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Getting it right, eventually

The Getting It First Right Time programme is shaping up to have a bigger impact than other clinical reconfigurations (and with a £60m budget over four years, it should do).

The GIRFT teams are already out and about in the English acute system talking to trusts at a specialty level, with data and specialist knowledge.

The most recent report produced by the team (based at NHS Improvement) was on vascular surgery and showed a situation in which not enough had changed since the last review.

The team led by Professor Michael Horrocks found too much variation in volume and outcomes, and trusts that had still not properly networked their services into a hub and spoke model.

Pleasingly, research by HSJ seems to show significant movement on this front, with many of the trusts that were beneath the thresholds that GIRFT set for vascular surgery hubs working to centralise services.

It’s easier to make plans than implement them, of course. But the signs are positive that work will be concentrated into fewer, bigger centres that do more work.

For one thing, there will be regional GIRFT leads tasked with pushing the adoption of these plans.

The last review, carried out by the Vascular Society 10 years ago, also recommended a hub and stoke network model. That significant swathes of the country still aren’t in one speaks volumes about how much impact such well intentioned work can have if it is not driven through.

Trusts are already implementing changes in GIRFT specialties for which the official reports have yet to be published – and there is a backlog building up.

The next official review – into cardiothoracic surgery – is expected in April.