A new follow-up guide summarises how 20 trusts taking part in GIRFT’s Further Faster initiative (FF20) have implemented high flow lists (HFL) in key specialties to increase theatre capacity and reduce numbers of patients on waiting lists.  

The guide provides detail on specialty level implementation with information on common enablers, and emerging challenges to support others in identifying where and how to apply this approach within services. It gives an update on where those FF20 trusts are with their implementation, the different funding models and cost challenges, and their future plans.  

High flow models are being adopted across a range of surgical specialties, with trusts using the approach to support elective surgery management and optimise theatre throughput. In January 2025, GIRFT published a guide called Delivering high flow lists which outlined the benefits of high flow theatre lists and the different models currently being used by trusts.  

The Further Faster 20 cohort has gained valuable insights through the early design, testing, and implementation of high flow lists. This follow-up guide includes lessons learned across workforce planning, operational design, data and financial insight, patient selection, governance and monitoring. A number of the FF20 trusts have also shared case studies about their experience and learning to help trusts looking to adopt high flow lists or scale their own models. 

The Further Faster 20 (FF20) cohort has a key focus on both reducing waiting times and enabling people to return to work in areas with high levels of economic inactivity due to musculoskeletal issues such as back pain or other conditions like diabetes and cardiovascular disease.