Feature shows how GIRFT has influenced fall in litigation claims for orthopaedic surgery

Professor Tim Briggs, John Machin and Daren Forward

A new feature published in an international journal highlights the positive impact the Getting It Right First Time (GIRFT) programme has had on reducing litigation claims in orthopaedic surgery.

GIRFT Chair Professor Tim Briggs and litigation clinical lead John Machin worked with Daren Forward, an orthopaedic consultant from Nottingham, to write the article for Bone & Joint 360 journal, showing how GIRFT’s ongoing work with trusts to learn from litigation has led to a reduction in orthopaedics claims.

GIRFT began reviewing claims in 2014 as part of its national review of adult elective orthopaedic services. Litigation data was shared during meetings with clinicians and managers in every trust in England, and it was clear many were unaware of the claims against their department and therefore unable to learn from them.

As reported in the February 2020 report Getting It Right in Orthopaedics, in the four years since those visits – to 2017/18 – the number of clinical negligence claims against trauma and orthopaedic surgery has fallen from 1,617 to 1,202, with a reduction in the estimated cost of claims from £176m to £147m.

Figures show orthopaedics has moved from its historical top ranking in claims volume to second place behind emergency medicine, while the specialty’s share of NHS clinical negligence costs has fallen from 10% to 4%.

“Both our experience and the data produced by NHS Resolution suggests there has been a change in trauma and orthopaedic surgery compared to other specialties,” says the Bone & Joint 360 article. “Regardless of [other] improvements, NHS Resolution has not seen the same reduction in litigation across all surgical specialties, suggesting that something different is occurring in orthopaedics.”

GIRFT is the first national programme to review clinical negligence claims against the NHS to help improve patient care, and now looks at litigation across all 40 of its surgical, medical and cross-cutting clinical service workstreams.

The article also outlines how the programme has worked closely with NHS Resolution to create data packs which allow every trust in England to review their claims across all medical and surgical specialties in one document. These packs are being used to not only learn from claims but also to shape safety and governance processes to make sure clinicians are better involved in the review process.

The feature also outlines the key priorities for improving claims learning – including improved clinical attribution of claims and sharing best practice – as well as explaining the legal factors which have led to the overall rise in NHS clinical negligence costs to £2.4bn in 2019. 

Bone & Joint 360 is a website and journal which supports orthopaedic clinicians and researchers by summarising clinical messages from orthopaedic literature worldwide. The full feature can be read here

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