11 May 2025
There has been recent discussion in the media and Scottish Parliament about Significant Adverse Event Reviews (SAERs) carried out by NHS bodies, and whether SAER reports - or learning from these reports - should be proactively published to support public scrutiny, transparency and accountability in this important area.
Significant Adverse Event Reviews are undertaken by NHS bodies where an event may, or did, cause harm to a patient, staff member or visitor. The aim of the review is to examine what happened and, if it was avoidable, to try and prevent it happening again.
Decisions around the publication of SAER reports can be complex, as these reports will often contain extensive personal information relating to the people involved. The outcome from previous cases where the Commissioner has been asked to consider whether information from these reports should be disclosed has varied, depending on the specific content of the information requested.
On the issue of the proactive publication of information from SAER reports, Scottish Information Commissioner David Hamilton says:
“The sharing of learning from significant adverse events that arise in our hospitals is a crucial part of preventing a reoccurrence. If learning can be shared publicly in a way that does not breach data protection or patient confidentiality it may be good practice to do so, to support scrutiny and accountability and build public trust.
“As not every case is suitable for sharing publicly, there can be no blanket policy to either proactively publish or not publish. Each record must be considered on a case-by-case basis. However, we would expect to see the learning published where possible. Health agencies should consider whether a change in the format of recording practices is required.
“Where information isn’t made public, people still have rights under freedom of information law to ask for it, followed by a right to appeal to my office if they feel it has been unjustly withheld.
"The balance between protecting sensitive information and ensuring appropriate disclosure can sometimes be finely balanced, and my role is to help ensure that public bodies get it right.”
