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Getting It Right First Time (GIRFT) is a national programme designed to improve medical care within the NHS by reducing unwarranted variations.

By tackling variations in the way services are delivered across the NHS, and by sharing best practice between trusts, GIRFT identifies changes that will help improve care and patient outcomes, as well as delivering efficiencies, such as the reduction of unnecessary procedures, and cost savings.

The programme was rolled out in orthopaedic surgery. In the 12 months after the pilot programme, it delivered an estimated £30m-£50m in savings – predominantly through changes that reduced average length of stay and improved procurement.

The same model has been applied across 40 surgical and medical specialties and other cross-cutting themes. It consists of five key strands:

• a broad data gathering and analysis exercise, performed by health data analysts, which generates a detailed picture of current national practice, outcomes and other related factors;
• direct clinical engagement via visits or virtual meetings between clinical specialists and individual hospital trusts, which are based on the data – providing an unprecedented opportunity to examine individual trust behaviour and performance in the relevant area of practice, in the context of the national picture. This then enables the trust to understand where it is performing well and what it could do better – drawing on the input of senior clinicians;
• a national report, that draws on both the data analysis and the discussions with the hospital trusts to identify opportunities  for improvement across the relevant services;
• an implementation phase where the GIRFT team supports trusts, commissioners, and integrated care systems to deliver the improvements recommended; and
• best practice guidance and support for standardised / integrated patient pathways and elective recovery work in ‘high volume/ low complexity’ specialties.

The value of the programme to patients and the NHS

GIRFT collaborates and works in genuine partnership with NHS trusts, specialist clinical professional bodies (Royal Colleges and societies), and its partner NHS organisations in collating, scrutinising and sharing data, highlighting both underperformance and excellence. This evidence has had a major impact in identifying variation in clinical outcomes and has provided the focus for hospital teams, departments and clinical networks to tackle unwarranted variation, where it exists, through benchmarking and adopting best practice.

The NHS benefits through improved productivity, efficiency, and capacity, which in turn benefits patients, who can receive treatments quicker, have more equity of access to high quality care, and have better outcomes.