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NJR welcomes findings from the Getting It Right First Time national review

17 March 2015

‘Fundamental change needed to ensure the best care for orthopaedic patients’ 

The National Joint Registry for England, Wales and Northern Ireland (NJR) welcomes the findings of the Getting It Right First Time Project national review (GIRFT) published this week (Monday 16 March) by the British Orthopaedic Association.

Commissioned by NHS England, and led by Professor Tim Briggs, the review highlights some of the improvements and approaches needed to ensure that orthopaedic surgery can deliver the best possible care for patients in the future.

The England-wide exercise combined NJR data with other national information sources to develop individual hospital reports, supporting on-site visits to hundreds of NHS orthopaedic departments.  
Some of the report’s key findings outline the need to:
  • Reduce the variation in surgical practice across the country and implement evidence-based treatment protocols, saving time and money while improving patient care
  • Standardise the approach to care and establish minimum requirements for effective service provision (for example, ring-fenced beds)
  • Investigate a ‘minimum’ case load for any one procedure and enable implementation through clinical and specialist networks
  • Encourage a new style of collaborative ‘shoulder to shoulder’ communication and management for the benefit of surgeons, hospitals and commissioning bodies
  • Drive up compliance with national audit and encourage engagement with the culture of data collection and professional leadership in this area
  • Generate understanding and best practice in the assessment of clinical evidence in order to drive forward quality decision-making and effective service redesign
“Providing patients with excellent orthopaedic care is at risk if the evidence continues to be ignored. That’s a clear message from the GIRFT review findings,” said NJR Medical Director Martyn Porter. “The variation in the treatment offered at hospitals and surgeons across the country is a clear signal that a new, more unified approach to delivering orthopaedic services is needed.”
“It’s worth noting that variation in itself is not always bad thing” added Porter. “What we want to see is a balanced, defined, explainable patterns of practice rather than surgical activity that has no base in reliable, robust national, regional and local evidence.”
The review also suggests ways that the NJR can assist the continued development improvement of joint replacement surgery, as part of national orthopaedic service provision.
“We are pleased that much of our current work is already responding to the future needs of surgeons and hospitals, as outlined in the GIRFT report” continued Porter, “we recognise that the registry has a significant role to play in providing much needed evidence to move forward discussions and decisions on quality.”
Specifically, the registry is already developing the following services:
  • A data quality strategy to develop and implementing new validation activities for and in hospitals to ensure full NJR compliance. This will engage providers further in the need to improve process and commitment to national audit data accuracy and completeness
  • Annual Clinical Reporting to Trusts, in its third year, is developing to provide important data and benchmarking for mortality and revision outcomes. This will be supported by extended reporting through publically available dashboards and help provider management to fully understand their current practice and areas for improvement
  • Individual consultant-level reports, launched in June this year, provide an annual summary of practice for each and every recorded Consultant. This will support surgeons in their revalidation activity but also accessing data to help support professional engagement in evaluating evidence, practice and outcomes for patients
  • Implementation of a new, free of charge price benchmarking service to procurement teams in England. This will provide hospitals with a way of benchmarking their purchasing activity and enable Trusts to benefit from cost and efficiency savings
  • Continued and planned enhancements to established, advanced online feedback services to surgeons, hospitals and suppliers
  • Work collaboratively on research to grow understanding and knowledge in order to answer some of the uncertainties on what constitutes best practice in the sector
Notes:  For press enquiries and to arrange an interview with Martyn Porter, NJR Medical Director then please email or call 020 7997 7317.
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