Orthopaedic Surgery

GIRFT has published two reports on orthopaedic surgery. The first publication in 2015 was a landmark report for the orthopaedic specialty, highlighting areas of excellence and areas for focus and improvement. The initial orthopaedic surgery review established the GIRFT methodology and became the pilot for the current programme. Professor Tim Briggs and his team visited over 140 providers, covering more than 200 hospital sites. His original report coined the term ‘Getting It Right First Time’.

In February 2020 a follow-up document was shared, reflecting on success and reinforcing improvement. It marked the progress made since the first report and the work that has continued in improving outcomes for patients, including reductions in complications, rates of hip revision surgery, length of stay and infection.

Headline findings included:

A reduction in revision rates every year since 2012, even while total activity and demand grew.
Average length of stay reduced by 20%, releasing more than 368,000 bed days.

Professor Tim Briggs CBE

Clinical Lead for Orthopaedic Surgery

Consultant Orthopaedic Surgeon at the Royal National Orthopaedic Hospital, GIRFT programme Chair, National Director of Clinical Improvement and Elective Recovery. Chair and National Lead of the Veterans Covenant Healthcare Alliance (VCHA) and Honorary Colonel of 202 (Midlands) Field Hospital RAMC

Tim is a consultant orthopaedic surgeon and was appointed National Director for Clinical Improvement and Elective Recovery for NHS England in November 2022. He is Chair of the GIRFT programme and leads the roll out of GIRFT methodology across all surgical and medical specialties.

Tim was appointed to the Royal National Orthopaedic Hospital as a consultant in 1992. His specialist interests are in orthopaedic oncology as well as surgery to the hip and knee. He was medical director at the RNOH for 15 years, ensuring a re-build, and was president of the British Orthopaedic Association in 2014.

He is also chair and national lead of the Veterans Covenant Healthcare Alliance (VCHA) and Honorary Colonel of 202 (Midlands) Field Hospital RAMC.

He was made a Commander of the Most Excellent Order of the British Empire (CBE) in the 2018 New Year’s Honours List for services to the surgical profession.

Useful information

The original GIRFT orthopaedic surgery review
The initial Orthopaedic Surgery review established the GIRFT methodology and became the pilot for the current programme. Professor Tim Briggs and his team visited over 140 providers, covering more than 200 hospital sites. His original report coined the term “Getting It Right First Time”.

The British Orthopaedic Association (BOA) and its annual conference
BOA co-badged and endorsed the GIRFT national report on orthopaedics and the GIRFT programme is one of the key strands of the BOA’s Practice Strategy. Find out more about BOA and register for its Annual Congress.

The report included a raft of recommendations, many of which have been adopted by orthopaedic trusts and delivered real benefits

The recommendation to adopt cemented hip replacements for patients aged over 65 has led to a 10% increase in the use of this method, saving an estimated £4.4m p.a.
Reduced length of stay for hip and knee operations has freed up 50,000 beds annually
Trusts have moved to more ring-fenced orthopaedic beds, reducing cross infection
An increase in localised consolidated working between trusts, sharing resources and maximising the number of procedures carried out
75% of trusts have renegotiated the costs of implant stock and rationalised their use
Greater awareness of costs has led to reduced use of expensive “loan kit”
Litigation claims are down from 1,758 in 2013/14 to 1,505 in 2015/16
A GIRFT “Pricing Letter”, providing transparency of the prices different orthopaedic trusts pay for prosthesis, is now used by consultants selecting implants
In 2016 the British Orthopaedic Association used GIRFT principles in published guidance to ensure best practice amongst its members

In a survey carried out by the NHS more than 70 of the trusts visited during the orthopaedic review responded: they reported total savings of between £20m and £30m for 2014/15 as a result of adopting GIRFT’s recommendations. If extrapolated across the more than 140 providers visited, these savings would increase to an estimated at £40m to £60m. Furthermore, the trusts that responded forecast a further £15m to £20m of savings for 2015/16, estimated at £30m to £40m if replicated across all the orthopaedic trusts. Professor Briggs is currently carrying out revisits of all the trusts he visited during the first review to gauge changes and improvements since the initial GIRFT report.

Find out more about GIRFT’s data-led approach and best practice resources:

In March 2015, GIRFT published its national speciality report for Orthopaedic Surgery:

Click above to view the pdf report

In February, GIRFT published Orthopaedic Surgery follow-up report:

Click above to view the pdf report

Orthopaedic follow-up report: Professor Briggs held his first deep-dive visits to trusts in late-2012, and the follow-up report’s findings show evidence of substantial improvement against all the key GIRFT metrics, meaning that the NHS is providing better quality orthopaedic care and getting better value for money.