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November 2019 - GIRFT Stakeholder Newsletter - Read online

stakeholder newsletter

November 2019

ENT report calls for more day case surgery 

The latest GIRFT national report - looking at Ear, Nose and Throat (ENT) surgery - has been published, with recommendations for improving the experience for millions of patients by lowering admissions and repeat visits and potentially reducing waiting times.

The report, written by Mr Andrew Marshall of the Nottingham University Hospitals NHS Trust, says both patients and hospital trusts will benefit if more ENT surgery in England is carried out as a day case.

As well as enabling patients to get home more quickly, increasing day case rates for tonsillectomy operations alone could release between £1.4m and £3.7m per year for the NHS.

This is the ninth national report from the GIRFT programme. Read more about its recommendations and download a copy here.

Extending GIRFT's expertise and knowledge

GIRFT has appointed two new advisors to support work on its radiology workstream. Elaine Quick (left), a former radiology service manager at Salford Royal NHS Foundation Trust, and Lucy Beeley (second left), the group manager for radiology at Mid Yorkshire Hospitals NHS Trust, are working with GIRFT clinical lead Dr Kath Halliday and senior clinical advisor Dr Giles Maskell in their review of radiology and imaging. Read more about them here.

Two specialist nurses have also joined the programme to support the lung cancer leads as they prepare to begin pilot visits. Victoria Anderson (centre) has worked as a lung cancer nurse specialist at the Newcastle upon Tyne Hospitals NHS Foundation Trust for seven years, while Monica Hugh (second right) has been a lung cancer nurse for the past eight years at University Hospitals of Derby and Burton NHS Foundation Trust. Read more about them here.

Mr Vinay Takwale (right) has also joined GIRFT as a clinical ambassador supporting trusts in the London region. Mr Takwale is a consultant orthopaedic surgeon and the chief of the division of surgery at Gloucestershire Hospitals NHS Foundation Trust. Read more about his appointment here.

NCIP portal 'live' at trial trusts


A new digital portal developed in partnership with GIRFT has gone ‘live’ as part of an early adopter phase of the National Clinical Improvement Programme (NCIP). 

The secure online portal enables NHS consultants in England to review information about their clinical activity and their patient outcomes data.  It provides a series of dashboards presenting information from consultant-level data across eight surgical specialties as part of the trial. Only the registered individual consultants will be able to log in and access their data.

Five trusts have gone ‘live’ to trial the portal - they are Salford Royal NHS Foundation Trust, Alder Hey Children’s NHS Foundation Trust, Kingston Hospital NHS Foundation Trust, University College London Hospitals NHS Foundation Trust and the Royal Free London NHS Foundation Trust.

The NCIP team is working with these trusts to test critical processes and identify any data quality issues. The consultant surgeons invited to login to the portal will evaluate the user experience before the programme moves to a wider roll out. The NCIP portal will eventually be hosted by NHS Improvement alongside its Model Hospital portal which provides trust-level data. 

More information is available here. 

Plymouth trust shares its GIRFT successes 

Around 200 guests gathered in Plymouth for University Hospitals Plymouth NHS Trust’s first Getting It Right First Time (GIRFT) symposium.

Organised by the trust, the event saw colleagues from across the south west visiting Derriford Hospital to hear examples of service transformation across a range of clinical specialties.

Lord Carter of Coles (pictured below right), author of the 2016 Carter review of operational productivity of acute trusts, was in attendance, along with GIRFT chair and the national clinical director of improvement for the NHS, Professor Tim Briggs (below left), to hear how the trust has been tackling unwarranted variation.

Read our report in full here.

Urology study shows day case outcomes 'just as good'

Data examined by the Getting It Right First Time (GIRFT) programme suggests that patients undergoing bladder tumour resection surgery as a day case have at least as good HES-reported outcomes as those having an overnight stay.

The findings have been published in the Journal of Clinical Urology following a study of 2017/18 data for all NHS transurethral resection of bladder tumour (TURBT) surgery. The study compared outcomes of day-case surgery alongside outcomes for patients who stayed more than one night in hospital for a TURBT procedure.

The study was undertaken by GIRFT’s senior research associate William K Gray (pictured top left)working with GIRFT’s urology clinical lead Simon Harrison (bottom left), who authored GIRFT’s national report on urology services in England.  

You can read more about their findings here.

Reducing length of stay for prostate patients

Staff at Nottingham University Hospitals NHS Trust are now providing day case surgery for patients with an enlarged prostate, in response to a GIRFT recommendation.

Around 5-10 per cent of patients are opting to have the new UroLift procedure, which is minimally invasive and can be carried out in just 20 minutes. As well as relieving bed pressures at the trust, the procedure also has significant benefits for patients, who have a lower risk of complications and can be treated without the need for a catheter.

