GIRFT invites all trusts to go further and faster to reduce 52-week waiting times

Following a successful pilot, Getting It Right First Time (GIRFT) is rolling out its Further Faster programme to all NHS trusts in England to support them in rapidly reducing the number of patients waiting over a year.

GIRFT is inviting all trusts to follow the Further Faster methodology developed during the pilot phase – that of networking and learning from shared experience to mitigate challenges, and utilising standardised patient pathways in 19 specialties* – and is now offering a set of resources to guide them.

Resources now available to all trusts include:

  • Further Faster Handbooks: specialty-based guidance providing regional data to enable benchmarking, plus best practice case studies, checklists, and links to associated resources. The specialty handbooks use a checklist approach to outline clear actions and practical advice for improvement in areas such as DNAs, PIFU and follow-up ratios. To access them, first join the GIRFT FutureNHS workspace; once accepted, handbooks can be found under ‘specialty handbooks’ > ‘regional handbooks’.
  • Mini-modules: video excerpts from the pilot Further Faster specialty meetings, based on a particular topic. These capture presentations and discussions on areas including referral optimisation, the outpatient pathway, follow-up appointments and delivering ‘super clinics’.
  • Clinicallyled specialty meetings: regular specialty meetings held across the 18 specialties, led by GIRFT’s clinical leads and implementation team, to enable innovation and good practice to be shared between colleagues.
  • Online discussion forums: enabling those engaged with the Further Faster programme to ask questions and share learning with others.

Forty-nine trusts in two cohorts have taken part in the Further Faster pilots to date, which saw teams of clinicians and operational colleagues coming together with the challenge of collectively transforming patient pathways to reduce unnecessary appointments and improve access and waiting times.

Data from the initial pilot shows that from July 2023 to January 2024 the 52-week backlog reduced by 34.8% across cohort 1 and 12.4% across the later onboarded cohort 2 trusts. Non-participating trusts reduced their backlog by 7.1%.

"GIRFT has earned the reputation for moving at pace, and we were confident that bringing together teams of highly-engaged clinical and operational colleagues to pool knowledge and resources under Further Faster we could ambitiously reduce the number of patients waiting over a year. We are delighted that trusts in the pilot have proven us right, and we can now widely share the fundamentals and methodology of Further Faster to allow other trusts to be just as ambitious with reducing their waiting times backlog.”

Further Faster supports the adoption of Clinically-led Specialty Outpatient Guidance, which was developed in 2023 in a collaboration between GIRFT and the Outpatient Recovery and Transformation (OPRT) programme, as well as GIRFT’s HVLC standardised pathways.

The programme aims to support trusts with elective recovery through key fundamentals to ensure efficient patient pathways, such as

  • Maximising patient appointments (eg; advice on reducing DNAs, implementing PIFU, and waiting list validation);
  • Meeting demand and capacity (eg; super clinics, surgeon passporting, mutual aid, and standardising clinic templates); and
  • Enhancing elective surgery (eg; utilising GIRFT best practice pathways, and improving region-wide capacity through theatre productivity and increasing day case rates).

Trusts opting to take part in Further Faster will need to appoint a Senior Responsible Officer, engage trust GIRFT leads to co-ordinate and disseminate resources, and appoint speciality clinical and operational leads in each speciality, before downloading the GIRFT handbooks and checklists to begin reviews at specialty-level.

NHS England’s regional teams will hold programme management responsibility for the national rollout, communicating and engaging with trusts as required.


*The 19 Further Faster specialties are:

1. APOM and Theatres
2. Cardiology 
3. CYP
4. Dermatology
5. Diabetes 
6. ENT 
7. Endocrinology and Endocrine Surgery
8. Gastroenterology 
9. General Surgery
10. Geriatric Medicine 
11. Gynaecology
12. Neurology
13. Ophthalmology
14. Orthopaedics
15. Paediatric T&O
16. Respiratory
17. Rheumatology
18. Spinal Surgery
19. Urology

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