Getting It Right in Orthopaedics: A follow-up on the GIRFT national specialty report on orthopaedics

The British Orthopaedic Association (BOA) is delighted and proud to support this follow-up report on Orthopaedics from the Getting It Right First Time programme. This initiative originally started as a ‘pilot’ when Professor Tim Briggs was the President of the BOA, and we are pleased to see how it has gone from strength to strength ever since the first work began in 2012, expanding its remit into over forty other surgical and medical specialties as a clinically-led activity to improve quality and patient safety, and reduce unwarranted variation. Spinal surgery has its own GIRFT work stream that reported last year which we particularly supported given the close professional inter-relationship between orthopaedics and spinal surgery.

The very first GIRFT publication in 2015 was a landmark report for the orthopaedic specialty, highlighting areas of excellence and areas for focus and improvement. This follow-up document is particularly welcome as it clearly demonstrates the significant progress made since that time. We commend the efforts of the Orthopaedic workforce and multidisciplinary teams that have all contributed to the major improvements described here. I would like particularly to highlight the important progress that has been made in improving outcomes for patients, including reductions in complications, rates of hip revision surgery, length of stay and infection. We at the BOA are continuing to work with the GIRFT programme, our specialist societies and our members to further develop areas of work proposed in this document. The original report was based on data from England so it is important to note that this document includes work in Wales, Northern Ireland and Scotland, which have also now engaged with the GIRFT programme.

Download report from GIRFT website


The Getting it Right First Time (GIRFT) report, published in March 2015, identified both variation and scope for quality improvement in terms of procedure volumes, implant selection and infection rates.This was not simply a snap-shot of orthopaedic practice in the country but is intended by NHS England to be a recurrent audit which will be used to influence aspects of orthopaedic delivery. Our guidance aims to provide appropriate clarity on how to implement GIRFT and should be used in conjunction with GIRFT performance dashboards and NJR data.

All discussion of data within the implementation framework of GIRFT is consistent with the principles of the BOA’s position statement on outcome data, T&O surgeons and units. Specifically, the guidance embodies the ethos that: “all individuals or units that are highlighted as having variance issues… must act upon this information to review their data, consider the reasons for variation and whether any further action or alteration to practice is required”.

The BOA’s Professional Guidance to implement Getting it Right First Time in England is available below. The BOA’s position statement on outcome data, T&O surgeons and units is also available below.
In cases of any doubt about the application of this guidance the T&O clinical lead for your unit should contact the BOA Professional Practice Committee via [email protected].