Management of investigations and serious incidents policy

The purpose of this policy is to ensure that risks associated with serious incidents are identified and managed in accordance with best practice and in line with the expectations of the NHS Resolution, the Health and Safety Executive, the Care Quality Commission, NHS England and NHS Improvement, Clinical Commissioning Groups and the public.

Publication date:: 01 September 2019
Date range:: September 2019 - September 2022

11. Links with other procedures

11.1

This procedure does not stand alone. It must, where appropriate be read with the following:

Learning from Experience Policy
Duty of Candour Policy
Safeguarding Policy
Complaints Policy
The Disciplinary Procedure

Download as a PDF

Contents

1. Introduction
2. Purpose
3. Definitions
4. Duties
5 Key issues, Investigation, Root Cause Analysis and Support for All Involved (Staff, Patients and Families)
6. Investigation and root cause analysis
7. Just culture guide
10. Retention of records
11. Links with other procedures
10. Training
11. Training needs analysis
13. Equality impact assessment
13. Human rights
14. Monitoring compliance with and effectiveness of this document
Appendix 1 Overview of the investigation process
Appendix 2 Never events list 2018
Appendix 3 72 hour flow chart
Appendix 4 Death in the community and mortality panel decision making
Appendix 5 Inpatient death
8. Covid-19 STEIS cases
9. Use of Force Act Investigations

11. Links with other procedures

11.1

Learning from Experience Policy

Duty of Candour Policy

Safeguarding Policy

Complaints Policy

The Disciplinary Procedure