Guidance

Surgical site infection surveillance service (SSISS)

This service allows hospitals to record incidents of infection after surgery, track patient results and review or change practice to avoid further infections.

Public Health England’s healthcare associated infection and antimicrobial resistance department (HCAI & AMR) run the surgical site infection surveillance service.

This service helps hospitals in England record and follow up incidents of infection after surgery, and use results to review or change practice as necessary.

This service supports both the mandatory surveillance of SSI in 4 categories of orthopaedics and voluntary surveillance in 13 categories of surgical procedures.

The HCAI & AMR department contributes England’s surgical site infection data to the healthcare-associated infections surveillance network (HAI-Net) to enable inter-country comparisons of SSI rates.

Surveillance service goals

The service:

  • provides hospitals with a protocol and tools to collect and analyse data on SSI using the minimum set of data required to take account of key risk factors
  • provides national data for use in benchmarking rates of SSI
  • ensures high standards of data quality
  • maintain, as far as possible, comparability with data previously collected so staff can evaluate trends over time
  • analyses data to improve our understanding of SSI epidemiology

The service includes:

Mandatory surveillance

Surveillance of infections in these procedures started in April 2004, specifying that each trust should conduct surviellance for at least 1 orthopaedic category for 1 period in the financial year. The categories are:

  • hip replacements
  • knee replacements
  • repair of neck of femur
  • reduction of long bone fracture

Voluntary surveillance

The surveillance service records infections in other categories of procedures including:

  • abdominal hysterectomy
  • bile duct, liver, or pancreatic surgery
  • breast surgery
  • cardiac surgery
  • cranial surgery
  • cholecystectomy (non-laparoscopic)
  • coronary artery bypass graft
  • gastric surgery
  • large bowel surgery
  • limb amputation
  • small bowel surgery
  • spinal surgery
  • vascular surgery

See the eligible procedures for each category in the operating procedure codes (OPCS).

Register a hospital with the surveillance service

This form requires the contact details of a designated surveillance administrator, who is responsible for all communication between the hospital and SSISS. The administrator must receive training from SSISS before conducting surgical site infection surveillance.

Successful surveillance requires commitment, team work, effective communication and accurate data collection. A pilot period is strongly recommended to assess the resources required, make necessary amends and set up contingency plans.

We recommend that each Trust form a surveillance group, to plan how to run the surveillance locally. Membership of the group can vary, but ideally includes:

  • director of infection prevention and control (DIPC)
  • surgeons
  • anaesthetists
  • infection control team
  • surveillance staff
  • ward and theatre nurses
  • clinical governance
  • the trust board

The surveillance group promotes surveillance within the Trust, interprets and distributes results to clinical staff and others who need to know about them, and enables policy and practice review when results indicate the need for further action.

Surgical site infection surveillance service

Heathcare associated infection and antimicrobial resistance department
Public Health England
61 Colindale Avenue

London
NW9 5EQ