A key initiative published by NHS Improvement (now NHS England) in 2015 was The National Safety Standards for Invasive Procedures (NatSSIPs). This brought together national and local learning from the analysis of Never Events, Serious Incidents and near misses setting out a set of recommendations that would help provide safer care for patients undergoing invasive procedures. This did not in any way replace the WHO Surgical Checklist, but rather enhanced it by looking at additional factors such as the need for education and training.

In January 2023, the Centre for Perioperative Care published revised National Safety Standards for Invasive Procedures (NatSSIPs 2), designed to reduce misunderstandings or errors and to improve team cohesion. In the original NatSSIPs, organisations were required to write Local Safety Standards for Invasive Procedures (LocSSIPs) for each procedure. However, there was a risk of over-complicating checklists and introducing bureaucracy. NatSSIPs now recommends that Standard Operating Procedures or LocSSIPs may be developed, based on NatSSIPs 2. The NatSSIPs are meant to be modified for local use, i.e. used as the basis to produce LocSSIPs. The local standards for a major surgical procedure performed under general anaesthesia in an operating theatre cannot and should not be identical to those supporting the safe insertion of a chest drain under local anaesthesia in a ward.

NHS England expect organisations to base their LocSSIPs on the structure of the NatSSIPs, with the understanding that local circumstances will mean that some steps and standards are combined, and that they may not necessarily be a LocSSIP for each NatSSIP. The important thing is that all steps are considered when creating LocSSIPs.

The NatSSIPs do not include every step that will need to be included in LocSSIPs, as they are meant to inform and harmonise the production and review of local standards, not to replace them or add to them.

This LocSSIP Implementation Checklist issued by MIAA covers areas for organsations to consider around implementation, governance, training, workforce planning and how to consider lessons learnt and a checklist can be used to evaluate the content of your LocSSIPs to ensure compliance with the requirements of the NatSSIP2 guidance.

Download the checklist