GIRFT starts work on lung cancer review

The Getting It Right First Time (GIRFT) programme has appointed a team of specialist clinicians to lead a national review into services for lung cancer patients.

Run in collaboration with NHS England, and in line with the ambitions of the NHS Long Term Plan, the latest GIRFT review is bringing together expert clinicians to help improve care for the 38,000 people diagnosed with lung cancer in England every year. Lung cancer is the third most common cancer in the UK, accounting for 13% of all new cancer patients*.

The NHS Long Term Plan (LTP) prioritises cancer care and establishes a number of important ambitions for improving cancer outcomes, including a new survival goal that by 2028, 55,000 more people each year will survive cancer for at least five years. This aims to place England among the best countries in Europe for cancer survival.

The GIRFT review will focus on making improvements in line with the roll-out of the National Optimal Lung Cancer Pathway. The first task will be to compile data packs for 133 individual trusts in England, as well as six tertiary centres, before deep dive visits to them all.

Pilot visits are scheduled to begin in October 2019, with the aim of completing meetings with all trusts by May 2020. The national report which follows will present the data, GIRFT’s findings, examples of best practice and an action plan of proposed changes and improvements. Action plans will then be jointly supported by GIRFT’s implementation managers and NHS England.

Three clinicians have been appointed to the new GIRFT workstream. They are:

Dr Paul Beckett

Dr Beckett is a respiratory physician at University Hospitals of Derby and Burton. He has been a clinical lead for the National Lung Cancer Audit for more than 10 years, and is looking forward to helping to drive change at pace with GIRFT.

He said: “There is a huge interest nationally to improve outcomes for lung cancer patients, particularly focusing on implementing the National Optimal Pathway. Through our work on the National Lung Cancer Audit, we have highlighted the wide variation in practice and outcomes but have sometimes been frustrated at the inability to implement local service improvement – I’m convinced that the GIRFT methodology will allow us to do just that.

“I’m really looking forward to visiting lung cancer teams up and down the country to hear about their services and to share examples of innovative practice to help them on their improvement journeys.”

Dr Elizabeth Toy

Dr Toy is a consultant clinical oncologist based at the Royal Devon and Exeter Foundation NHS Trust, where until recently she was clinical director for cancer and end of life care.

She said: “There is an urgent need to improve outcomes for patients diagnosed with lung cancer in England and ensure everyone has rapid access to expert care.

“I believe the GIRFT process will facilitate full implementation of the National Optimal Lung Cancer Pathway enabling teams to deliver truly personalised care in a timely manner. I am delighted to have this opportunity to work alongside clinical colleagues to truly improve the service we offer patients and their families.”

Dr Sarah Doffman**

Dr Doffman is a respiratory physician at Brighton and Sussex University Hospitals and a past Chair of the Sussex Cancer Network Lung Tumour group.

She said: “I am delighted to have been appointed into this role with GIRFT and I am very much looking forward to working with many lung cancer teams across England.

“It is imperative that we roll out the National Optimal Lung Cancer Pathway and improve outcomes for our patients with lung cancer. It will be a challenging year but I am looking forward to the programme’s success and pleased that lung cancer has been prioritised for national focus.”

Dr Toy’s appointment is endorsed by The Royal College of Radiologists. President Dr Nicola Strickland said: “Lung cancer is one of the UK’s most common and deadly cancers. However, there is wide variation in treatment access and patient outcomes across cancer centres and hospitals in England.

“We are delighted that Dr Toy is part of the team driving this GIRFT workstream. She has an impressive track record in clinical evaluation – having authored a Cochrane review into evidence-based fractionation in palliative radiotherapy for lung cancer – as well as hospital management. We know her expertise as a multi-modality thoracic clinical oncologist will be a great asset to the investigation.

“We very much look forward to the team’s future findings around reducing variation and improving services so that all lung cancer patients can benefit from the best treatment options and care, wherever they live.”

Dr Beckett and Dr Doffman’s appointments are endorsed by the British Thoracic Society. Chair of the BTS Board, Professor Jonathan Bennett, said: “It is fantastic that the GIRFT programme is starting a lung cancer workstream which will support important quality improvement work in the respiratory oncology field.

“We are certain that Dr Sarah Doffman, Dr Paul Beckett and Dr Liz Toy will deliver the programme on time and to the highest standard, and we look forward to seeing the results of this project to improve the care of all patients diagnosed with lung cancer.”

The three leads will be supported by Dr Martin Allen, who will work as a clinical advisor to the workstream. Dr Allen is already leading the GIRFT respiratory review. GIRFT will also be appointing specialist lung cancer nurses to support the workstream.

The NHS Long Term Plan pledges to extend lung health checks over the next two years so that patients have a breath test and a discussion to assess their individual lung cancer risk. Any patient assessed as being at high risk of lung cancer will have an immediate low-dose CT scan.

In February 2019, the NHS announced £70m for 10 new lung cancer scanning trucks which operate from supermarket car parks. CT screening helps to identify more cancers quickly, pick up a range of other health conditions, including chronic obstructive pulmonary disease (COPD), and helps reduce inequalities in cancer outcomes.

GIRFT Chair and National Director of Clinical Improvement for the NHS, Professor Tim Briggs, said: “The Long Term Plan contains some very clear ambitions for improving cancer outcomes and I am delighted to see this team of well-respected colleagues coming together to help drive change at pace.

“GIRFT will be working closely with the National Cancer Team, led by Cally Palmer, to deliver this initiative, which will help to create world-class cancer services and hopefully save thousands of lives each year.”


*according to 2016 figures from Cancer Research UK

** Dr Doffman has since left the GIRFT programme

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