Table 3

Summary of pleural service categories

Category 1 pleural service
  • Basic pleural interventions.

  • Streamlined referral pathways for advanced diagnostics and therapeutics.

  • Dedicated pleural lead with appropriate time allocated within job plan.

  • Published hospital pathways for pleural disease management.

  • Standardisation of equipment optimising safety of pleural intervention.

  • Standardised procedural documentation and checklists.

  • Implementation and compliance to National Safety Standards for Invasive Procedures and Local Safety Standards for Invasive Procedures standards.

  • Unified process for Incident investigation in pleural medicine.

Category 2 pleural service
  • At least one intermediate thoracic ultrasound and pleural procedure operator.

  • Dedicated pleural clinic and ambulatory pathways.

  • Dedicated pleural procedure area/room.

  • Inpatient in-reach with physician led bedside ultrasound.

  • Consideration to specialist pleural nurse and pleural administrator roles.

  • Prospective data collection for performance monitoring.

  • Audit trail for ultrasound images prior to pleural procedures.

Category 3 pleural service
  • Lead consultants have a minimum 4× programmed activities for service delivery and development.

  • Advanced diagnostics and therapeutics including medical thoracoscopy and IPC.

  • Dedicated pathways and rapid access for IPC-related problems.

  • Active engagement in pleural research trials.

  • Consideration to developing a fellowship programme.

  • Multidisciplinary team framework for pathway and list planning, trial screening, difficult cases.

  • IPC, Indwelling Pleural Catheter;