encompass a doctor’s whole shift, where the SCI relates to the same clinical issue, e.g. where an obstetrician is alleged to have failed to monitor a CTG trace over several hours. However, allegations about two separate single incidents cannot be considered an SCI, for example about more than one consultation or doctor’s shift, for example if an anaesthetist fails to appropriately monitor several unconscious patients’ observations during an endoscopy list.

In addition, the GMC identifies the ‘significant event’ which is any unintended or unexpected event, which could or did lead to harm of one or more patients. This includes incidents which did not cause harm but could have done, or where the event should have been prevented.

The GMC advises trainees to reflect on such events in their portfolio:

• https://www.gmc-uk.org/registration-and-licensing/managing-your-registration/revalidation/guidance-on-supporting-information-for-appraisal-and-revalidation/your-supporting-information---significant-events

When an SCI has been reported, the GMC advises the case examiners to assess whether the information about the incident indicates that there may have been a serious failure to meet the standards in Good Medical Practice (GMC 2013). In addition, case examiners are advised that it is important that the outcome of the incident should not be considered in isolation. Case examiners must consider the circumstances in which the incident occurred, including the extent to which the doctor’s actions fell below what could reasonably be expected of a practitioner at his or her grade and level of experience. For example, the case examiners consider whether the doctor was in a training grade and what, if any, supervision, and support mechanisms were in place.

 

Action Point 2 Search for your trust’s annual report. What key themes and learning points are identified in it? How is the report disseminated? Ask to be an observer at the next Quality Committee meeting to deepen your understanding of SCIs. It might give you ideas for a continuous improvement activity that you might like to get involved in or take forward.