Strengthening Surgical Capacity overview - find out about the projects and the positive impact they are having.

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Funded by Johnson & Johnson, the Strengthening Surgical Capacity (SSC) Programme focuses on health partnerships working in maternal and child health across Sub-Saharan Africa. Specifically, it supports projects that aim to reduce morbidity and mortality from conditions requiring surgical intervention, either directly or through enhanced patient safety as a result of improved anaesthetic care.

Now in its fourth round, the SSC Fund has awarded 14 grants between £6,300 and £9,600 since its launch in 2011. Third round grants came to an end in December 2014 having provided training to health workers across Malawi, Zimbabwe and Sierra Leone. Partnerships are helping to improve skills and service provision, as well as strengthening relationships between the partners. 


Great Ormond Street Hospital NHS Trust in partnership with the Queen Elizabeth Central Hospital, Blantyre used quality improvement methodology to implement projects designed to enhance perioperative care for paediatric surgical patients. These included the development and implementation of a clinical care pathway and inpatient database, daily senior ward rounds, introduction of new protocols and improved communication between departments. Indicators of improved care such as reduced stay, increased drug administration and reduced mortality were recorded in the six months after implementation and many of the interventions have continued beyond the life of the project.

Staff members from across the partnership were engaged in the project, including 130 doctors, nurses, interns, anaesthetic staff, clinical officers and clerical staff who received formal training. The use of quality improvement methodology was key to achieving this level and scope of involvement as it encouraged staff to feel confident employing certain techniques and subsequently own their results.

Read about the perception of Quality Improvement methodology as a vehicle for change by Dr Bip Nandi, United Nations Volunteer Surgeon & Consultant Paediatric Surgeon, QECH.

Working together in formal partnership since 2011, North Bristol NHS Trust and Mpilo Central Hospital, Zimbabwe, had previously introduced Practical Obstetric Multi-Professional Training (PROMPT) and clinical outcome monitoring at Mpilo in order to improve maternal and neonatal care. As this work progressed, the partners began to recognise the need for better patient monitoring to enable the earlier identification and treatment of deteriorating patients. In response, and with support from the SSC Programme, a Maternal Obstetric Early Warning System (MOEWS) was introduced. A locally appropriate chart was designed and implemented using an iterative process of development, testing and adaptation alongside training for ward staff. By the end of the project, over 3,300 charts had been used during the treatment of high risk patients and just seven months after introduction, 77% of patients whose observations ‘triggered’ a MOEWS received appropriate and timely treatment. This is compared to 4% before.

Although changes in the approach to patient care were achieved following the introduction of MOEWS, ongoing intervention, including monitoring, will be key to sustaining these in the longer term. The Bristol-Mpilo partnership is well placed for this having demonstrated the ability to work collaboratively and respond positively and quickly to the ongoing and emerging needs of the Mpilo team.

Read about the challenges of adapting a UK tool into something locally appropriate by Abi Merriel, Academic Clinical Fellow in Obstetrics and Gynaecology.

A tripartite structure between Ghana Health Services, Afrikids and the Southampton University Hospitals NHS Trust, the GAS Partnership was launched in May 2010 to strengthen local healthcare in the Upper East Region of Ghana. Through training, collaboration with Lifebox charity and also its involvement in the annual conference of Nurse Anaesthetists, this particular project has been successful in reaching healthcare professionals across Ghana in order to promote the more widespread use of oximetry and the WHO safety checklist. A course entitled ‘Safe Surgical Practice – Team Working at its Best’ was accredited the highest award of ten CPD points and the partnership made further progress in building local faculty for future training.

Southern input into the partnership evolved over the duration of the grant with individuals from the Ghanaian team demonstrating more effective strategic planning and leadership and really starting to drive its agenda. Similarly, those involved in training felt empowered by their new skills and the idea that they could help spread these to other hospitals.

Read about the impact of such empowerment as recognised by UK Lead Dr Malvena Stuart Taylor, Consultant Anaesthetist.