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February 2020 - GIRFT stakeholder newsletter - Read online

stakeholder newsletter

February 2020
L-r: Doug West, John McGrath and Kieran O'Flynn

Three new clinical leads appointed to carry out revisits 

GIRFT has appointed three new clinical leads in 2020, ahead of revisits to trusts.

Doug West, a consultant thoracic surgeon at University Hospitals Bristol NHS Foundation Trust, replaces David Richens as the programme's clinical lead for cardiothoracic surgery. David retired in 2018, after the publication of the GIRFT national report. 

Doug chairs the Society for Cardiothoracic Surgery’s audit committee, and was the lead author on its 2018 National Database Report in Thoracic Surgery. He has worked on the development of NHS England’s National Optimal Lung Cancer Pathway and the 2019 NICE Quality Standards in Lung Cancer. Read more about his appointment here.

Joint leads have also been appointed for GIRFT's urology workstream. Kieran O’Flynn, a consultant urological surgeon at Salford Royal NHS Foundation Trust, and John McGrath, a consultant urologist at Royal Devon and Exeter NHS Foundation Trust, replace Simon Harrison after his retirement as GIRFT clinical lead last year. Read more about them here.

Celebration event showcases ENT report

More than 50 specialists and stakeholders gathered at an event in Nottingham, held to showcase the key findings and recommendations from the GIRFT ENT national report.

Andrew Marshall, author of the report and a consultant ENT surgeon at Nottingham University Hospitals NHS Trust (NUH), pictured left, welcomed guests from across the country to an early evening reception.

Mr Marshall outlined some of the findings of his national review, before the audience heard examples of good practice from staff at NUH’s ENT and audiology departments, as well as from James Ramsden, an ENT consultant at John Radcliffe Hospital in Oxford.

Read more about the event here. To watch a video about good practice in Oxford, click here.

Community visits help to address winter pressures

 
GIRFT is working with the NHSE/I community care improvement programme to carry out visits to selected community health trusts this winter, to help address pressures on urgent and emergency care (UEC).
 
The community winter pressures programme is focusing on community inpatient beds and community respiratory services as core services for supporting patient flow. The aim is to support trusts and systems in implementing any learning and changes in the remaining winter period, as well as informing the approach and methodology of the wider community health pathways optimisation programme.
 
GIRFT chair and national director of clinical improvement for the NHS, Professor Tim Briggs, is leading visits to eight community providers, which will then inform the GIRFT community pilot, due to start in 2020.

Video promotes GIRFT metrics on Model Hospital

Last month we launched our GIRFT & Model Hospital video, in which our senior business intelligence manager, Jamey Barron, explains the benefits of having GIRFT metrics on Model Hospital and how to access them. You may have seen it on Twitter, but if not give it a watch here.
 
We also now have a new Model Hospital page on our GIRFT website here.
 
Ten of GIRFT’s surgical workstreams now have metrics on the Model Hospital platform. These are orthopaedics (T&O), orthopaedics (spinal), general surgery, vascular, urology, cardiothoracic, oral maxillofacial, ophthalmology, ENT and neurosurgery. Model Hospital can be accessed by anyone who works at an NHS trust, as well as arm’s length bodies, and provides up-to-date data to enable trusts to gain a deeper understanding of their own performance and opportunities for improvement.
 
If you don’t already have an account, you can sign up at model.nhs.uk

Improving clinical coding in hospital dentistry


GIRFT, the British Orthodontic Society and the Royal College of Surgeons have published a booklet to clarify the guidance on coding for hospital dentistry.

The guidance has been developed for clinicians, clinical coders and other health professionals at secondary care trusts and aims to improve the quality of data and reduce unwarranted variation. It was developed by the Consultant Orthodontic Group, based on the findings of GIRFT deep dive visits carried out by Liz Jones (pictured) and many conversations with clinical coding teams within trusts. Click here to read more and download the booklet.

Helping trusts to improve patient flow 


GIRFT has set up a project working with the emergency care intensive support team (ECIST) and NHSE/I regional teams to help trusts maintain elective care. This is in response to a request directly from NHS England's chief executive Simon Stevens.

Data packs covering a range of metrics have been shared with all acute trusts and are being followed up with deep dive meetings in selected trusts, led by GIRFT chair and national director of clinical improvement for the NHS, Professor Tim Briggs, GIRFT’s joint lead for anaesthesia and perioperative medicine Dr Chris Snowden and GIRFT joint lead for ophthalmology Alison Davis. The aim is to help trusts review opportunities to improve patient flow.
 
The visits are run jointly with ECIST and NHSE/I regional teams. The aim is to complete around 40 visits by the end of March, with GIRFT’s regional hub teams providing follow up and ongoing support. 
 
Concurrently, GIRFT is also working with ECIST and NHSE/I partners on an Improving Patient Flow collaborative, supported by NHS Elect. The programme will work with an initial cohort of 14 systems, with workshops and embedded QI support focusing on initiatives such as same day emergency care and acute frailty.
 
