NatSSIPs (National Safety Standards for Invasive Procedures) cover all invasive procedures, which can be defined as a procedure that requires piercing the skin to gain access to the inside of a patient’s body (e.g. inserting a tube in to a blood vessel), or gaining access to a body cavity without cutting into the body (bronchoscopy) or using electromagnetic radiation (laser eye treatments).


LocSSIPs (Local Safety Standards for Invasive Procedures) have arisen from a framework document produced by NHS England’s Patient Safety Domain and the NatSSIPs group to promote safe practice locally. The aim is to build on the positive aspects of the WHO Safer Surgery Checklist acknowledging that checklists alone are not enough to ensure patient safety; a team trained in this area with safe practice at the forefront of their thinking would reinforce best practice and improve patient safety.

The NatSSIP guidelines outline the key elements for the development of LocSSIPs including: governance, documentation, handovers, briefing, procedural verification, and sign in and out. As each institution will have their own approach to invasive procedures, an overarching, inflexible, centrally driven dictat was not appropriate.

With this in mind the FICM and the ICS have produced, in collaboration with Ged Smith at the Walton Centre in Liverpool, a set of WHO style checklists for the following procedures:

  • Percutaneous tracheostomy
  • Intubation
  • Central line insertion
  • Bronchoscopy
  • Chest drain
  • NG insertion

These have been designed to give any institution which has not yet created localised guidelines, a starting point to develop their own hospital specific LocSSIPs. The checklists will obviously require relevant educational and clinical governance to accompany their use in the clinical workplace and again the intention is for this to be developed to fit in with local working practices and staffing.

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