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

  • The programme was first conceived by Professor Tim Briggs to review elective orthopaedic surgery to address a range of observed and undesirable variations in orthopaedics.
  • In the 12 months after the pilot programme, it delivered an estimated £30m-£50m savings in orthopedic care – 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.
  • The NHS serves a million patients every 36 hours, spending over £120bn annually. Whilst the NHS benefits from some of the best leadership and innovation, there is also widespread unwarranted variation which affects patient outcomes, costs and productivity.
  • Lord Carter’s 2016 report on unwarranted variation in acute NHS trusts highlighted the opportunity to save up to £5bn if unwarranted variation can be tackled and all providers’ cost bases were at the median level.

The GIRFT programme is continually evolving, and their plan for 2021/2022 is to move away from deep dive visits to the new systems led gateway reviews within the High Volume Low Complexity (HVLC) programme. 

The GIRFT methodology:

The programme is made up of a series of 40 surgical and medical workstreams alongside several other cross-cutting, system-wide projects.

  • Each workstream or project is led by a clinician who works with the GIRFT team to assemble and review data analysis from across a range of agreed metrics.
  • The work involves combining publicly available information, other relevant registry or professional body data, and the results of a questionnaire issued to the trusts in which services or pathways are being reviewed.
  • This then informs actions and recommendations for improvement.