Orthopaedic follow-up report
GIRFT has published a follow-up report on the orthopaedics specialty, which looks back at the substantial improvements seen in orthopaedic services since Professor Briggs held his first deep-dive visits to trusts in late-2012.
The follow-up report’s findings show evidence of substantial improvement against all the key GIRFT metrics, meaning that the NHS is providing better quality orthopaedic care and getting better value for money. The headline findings include:
- Revision rates have fallen every year since 2012, even while total activity and demand grows
- Average lengths of stay have been reduced by a fifth, releasing over 368k bed-days
- £696 million of operational and financial opportunities have been released to trusts
The original GIRFT orthopaedic surgery review
The initial Orthopaedic Surgery review established the GIRFT methodology and became the pilot for the current programme. Professor Tim Briggs and his team visited over 140 providers, covering more than 200 hospital sites. His original report coined the term “Getting It Right First Time”.
The British Orthopaedic Association has co-badged and endorsed the GIRFT national report on orthopaedics and the GIRFT programme is one of the key strands of the BOA’s Practice Strategy. Click here or on the logo below to read more information about the BOA or to register for its Centenary Annual Congress. The report included a raft of recommendations, many of which have been adopted by orthopaedic trusts and delivered real benefits:
- The recommendation to adopt cemented hip replacements for patients aged over 65 has led to a 10% increase in the use of this method, saving an estimated £4.4m p.a.
- Reduced length of stay for hip and knee operations has freed up 50,000 beds annually
- Trusts have moved to more ring-fenced orthopaedic beds, reducing cross infection
- An increase in localised consolidated working between trusts, sharing resources and maximising the number of procedures carried out
- 75% of trusts have renegotiated the costs of implant stock and rationalised their use
- Greater awareness of costs has led to reduced use of expensive “loan kit”
- Litigation claims are down from 1,758 in 2013/14 to 1,505 in 2015/16
- A GIRFT “Pricing Letter”, providing transparency of the prices different orthopaedic trusts pay for prosthesis, is now used by consultants selecting implants
- In 2016 the British Orthopaedic Association used GIRFT principles in published guidance to ensure best practice amongst its members
In a survey carried out by the NHS more than 70 of the trusts visited during the orthopaedic review responded: they reported total savings of between £20m and £30m for 2014/15 as a result of adopting GIRFT’s recommendations. If extrapolated across the more than 140 providers visited, these savings would increase to an estimated at £40m to £60m. Furthermore, the trusts that responded forecast a further £15m to £20m of savings for 2015/16, estimated at £30m to £40m if replicated across all the orthopaedic trusts. Professor Briggs is currently carrying out revisits of all the trusts he visited during the first review to gauge changes and improvements since the initial GIRFT report.
The project manager for this workstream is Rebecca Dooley ([email protected])
Clinical Lead: Professor Tim Briggs CBE
Consultant Orthopaedic Surgeon at the Royal National Orthopaedic Hospital, GIRFT programme Chair, National Director of Clinical Improvement
Professor Briggs qualified from The Royal London Hospital in 1982 with honours in surgery and a number of prizes. After his senior registrar training he was appointed to the Royal National Orthopaedic Hospital as Consultant in 1992. His specialist interests are in orthopaedic oncology as well as surgery to the hip and knee. He was Medical Director at the RNOH for 15 years, ensuring a re-build and was President of the British Orthopaedic Association in 2014. He was appointed as National Director for Clinical Quality and Efficiency for NHS Improvement in September 2015 and was asked to lead and roll out his GIRFT methodology, developed in orthopaedics, across all surgical and medical specialties within the provider network. In January 2019, he was appointed to the role of National Director of Clinical Improvement for the NHS, working with Hugh McCaughey to oversee the delivery of support to the NHS to help reduce unwarranted clinical variation, improve quality and access, and ensure the most efficient use of resources. Professor Tim Briggs was made a Commander of the Most Excellent Order of the British Empire (CBE) in the 2018 New Year’s Honours List for services to the surgical profession.