Published in July 2018, the GIRFT national report into urology services recommends reducing the length of stay for urological procedures, including prostate surgery.

Read more about NUH's work here.

Putting breast surgery patients first

To mark Breast Cancer Awareness Month, our two leads for breast surgery have been updating on the progress of their national review.

The breast surgery workstream – led by Fiona MacNeill and Tracey Irvine – has carried out 100+ visits to hospitals across England, and the two clinicians have been impressed by the level of care on offer to patients, and the willingness of hospital teams to review and refine their services.

Fiona said: “It has been fantastic to visit so many engaged teams, and see the enthusiasm and openness for reviewing their data and using the GIRFT process to improve care further. We have been consistently impressed with the dedication and high standards of care."

Read the article in full by clicking here.

GIRFT in just two minutes

GIRFT now has two short videos on its website - one explaining what GIRFT is and what we do, and the other explaining what to expect when we arrange a 'deep dive' meeting at your trust.

You'll find the 'all about GIRFT' video here and the 'deep dive' one here.

Take a look and please feel free to share with colleagues if you think it will help spread the word about GIRFT.

Ophthalmology metrics on Model Hospital

GIRFT data for ophthalmology has now been added to the Model Hospital.
 
Senior business intelligence manager Jamey Barron and his team have been working hard to provide more than 50 ophthalmology metrics in the initial release, including data on cataracts (both simple and complex), vitrectomy and trabeculectomy.
 
As with all GIRFT metrics on Model Hospital, the data is live up to the last full quarter, allowing trusts to see their progress and benchmark with their peers.
 
It is hoped another GIRFT workstream will be added to Model Hospital before the end of the year. Those currently available are orthopaedics (T&O), orthopaedics (spinal), vascular, urology, oral and maxillofacial surgery, cardiothoracic surgery, general surgery and now ophthalmology.

If you work at a provider trust and you don’t yet have an account, you can sign up at model.nhs.uk for access to all of the available metrics for your trust.

Sign up to take part in thrombosis suvey

A GIRFT Thrombosis Survey launched in October and will run until 31 March 2020.

Co-badged by the Royal College of Surgeons and the Royal College of Pathologists, and supported by the National VTE (venous thromboembolism) Exemplar Centres Network in collaboration with Thrombosis UK, the survey aims to identify the number of cases of Hospital Acquired Thrombosis in each hospital, determine the proportion of HAT cases which are deemed potentially preventable and to drive better scrutiny and investigation of HAT and its causes.

To take part in the survey, contact GIRFT project manager Anne-Marie Ridgeon at
a.ridgeon@nhs.net. You can find more information on the survey here

Use your voice to help save sight

A campaign run in collaboration with the Getting It Right First Time (GIRFT) programme is seeking to gather the stories of patients, carers and staff about their experience of using eye services.

EyesWise – an initiative led by the NHS Elective Care Transformation Programme in collaboration with GIRFT and the Royal College of Ophthalmologists – encourages new ways of working to save sight and improve lives.

As part of EyesWise, the 100 Voices campaign is asking patients, carers and members of staff to share their experiences of ophthalmology services since April 2018. Their stories will be fed back to NHS commissioners and providers along with information and guidance to help them use these patient stories to shape their decisions on eye services.

Anyone who wants to take part can contact the 100 Voices team on 0113 824 8672 or fill in an online form here.

Five minutes with... Mike Hutton

GIRFT's clinical lead for spinal services tells us about his rugby career and what he loves most about his specialty...

Q: How did you first become interested in spinal surgery?

I was formerly a professional rugby player and had planned to go into sports medicine/surgery, so much so that I undertook a sports surgery fellowship in New Zealand during the British Lions tour of 2005.

During my training programme as an orthopaedic registrar I worked with some inspiring spine surgeons at Ipswich Hospital and in Cambridge, who taught me how to assess and make sense of patients with spinal problems, and that with the right indication patients could have a good outcome from spine surgery. They flattered me by saying they thought I would make a good spine surgeon, which made me change my career path.

Q: What excites you most about your specialty?
Helping people with an emergency but reversible catastrophic change in their function. For example, operating on someone who is paralysed by spinal infection.

Q: What has been the highlight of your career to date?
On a sporting front, playing for the Barbarians. On a career front, publishing my GIRFT national report on spinal services after 127 visits - a lot of blood, sweat and tears went into it.

Q: Who or what inspires you?
Anyone who faces adversity in their life and fights through it to their benefit.

Q: How do you relax?
Watching the rugby or watching a good movie. And thinking about the next challenge I’m going to take on.


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