Following the publication of the GIRFT report in England, we are working with the Department of Health on extending the GIRFT project in England.  To get the latest information, you can join the Department of Health web portal.  Here, you will receive regular updates and information on next steps regarding the extended programme.  Please contact Nicola Joyce on for further information.


The ‘Getting it right first time’ (GIRFT) report published by Professor Briggs in late 2012, considered the current state of England’s orthopaedic surgery provision and suggested that changes can be made to improve pathways of care, patient experience, and outcomes with significant cost savings. The report takes the view that this approach has the potential to deliver a timely and cost effective improvement in the standard of orthopaedic care across England.   

The Secretary of State has now approved a national professional pilot of this approach across England, financially supported by the NHS PCC (Primary Care Commissioning).  The pilot formally will be a national professional trial of clinicians offering what is, in effect, management consultancy services.  It will be led by the sector of clinical professionals involved in leading the provision of local services; funded by the NHS; and endorsed by the Department of Health and the Medical Directorate of the NHS Commissioning Board. 

The pilot will undertake a national review of baseline data and “deep dive” meetings with providers and thereafter offer a succession of regional healthcare economies a review. This review features targeted self-assessment and peer review at local level of data relating to musculoskeletal services and their:

  • Clinical outcomes,
  • Processes (including revisions),
  • Patient experience,
  • Patient pathways,
  • Network arrangements,
  • Financial impacts
  • Waiting times

This in turn will lead to the development of bespoke peer to peer advice about options for the configuration of services in selected elective orthopaedic pathways considered to be most in need of improvement to be considered at local and national level (as appropriate to commissioning decisions and recommendations to providers for change).  

Clinicians with recognised professional status will undertake a national review of baseline outcomes data and use this as the basis for meetings with providers. In doing so they will offer support to colleagues at a local level to audit orthopaedic performance against national norms and suggest options for improvement consistent with the principles and recommendations of GIRFT; quantifying as far as possible the impact on patient outcomes, waits, the cost to commissioners and impact on the fixed costs of providers.