Professor Briggs, GIRFT joint lead for emergency medicine Dr Cliff Mann, and NHSE/I's medical director for elective and emergency improvement, Kevin Reynard, are jointly leading the workstream, which will be formally launched next month.

Clinical lead's paper of the month   

The author of GIRFT’s national report on urology, Simon Harrison, has presented a video on the findings of a study into the impact of centralising complex uro-oncology surgery in centres delivering high volumes.
 
The study, conducted by Simon Harrison, William K. Gray, Jamie Day and Professor Tim Briggs, has been published as the British Journal of Urology International (BJUI) paper of the month. It investigated volume-outcome relationships in nephrectomy and cystectomy for cancer, and also tested GIRFT’s recommendation for a minimum annual volume for specialist urology procedures. The paper found that the current level of centralisation of complex surgery for urological cancers is reasonable and further centralisation would not, in itself, be a driver for improved patient outcomes.
 
Mr Harrison said: “I think it is encouraging that there is no obvious benefit to be gained by greater centralisation, and that the guidance on numbers in our GIRFT report, which mirrors the current situation for urological cancer, is reasonable. The agenda should focus on ensuring that all hospitals and surgeons providing uro-oncology surgery are delivering best practice techniques, training and quality improvement programmes to optimise outcomes.”

You can find the BJUI paper and video here.

Study supports GIRFT spinal report   

A new study has found there are no sustained positive outcomes for low back pain from the use of multiple spinal injections, supporting a recommendation made in the GIRFT spinal services report.

The study, titled Multiple injections for low back pain: What’s the future?, was published in the European Spinal Journal and supports the GIRFT position that short-term pain relief injections should be replaced with long-term physical and psychological rehabilitation programmes to help tens of thousands more patients cope with debilitating back pain.

The GIRFT spinal services report was published in January 2019 and authored by Mike Hutton, pictured.

Read more about the study here.

Two more trusts secure Veteran Aware accreditation


Shrewsbury & Telford Hospital NHS Trust and Calderdale & Huddersfield NHS Foundation Trust have joined the wave of NHS providers named as Veteran Aware for their commitment to improving care for veterans, reservists and members of the armed forces community.
 
The accreditations from the Veterans Covenant Healthcare Alliance (VCHA), which is managed by GIRFT, acknowledges their commitment to a number of key pledges, such as ensuring members of the armed forces community are never disadvantaged when receiving care, training staff on veteran-specific needs, and supporting the armed forces as an employer.
 
Shrewsbury & Telford Hospital NHS Trust and Calderdale & Huddersfield NHS Foundation Trust join 47 other acute and mental health services across the country that have achieved the status. Read more here.

Pictured left, VCHA director Ian Donnelly

Eyeswise 100 Voices workshop


The Eyeswise 100 Voices campaign - run in collaboration with GIRFT - is concluding with a workshop for commissioners and providers of ophthalmology services, offering insight into the stories that have been shared and how they can be used in service improvement.

Click here to register for the workshop, which is being run on 2nd March in London.

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

The 100 Voices campaign asked patients, carers and members of staff to share their experiences of ophthalmology services to help guide future decisions on eye services.

Five minutes with... Professor Partha Kar

One of GIRFT's clinical leads for diabetes tells us what makes him tick...

Q: How did you first become interested in diabetes care?
A: A lot of the credit for that goes to two inspirational figures I met in my formative years - Dr Tony Zalin and Dr David Jenkins. There was something about them which made this an incredible specialty to pick - their unbridled passion to improve care, their ability to see the person as a whole, the ability to make a difference and be a guide in the journey of another person, all seemed to resonate and eventually coalesce into making this a career choice.
 
Q: What excites you most about your specialty?
A: The opportunity in front of us all is perhaps most exciting - whether it's the rise of patient power, new data on the impact of diet in type 2 diabetes, new medications or a new generation of professionals stepping up to make a difference, the future is bright. And the possibilities? Endless
 
Q: What has been the highlight of your career to date?
I have been blessed to have many highs in my career, but the highlight will always be getting the consultant job in Portsmouth. It has been the best decision I have ever made and time has borne that out - the ability to work among friends and enjoy one's job on a day to day basis. It gives me the cushion needed for the other roles I hold on a day-to-day basis.
 
Q: Who or what inspires you?
The 'what' is the ability to deliver outcomes. I place intrinsic faith in people who say they are experts and am inspired by the outcomes they deliver, not by how many papers they have written or their degrees. The 'who' are the individuals with the ability to establish themselves although surrounded by folks with greater talent - individuals such as Shahrukh Khan and MS Dhoni. Personally I am not blessed with as much talent as many of my colleagues, but it’s not about the extra talent but the outcomes you deliver with it. That is more important to me.
 
Q: How do you relax?
I love movies and I'm a big fan of reading comic books. Beyond that? Friends and, most importantly, family all contribute a huge amount to relaxing. Did I mention food? That is certainly something I enjoy. I have many avenues for relaxation and I take the opportunity to do so whenever it presents itself.


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