Local Safety Standards for Invasive Procedures (LocSSIPs)

Background

Following the publication of National Safety Standards for Invasive Procedures (NatSSIPs) on 7^th September 2015, NHS England issued a stage two alert (Alert Reference Number NHS/PSA/RE/2015/08) on 14^th September 2015 asking for relevant NHS organisations to develop "their own Local Safety Standards for Invasive Procedures (LocSSIPs) based upon the high-level national standards"  with an overarching objective of reducing "Never events" (NE) and improving the safety of invasive procedures.  Amongst other things, the alert asked organisations providing NHS-funded care to "develop and test LocSSIPs based on the relevant NatSSIPs using local insight".

Locally, this alert led to many LocSSIPs being developed at various constituents that are now part of the new STSFT Trust but there was no clear strategy to drive this work forward. Over the last couple of years, some progress has however been made. Notably, there is now the new role of corporate lead for "Safety of Invasive Procedures" with direct accountability to the "Medical Director" who is, in turn, the nominated Director on the Trust Board with board-level responsibility for LocSSIPs across the Trust.

• LocSSIP Implementation Group: Trust has formed a “LocSSIP Implementation Group” (LIG) chaired by the corporate lead for “Safety of Invasive Procedures”. The LIG has defined Terms of Reference and its members include a range of key stakeholders. The group meets bi-monthly and is supported by the Clinical Effectiveness Team. The LIG has direct links with the Trust IT team, Clinical Governance, Patient Safety, and Clinical Teams and is represented on the Trust’s Clinical Governance Steering Group (CGSG) through its chair.
• Corporate Lead Safety of Invasive Procedures: Kamal Mahawar, Consultant General Surgeon has been appointed Corporate Lead for Safety of Invasive Procedures with a clear outline of responsibilities and authority to effect change.
• Process for Development and Structure of LocSSIPs: The LIG has established a clear process for the development of LocSSIPs across the Trust. Each LocSSIP at STSFT consists of three separate parts – i) A checklist on Meditech for routine use ii) An easily accessible and printable checklist that can be printed out easily for use during Meditech downtime and emergencies, and iii) a supporting document explaining key aspects of that invasive procedure.

A LocSSIP document library has been created on the Trust intranet to allow staff access to the printable versions of the checklist and supporting documents for individual LocSSIPs. These can be accessed following the link above.

• Database of Invasive Procedures, LocSSIPs, and Never Events: The LIG has developed a database supported by the Clinical Effectiveness Team which is periodically updated with help from Clinical Governance Leads and it records the following:
• All invasive procedures, as defined in the national standards, performed at any site across the Trust. Each department is expected to have a list of all invasive procedures performed in different clinical areas along with the numbers in each area. This will help them identify the training needs of staff and plan audits.
• Whether or not there is a LocSSIP for each invasive procedure being performed in any clinical area that meets the guidelines suggested by the LIG (as above). In many areas, there are existing LocSSIPs that will need to be amended to follow LIG’s recommendations for a standardised trust-wide format and there are many invasive procedures for which, there are no LocSSIPs and they need to be developed.
• If there are mechanisms in place for the training of existing and new staff.
• If there are mechanisms in place for audit of the use of the LocSSIPs.
• Any Never Event related to that invasive procedure.