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| Getting It Right First Time | |
|---|---|
| Name | Getting It Right First Time |
| Abbreviation | GIRFT |
| Established | 2012 |
| Founder | Mr. Tim Briggs |
| Country | United Kingdom |
| Sector | Healthcare quality improvement |
Getting It Right First Time is a national quality improvement programme focused on procedural and clinical variation reduction in specialist services across the National Health Service. It was founded to improve outcomes, reduce unwarranted variation, and optimise resource use by analysing clinical data and convening multidisciplinary teams. The programme draws on audit, peer review, and commissioning levers to disseminate best practice across surgical and medical specialties.
Getting It Right First Time operates as a practice-led initiative integrating data analysis, clinician-led review, and organisational change. Key collaborators include NHS England, NHS Digital, the British Medical Association, and specialist royal colleges such as the Royal College of Surgeons of England, Royal College of Physicians, and Royal College of Obstetricians and Gynaecologists. It engages trusts and foundation trusts including Guy's and St Thomas' NHS Foundation Trust, Royal Free London NHS Foundation Trust, and Great Ormond Street Hospital alongside commissioning bodies such as Clinical Commissioning Group (CCG) predecessors and NHS England regional teams. The programme's visible leadership has involved figures like Tim Briggs, senior clinicians, and management partners from consultancy and academic institutions including University of Oxford, University of Cambridge, and University College London.
The origin of the programme traces to national reviews of variation and outcome reporting initiated in the early 2010s within the Department of Health and Social Care environment and responding to recommendations similar to those in the Francis Report and the Berwick Review. Its first specialty reviews targeted orthopaedics, drawing on datasets assembled by NHS Digital and specialist registries such as the National Joint Registry. Subsequent expansion mirrored approaches seen in legacy programmes like the NHS Atlas of Variation and collaborative networks exemplified by Surgical Care Improvement Project-style audits. Governance evolved with input from bodies such as Health Education England, Care Quality Commission, and professional societies including the British Orthopaedic Association and the Society for Acute Medicine.
The methodology combines comparative analytics, site visits, and action plans rooted in clinical evidence from trials and registries. Core principles emphasize clinician-led change, transparency, and measured standardisation informed by data from sources like Hospital Episode Statistics and national registries. Peer review teams include consultants from specialist networks, service managers from trusts such as Royal Liverpool University Hospital and Moorfields Eye Hospital, and commissioners with experience at organisations like NHS Improvement. Recommendations often reference clinical pathways endorsed by bodies such as the National Institute for Health and Care Excellence, professional guidelines from the British Association of Plastic, Reconstructive and Aesthetic Surgeons, and outcome measures from registries like the National Vascular Registry.
Implementation occurs through specialty-specific programmes—orthopaedics, ophthalmology, urology, vascular surgery, maternity, and emergency care—working with local providers including Oxford University Hospitals NHS Foundation Trust, Manchester University NHS Foundation Trust, and Barts Health NHS Trust. Tactics include standardised pathways, reduction of low-value procedures, optimization of theatre lists, and workforce configuration changes influenced by staffing frameworks employed at institutions like Guy's and St Thomas' Hospital and Alder Hey Children's Hospital. Liaison with commissioning entities such as NHS Wales and collaborative exchanges with international health systems like Centers for Disease Control and Prevention-affiliated partners have been reported in cross-jurisdictional learning fora.
Reported impacts include reductions in length of stay, complication rates, and variation in procedure rates across trusts. Metrics have been benchmarked against datasets maintained by NHS Digital and analysed alongside outcomes published in journals affiliated with organisations such as the Royal Society of Medicine and the BMJ Group. Financial savings cited by programme reports reference efficiencies achieved at trusts including University College London Hospitals NHS Foundation Trust and Leeds Teaching Hospitals NHS Trust. Broader influence is evident in guideline uptake promoted by bodies such as the National Institute for Health and Care Excellence and specialty associations like the British Association of Urological Surgeons.
Critics have raised concerns about reliance on routinely collected data such as Hospital Episode Statistics that may undercapture clinical nuance, and about the potential for central targets to interact with local priorities in ways similar to issues highlighted in debates around the NHS Pay and Productivity landscape. Some commentators from professional organisations including the British Medical Association and academic centres at King's College London caution that top-down adoption risks homogenising care where individualised approaches are necessary. Others note the challenge of attributing causality for observed improvements given concurrent initiatives like specialty-led audits and national campaigns such as those promoted by the Care Quality Commission.
Case examples documented in programme outputs include surgical pathway redesigns at Royal Cornwall Hospitals NHS Trust with metrics tied to national registries, orthopaedic theatre optimisation at Sheffield Teaching Hospitals NHS Foundation Trust, and maternity pathway changes informed by reviews similar in scope to the Ockenden Review. Other reported implementations involve cross-site networks linking centres such as Addenbrooke's Hospital and St George's Hospital to standardise elective scheduling and share specialist expertise. International interest has led to exchanges with delegations from organisations like the World Health Organization and academic partnerships with universities including Imperial College London.
Category:Healthcare quality improvement programs