Getting It Right First Time, a programme designed to improve clinical quality and efficiency within the NHS by reducing unwarranted variations, has announced that it is recruiting new clinical leads as it grows to cover more than 30 clinical specialties.
It comes after the Government announced in November 2016 that GIRFT would receive an additional £60 million funding to expand and accelerate delivery of the programme. The programme uses actual trust data and insight from frontline medics to identify differences in the way services are delivered. In addition GIRFT also encourages the sharing of best practice between trusts and proposes improvements within specialties to help improve patient outcomes and bring about efficiencies that can be ploughed back into services.
Because GIRFT is led by clinicians, frontline medics in the specialties being reviewed welcome the programme because they can share both their best practice and their challenges with people that understand clinical service. We now need more clinicians to roll out that approach to more specialties.
The orthopaedic pilot has already helped deliver efficiencies and savings of up to £30 million, with another £20 million forecast for 2015/16. But importantly, good patient outcomes and safety have remained paramount throughout the programme.
Because each specialty area is led by a clinical expert, and it uses trust data which it explores with clinicians and trust managers on the ground, the programme not only indentifies unwarranted variations in service, it gets to the heart of why they occur and how best they can be remedied. By rolling out the GIRFT methodology to more clinical areas I am confident we will start to see the same level of efficiencies and savings we have seen in orthopaedic surgery, which will ultimately lead to even better patient outcomes
Dr Jeremy Marlow, Executive Director of Operational Productivity at NHS Improvement
Current specialities and clinical leads
The current specialties and clinical leads are:
- Orthopaedics, Clinical Lead, Professor Tim Briggs; orthopaedic spinal surgery, Clinical Lead, Mike Hutton; neuro spinal surgery, Advisor, Justin Nissen
- General surgery, Clinical Lead, John Abercrombie
- Vascular, Clinical Lead, Professor Mike Horrocks
- Urology, Clinical Lead, Simon Harrison
- Cranial neurosurgery, Clinical Lead, Nick Phillips
- Ear, nose and throat, Clinical Lead, Andrew Marshall
- Paediatrics, Clinical Lead, Simon Kenny
- Oral and axillofacial, Clinical Lead, Maire Morton
- Obstetrics and gynaecology, Clinical Lead, Rob Sherwin
- Ophthalmology, Joint Clinical Leads, Caroline McEwen and Alison Davies; Advisor, Lydia Chang
- Cardiothoracic surgery, Clinical Lead, David Richens
- Medical negligence, Clinical Litigation Lead, John Machin
Newly announced specialities
- Acute and general medicine
- Breast surgery
- Plastic surgery and burns
- Intensive and critical care
- Emergency medicine
- Imaging and radiology
- Geriatric medicine
- Diabetes and endocrinology
- Mental health
- Anaesthetic and perioperative medicine
Clinicians will lead a project to compile a data and insight driven report into their specialty, which is then followed up by trust meetings with their peers and trust managers to discuss the findings and provide more context around practice and challenges. The deep dive process is followed by a national report for each specialty presenting GIRFT’s findings, examples of best practice and an action plan of changes and improvements.
Getting It Right First Time (GIRFT) overview
GIRFT is a national programme, led by frontline clinicians, created to help improve the quality of medical and clinical care within the NHS by identifying and reducing unwarranted variations in service and practice. It is a partnership between the NHS Royal National Orthopaedic Hospital Trust (RNOH), which first hosted the pilot programme, and our Operational Productivity Directorate .
Having started as a pilot within orthopaedic surgery and then expanded to a further 10 medical specialities, the GIRFT methodology and process has now been extended to a total of over 30 medical and clinical specialities. A formal GIRFT implementation infrastructure is being developed to complement our existing regional footprint to help support trusts to make the service and cultural changes required to successfully implement the improvements presented in GIRFT’s reports, again with patient outcomes and safety of paramount importance.
The GIRFT programme team includes: Dr Jeremy Marlow, our Executive Director of Operational Productivity, which sponsors GIRFT; Professor Tim Briggs, Chair of GIRFT and our National Director of Clinical Quality and Efficiency; Rob Hurd, CEO of the RNOH and joint SRO of GIRFT; Rachel Yates, Managing Director of GIRFT and Deputy SRO; Nicola Joyce, Director of the GIRFT Review Team.