The independent patient safety investigation (IPSI) into Limb Lengthening services at Great Ormond Street Hospital for Children NHS Foundation Trust (GOSH) has begun.

As the commissioner of these services, NHS England has a responsibility to ensure the NHS learns and improves when standards fall short. This investigation has been commissioned to examine how GOSH responded when potential harm was identified within its limb-lengthening service, and to build on the existing understanding of what happened so that the NHS can learn from this and better protect children, young people and their families in the future.

Dame Celia Ingham Clark DBE will chair the investigation supported by Niche Health and Social Care Consulting Ltd, an independent investigation company. Dame Celia is an accomplished medical leader with significant experience at trust, regional and national level, she has previously held national roles including Medical Director for Professional Leadership and Clinical Effectiveness and Interim National Director for Patient Safety.

The investigation will focus on governance and organisational culture. It aims to promote openness and transparency about what occurred and the factors involved, identify opportunities for improvement to reduce the likelihood of similar events in the future, and provide recommendations to strengthen the delivery of health services. It will complement the Royal College of Surgeons assessments by concentrating on systems and processes.

As part of the process, families will be invited to take part, with the findings used to inform the investigation’s focus on governance, culture and processes at GOSH. Further information about how the families will be able to share their experience with Niche will take place from September.

The outcome of the investigation will be published on the NHSE London website.