Five key national pathways for elective orthopaedic surgery procedures have now been updated by the GIRFT team, in collaboration with the British Orthopaedic Association and orthopaedic specialist societies, supporting colleagues across England to use clinics and theatres more efficiently and reduce waiting times.
GIRFT has worked with a wide range of stakeholders* on the updates, and the following pathways are now available for download on the GIRFT website:
The pathways outline best practice along the patient journey – from presentation to discharge and follow-up – for these five high-volume, low-complexity (HVLC) procedures. First issued in 2020, their aim is to streamline the surgical patient journey, and standardise and therefore improve clinic and theatre capacity, which in turn will reduce waiting times for both new patients and the follow-up patients who need to be seen.
The 2026 updates ensure that the follow-up section of the pathways aligns with GIRFT’s Further Faster Follow-Up Protocols and GIRFT Standardising Follow-Up guidance.
Join our webinar
GIRFT and the British Orthopaedic Association are jointly presenting a webinar on making best use of the updated national pathways for elective orthopaedic surgery.
Taking place on 13 October 2026 (1pm-2pm), the session will be hosted by GIRFT programme lead Professor Tim Briggs and the President of British Orthopaedic Association, Professor Amar Rangan, and will highlight the key updates to the pathways.
Professor Tim Briggs, GIRFT programme lead and clinical lead for GIRFT’s orthopaedic surgery workstream said:
“The demand for elective care is expected to increase substantially over the next decade, and we know that current outpatient models are not sustainable. Now is the time to do something different; to find more efficient and innovative ways of working and individualise patient care.
These updated HVLC pathways, which we have developed with the BOA and other specialist societies, are evidence-based and proven to improve efficiency in many units. With their potential to make a big difference to patients who need orthopaedic surgery, it is imperative that all teams across England adopt them, to help reduce their waiting times and the risks to patient safety such delays can bring.”
*The five pathways have been co-badged by:
- British Orthopaedic Association (BOA)
- British Hip Society (BHS)
- British Association for Surgery of the Knee (BASK)
- British Elbow & Shoulder Society (BESS)
- British Orthopaedic Foot & Ankle Society (BOFAS)
- British Society for Surgery of the Hand (BSSH)
- British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS)
