High Volume Low Complexity (HVLC) programme

Following a successful collaboration with the NHS London region, GIRFT is now a key enabler for healthcare systems working on the High Volume Low Complexity (HVLC) programme. This is aimed at supporting elective recovery and the development of standardised patient pathways across regions.

The GIRFT team is working with local systems to help the NHS with post-COVID-19 elective recovery and restoration of services, aiming to reduce the backlog of patients waiting for operations and improve outcomes and access to care. Up to 60% of people on waiting lists need high-volume surgery, such as cataract removal, hernia repairs or joint replacement operations.

GIRFT’s HVLC programme is focusing initially on driving improvement in six high-volume specialties – ophthalmology, general surgery, trauma and orthopaedics (including spinal surgery), gynaecology, ENT and urology – but will support with other surgical and medical specialties going forwards. As the key element of NHS England and NHS Improvement’s Elective Recovery Programme, the HVLC programme engages Integrated Care Systems (ICSs) and regions to work at pace to agree standardised pathways and adopt best practice, as well as pooling capacity and resources, to deliver excellent (top decile) clinical outcomes and equity of access to care for their population.

The programme supports the establishment of fast track surgical hubs for high-volume procedures, where possible, and helps partners to agree system-wide theatre principles (e.g. accepting day surgery as the default), and theatre efficiencies (e.g. the number of cases per theatre list). In line with local populations needs, local systems are encouraged to identify their own priorities and use the GIRFT specialty ‘gateways’ to benchmark and review their performance against relevant metrics.

GIRFT is now rolling the programme out nationally to guide all systems and regions in achieving top decile performance, with the online learning and resources of the GIRFT Academy and Best Practice Library supporting their success.