GIRFT
Getting It Right First Time - is a national NHS England improvement programme that aims to improve the quality, safety, and efficiency of patient care by reducing unwarranted variation in clinical practice.
Led by clinicians, GIRFT uses data analysis, benchmarking, and peer-led service reviews to identify variation in practice and outcomes between organisations. It then provides specialty-specific recommendations to improve patient outcomes, enhance productivity, reduce costs, and promote evidence-based care.
History
GIRFT was founded by Professor Tim Briggs, a consultant orthopaedic surgeon, who recognised significant variation in orthopaedic practice and patient outcomes across England. In 2012, Professor Briggs conducted a national review of orthopaedic services, comparing outcomes, costs, and clinical practice across NHS organisations.
He identified considerable unwarranted variation that could not be explained by differences in patient populations, highlighting opportunities to improve quality, efficiency, and patient outcomes.
The success of the orthopaedic programme led to GIRFT being expanded by NHS England into a national improvement programme. Since 2015, it has grown to encompass more than 40 specialties, each led by a national clinical lead responsible for identifying variation and supporting service improvement.
What GIRFT Delivers
The aim is to understand why variation exists and support organisations to deliver consistently high-quality, efficient care.
GIRFT aligns closely with the NHS priorities of delivering high-quality, evidence-based, and value-based healthcare. By reducing unwarranted variation, it helps improve patient outcomes while ensuring NHS resources are used efficiently.
Each specialty has its own GIRFT workstream, led by a national clinical lead. These workstreams:
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Analyse national data and benchmark services.
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Conduct peer-led visits to NHS organisations.
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Identify opportunities for service improvement.
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Publish specialty-specific reports and recommendations.
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Share best practice across the NHS.
How does GIRFT work?
Example
The GIRFT report for Anaesthesia, Perioperative Medicine and Pain (2021) identified increasing day-case surgeryas a key priority for improving patient care and NHS efficiency. The report found that increasing the number of patients undergoing surgery without an overnight hospital stay, where clinically appropriate, could help reduce waiting lists, improve patient flow, and deliver cost savings of up to £2 million per NHS trust.
The report recommended that:
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Day-case surgery should be the default pathway for all suitable elective procedures.
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Performance metrics should be routinely collected and monitored to benchmark services and drive continuous improvement.
For anaesthetists, this involves optimising patients before surgery, selecting anaesthetic techniques that promote rapid recovery, minimising postoperative pain and nausea, and supporting enhanced recovery pathways to enable safe same-day discharge. This demonstrates how GIRFT recommendations translate into practical service improvements that benefit both patients and the wider NHS.
For a concise overview of the GIRFT programme, watch the short introductory video below. You can also explore further information on the GIRFT website.