HVLC programme - Getting It Right First Time

High Volume Low Complexity
(HVLC) programme

What is the HVLC Programme?

The High Volume Low Complexity (HVLC) programme is a priority data-led transformation programme supporting the recovery of elective care services post COVID-19 pandemic. It aims to reduce the backlog of patients waiting for planned operations, improve clinical outcomes and access to services through standardised clinical pathways.

How does it work?

The HVLC programme team works with trusts and integrated care systems (ICS) to:

agree standardised pathways and adopt best practice;
pool capacity and resources, to deliver excellent clinical outcomes and equity of access to care for their population.

Standardised pathways

In line with local population needs, local systems are encouraged to identify their priority clinical pathways for improvement. To support trusts with this, GIRFT has developed ‘gateway frameworks’ which include a range of metrics enabling trusts and integrated care systems to benchmark and review their performance against the relevant metrics.

Surgical hubs >

The HVLC programme is supporting systems to ring-fence elective capacity and create elective ‘hub’ facilities to carry out low and medium complexity procedures at scale within defined standards. These ‘hub’ sites will help increase elective activity with patient flows into the hubs from a number of different trusts or trust sites within a system.

Find more information on surgical hubs here >

Theatre productivity >

The programme is working to agree system-wide operating theatre principles (e.g. accepting day surgery as the default), and theatre efficiencies (e.g. the number of cases per theatre list). There is significant variation across England on how well operating theatres are utilised. Part of the programme’s work is to improve data quality and data collection to help trusts to understand what is driving reduced theatre productivity and how to increase theatre throughput.

Find more information on theatre productivity here >

What are the key priority areas for the HVLC programme?

GIRFT’s HVLC programme is focusing initially on driving improvement in six high-volume but low complexity surgical specialties:

1. Ophthalmology
2. General surgery
3. Trauma and orthopaedics (including spinal surgery)
4. Gynaecology
5. ENT
6. Urology

Key objectives of the HVLC programme

The HVLC programme is a key element of the wider NHS Elective Recovery Programme. HVLC is about working at pace with national and regional partners and providers to implement a data-driven approach against four key improvements:

Quality and outcomes – for non-complex surgical care through identifying and reducing unwarranted variation.

Equity of access – reducing variation in access to non-complex surgical care for patients.

Productivity – contributing to the reduction of the (national) elective waiting list by improving how HVLC procedures are carried out.

Capacity and resilience – to reduce the elective waiting list by increasing the resilience of elective services during peak periods of demand in winter.

What are the key measures of success for the HVLC programme?

Adopting best practice – delivering excellent top decile clinical outcomes

Agreeing standardised pathways – reducing variation and learning from the best

Ensuring equity of access – to support an aging national population

Sharing and pooling capacity and resources – to facilitate mutual aid when/where it’s needed

Engaging, collaborating to inspiring continuous improvement across our professional networks – utilising the range of expertise across clinical and professional networks

Find out more about HVLC’s data-led approach and best practice resources to support elective care recovery and improvement:

GIRFT has developed a number of guides for Trusts and ICSs to achieve top decile performance by 2024 and establish elective surgical hubs.

Click above to view the pdf

“By adopting best clinical and operational practice, we know we will achieve improved productivity and at the same time support our workforce to embed new ways of working and maximise the benefits of working together across systems.”