Surgical Site Infection Audit

GIRFT Surgical Site Infection programme

Surgical site infection (SSI) is an important area of focus for GIRFT.  Post-surgery infections can cause significant harm to patients and result in increased hospital stay, readmissions and re-operations. They are also a significant cost to the NHS.

During our GIRFT reviews of surgical departments across NHS trusts in England, we noticed the lack of awareness of SSI rates by some frontline clinicians. Hence the GIRFT SSI programme was set up to review SSI rates in surgical units in England and to review the current practice in prevention of SSIs.

The GIRFT SSI project seeks to complement the work of Public Health England (PHE) by engaging frontline clinicians in the data collection process and exploring variation in surgical practice and outcomes for a wide range of procedures across breast surgery, cardiothoracic surgery, cranial neurosurgery, ENT surgery, general surgery, obstetrics and gynaecology, ophthalmology, oral and maxillofacial surgery, orthopaedic surgery, paediatric general surgery, spinal surgery, urology and vascular surgery..

GIRFT plans to conduct annual SSI surveys allowing trusts in England to draw comparisons over time for procedures and specialties, including those procedures not currently included in the PHE SSI surveillance programme.

GIRFT SSI survey 2019

The first GIRFT SSI survey in 2017 helped our understanding of SSI rates for each specialty and started to identify areas of good practice which can be shared. Trusts used the information to review their SSI rates and look at where improvements can be made to prevention methods.  Building on this, a second survey in 2019, asked all trusts to participate to help deliver more comprehensive data and improved learning.

This second GIRFT SSI Survey ran over a period of six months from 1 May 2019 to 30 October 2019.  Data gathered during the survey is  shared with the trusts that participated – each trust receives an individual trust data pack with national benchmarks for SSI rates for the surgical specialties being surveyed.

Participants from more than 100 NHS sites and more than 50 independent sector sites contributed to the 2019 data collection, before the SSI survey portal closed in December 2019.  GIRFT’s clinical leads have been consulted on the survey results and contributed their specialist knowledge and insight.

A report on the 2019 SSI survey will follow in due course, with recommendations to help inform clinical practice.

How do trusts benefit from participating?

The SSI surveys have been established to:

  • Identify the surgical site infection rates of specific procedures within key surgical specialties.
  • Assess local practice in the prevention of surgical site infection for the specified procedures.

Participating in the survey should be an opportunity to better understand a trust’s SSI rates, to review and improve local practice, and to report on this to the trust management and board meetings.

Overall results and good practice are shared nationally.

How do trusts get involved?

The 2019 survey is fully supported and co-badged by the Royal College of Surgeons.  We ask trusts to nominate an SSI trust champion who co-ordinates the survey within their trust.

We are asking Medical Directors to encourage participation from clinicians in the survey.  Participation in the survey can also form part of the quality improvement activity within annual consultant appraisals, leading to an informed discussion regarding clinical quality.

Which specialties and procedures are included?

Please see the FAQ document for more detail and a list of specialties and procedures included in the survey.

SSI survey FAQ document >

Further support and information

The GIRFT SSI survey team is available for support and assistance with any queries. Please contact project manager Anne-Marie Ridgeon: [email protected]

GIRFT SSI Survey 2017

The first GIRFT SSI survey reviewed SSI rates across 13 surgical specialties in 2017, concluding in January 2018.  It involved junior doctors in the data collection process and a total of 95 NHS trusts encompassing 198 surgical units in England submitted SSI data. Following completion of the analysis of the data received, GIRFT shared individual trust results with each of the 95 trusts which had participated in the survey.

The survey encompassed 65 selected procedures across the specialties of: breast surgery, cardiothoracic surgery, cranial neurosurgery, ENT surgery, general surgery, obstetrics and gynaecology, ophthalmology, oral and maxillofacial surgery, orthopaedic surgery, paediatric general surgery, spinal surgery, urology, vascular surgery.

National overview report of 2017 SSI survey

Following the 2017 survey, GIRFT has produced a national overview of the high-level findings to promote wider understanding of the clinical impact of SSI rates.  GIRFT hopes this report will encourage increased participation in SSI surveys going forward and regular review of the current practice in prevention of SSIs.  Better scrutiny and investigation of SSIs will drive improvements in patient safety, treatment outcomes and delivery of care.

Click here to read the GIRFT SSI National Survey overview >

Joint Clinical Lead: Professor Tim Briggs OBE

Consultant orthopaedic surgeon at the Royal National Orthopaedic Hospital, GIRFT programme Chair, National Director of Clinical Improvement for the NHS

Clinical Fellow: Annakan Navaratnam

NHS England and NHS Improvement National Medical Director’s Clinical Fellow

 

Project Manager: Allison Beal