This multi-cycle audit evaluated adherence to Local Safety Standards for Invasive Procedures (LocSSIP) in peripheral nerve blocks within Northumbria Healthcare NHS Foundation Trust and assessed the impact of targeted interventions on compliance following a wrong-site block Never Event.

Methods

A retrospective review of approximately 50 LocSSIP checklists per cycle was conducted over four-week periods. Compliance was assessed using a standardised scoring tool evaluating completion of key safety elements including timing of checklist completion, dual practitioner verification, and documentation of the ‘Stop Before You Block’ check. Findings were presented at clinical governance meetings and shared via departmental communication. Subsequent re-audit cycles assessed changes in compliance following feedback and increased awareness.

Results

Initial compliance in July 2025 demonstrated only 56% compliance. Following governance feedback and targeted interventions, compliance improved to 64% in January 2026 and further to 77% in February 2026. Despite this improvement, omissions in key safety steps persisted.

Discussion

Simple interventions such as feedback and increased awareness improved LocSSIP compliance. However, persistent gaps reflect ongoing system pressures including time constraints and variable team engagement, limiting consistent checklist use in practice. While compliance improved, reliability remains incomplete. Embedding LocSSIP into routine practice requires sustained education, reinforcement, and repeated auditing to reduce the risk of future Never Events.