Our approach
Our approach.
Beyond what the record says.
A standard clinical review examines what the record says. CID investigates whether the record reflects the clinical reality — and what the differences reveal.
Our approach connects three functions — Identify, Investigate and Prevent — into a single, evidence-led pathway.
Each can be commissioned on its own. Together, they follow a concern from the first signal to verified improvement.
The pathway
From first signal to verified improvement.
Engagements can begin at any stage. At each point, the evidence determines the outcomes and findings.
Concern
An adverse outcome, a recurring signal or an unanswered question.
Assess the signals
FIRST-PASS · PASS+A structured preliminary review of the available evidence.
Chronology, warning signals and evidence gapsEstablish what happened
CASEIndependent reconstruction and six-dimension assessment.
Integrated findings and recommendationsStrengthen the safeguards
Governance & control assuranceDo proposed measures address the mechanisms of harm?
Control design and process recommendationsConfirm they work
Control verificationAre safeguards operating under real clinical conditions?
Verified improvement, or further actionEnter at any stage: a preliminary review, a full investigation, or an assessment of existing safeguards.
Who engages CID — and when
Start with the situation, not the method.
You don't need to know our methods to know whether we can help. Select the situation that best describes the concern to see where an engagement would typically begin.
Select the situation that best describes the concern.
An unexplained clinical event
A deterioration, complication or outcome that the available clinical account does not adequately explain.
Typical audiencesPatients and families, clinical directors, legal representatives
A serious adverse outcome
A clinical event requiring independent reconstruction, evidence assessment and examination of contributing clinical and organisational factors.
Typical audiencesBoards, chief executives, clinical governance, legal teams, regulators
Recurring patient safety concerns
Repeated incidents, escalation problems or adverse-event trends that existing reporting and review processes have not explained.
Typical audiencesClinical governance, clinical directors, boards, insurers
A disputed peer review
An internal or peer review whose findings are contested or uncertain, or where independence is needed for conclusions to be accepted.
Typical audiencesClinical governance, medical administration, legal teams
Uncertain governance effectiveness
Corrective actions have been implemented, but it is unclear whether the safeguards work under real clinical conditions.
Typical audiencesBoards, chief executives, clinical governance, regulators
A clinical technology or AI initiative
AI-assisted surveillance, decision support or a new clinical system whose effect on clinical risk and accountability needs independent assessment.
Typical audiencesDigital health and technology leaders, boards, clinical governance
Principles
The same principles at every stage.
Whether the work is a preliminary review or a full investigation, the same standards govern how evidence is gathered, interpreted and reported.
Evidence before conclusions
Analytical indicators are matters for assessment. Findings are what the evidence supports.
What was knowable at the time
Decisions are assessed in the circumstances in which they were made, without hindsight.
Systems, not just individuals
We examine the conditions in which care was delivered, not only the actions of those who delivered it.
Independence of findings
The commissioning party does not determine the findings.
Human-verified analysis
Analytical tools support the work. Investigators remain responsible for the findings.
Working with CID
How an engagement works.
Every engagement is defined in scope before work begins, so that the questions, the evidence and the expected outputs are clear from the outset.
- 1
Confidential enquiry
We discuss the circumstances, the questions that need answering and the evidence available.
- 2
Scope & independence check
We confirm the scope, the availability of evidence, and that no conflict of interest prevents an independent assessment.
- 3
Defined-scope engagement
Work proceeds against an agreed scope, timeframe and terms.
- 4
Report & findings
Findings are documented with supporting evidence, areas of uncertainty and recommendations.
- 5
Next steps
You decide whether further investigation, assurance or no further action is appropriate.
Initial enquiries are confidential and do not commit you to an engagement.
Our methods
One methodology. Integrated tools.
Each method is designed for a particular stage of the pathway, and each shares the same evidential standards. Together, they allow findings at one stage to inform the next.
| Method | Identify | Investigate | Prevent |
|---|---|---|---|
| FIRST-PASSPreliminary Clinical Safety Review | |||
| PASS+Patient Adaptive Safety Surveillance, including Signals Trajectory | |||
| CASEClinical Assessment & Systems-Level Evaluation | |||
| Governance & Control AssuranceBehavioural & systems viability, process re-engineering, control verification | |||
| CORAClinical Observation & Risk Analyser — the analytical capability across all three |
The analytical capability behind every stage. CORA identifies patterns, anomalies and relationships across complex clinical information — supporting the work, while investigators remain responsible for the findings.
Explore CORABegin with a conversation
Every engagement starts with the questions that need answering.
Tell us what has happened, what is known and what remains unclear. We will help determine the right starting point.