Completed a training course in basic pleural procedures including therapeutic pleural aspiration and chest drain insertion (including didactic lectures and simulated practice).

Completed a local induction programme (relevant to current trust) including education on out-of-hours pathways and equipment for pleural procedures relevant to the current hospital.

Are entrusted to independently perform pleural aspiration/drainage for air or fluid in context of ‘uncomplicated’ cases where immediate ‘out of hours’ action is required.

Documented satisfactory completion of a summative DOPS for therapeutic pleural aspiration and satisfactory completion of two summative DOPS by two separate assessors for chest drain insertion.

A minimum of five basic pleural procedures (therapeutic pleural aspirations and/or chest drain insertions documented within a formal logbook.

A minimum of 10 therapeutic pleural aspiration and 20 chest drain insertion procedures documented within a logbook.

At least emergency level thoracic ultrasound operator competence (see table 2).

A minimum of 2 years’ experience as a basic level pleural operator with regular practice in basic pleural procedures evidenced within a formal logbook.

Involved in the supervision and training of emergency and basic level pleural operators.

Intermediate level pleural procedural skills including direct (real-time)-guided aspiration and chest drain insertion, and indwelling pleural catheter insertion and removal.

At least basic level thoracic ultrasound operator competence (see table 2).

Annual review and appraisal of practice including standardised outcome measures.

Advanced level pleural procedures such as medical thoracoscopy and image-guided pleural biopsy.

Advanced level thoracic ultrasound operator (see table 2).

Annual review and appraisal of practice including standardised outcome measures.