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NHS could save £108m by introducing ‘at the door’ surgical assessments

NHS trusts could see significant reductions to unnecessary hospital admissions by introducing consultant-led surgical assessments at the front door, a report released today has found.

Research by the Getting It Right First Time Programme (GIRFT) has found that the implementation of this policy in hospitals could reduce general surgery admissions by 30% a year, leading to an annual cost saving of around £108m.

The change would also yield better results by freeing up hospital bed space, which has recently reached crisis levels as trusts across England continue to operate above the recommended capacity.

GIRFT also recommended a raft of other changes that could be brought in to improve general surgery and create better patient outcomes and reduce the disparity in quality between trusts across the country.

The plans drawn up by John Abercrombie, a leading colorectal surgeon and author of the GIRFT national report into general surgery, also put forward other recommendations that fall under five themes.

These include increasing the amount of day-surgery for some procedures so that patients can return home quickly, minimising problems that result in longer hospital stays or readmissions and the better use of data to reduce variation between trusts.

It also advised surgeons and consultants to increase the use of perioperative medicine to address ‘reversible risk factors’ prior to non-urgent procedures, and also measuring surgeons against new national clinical standards to help them get a better understanding of their own performance.

“By looking at the trusts’ own data I’ve been able to have a frank discussion with clinicians and managers about what’s working well and areas for improvement,” said Abercrombie.

“GIRFT’s focus on identifying unwarranted variation provided us with the opportunity to understand why differences exist, discuss the challenges trusts face and look for ways to improve services which will benefit patients and make trusts more efficient.

“My recommendations provide a blueprint for better care that will be good for patients and good for the NHS.”

GIRFT is a national initiative led by consultant surgeon Professor Tim Briggs, who successfully ran a pilot programme in orthopedic surgery which helped to save £30m in its first year and £20m the year after.

The recommendations have also been endorsed by the Royal College of Surgeons (RCS), an organisation which is a strong supporter of the GIRFT programme.

“The GIRFT initiative has shone a light on variation in surgical practice and processes across the NHS,” said Professor Derek Alderson, president of the RCS.

“Surgical change is most effective when driven by surgeons themselves and we are pleased to see this report is no exception to that principle. 

“As a professional body that exists to advance surgical care, we believe the recommendations have the potential to improve the quality and experience of care that patients receive, as well as deliver important savings to the health service.”

Health secretary Jeremy Hunt added: “We want to build the safest, highest-quality healthcare system in the world – and by reducing variation we can improve care and eliminate waste at the same time.

“As this excellent work led by Professor Tim Briggs shows, some hospitals are already working smarter with their money to save time and get better outcomes – but there’s more to be done and I hope to see hospitals across England replicate this work.”

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Leila Williams   07/08/2017 at 13:24

Great to see spreading of the learning and pioneering acute transformation that Greater Manchester has led, through the Healthier Together programme, being championed for all areas

Dr Grumpy   07/08/2017 at 14:35

Well well well! Having consultants in the A&E dept is being revisited yet again! This brilliant idea has been mentioned before but rejected as too expensive as it would require the on call consultant to be free of all duties except emergency care so no clinics or elective surgery on the on call days. Has this loss of service been factored into the equation to arrive at the £108m savings? I have to say that I have always agreed with this idea but then again I'm not the one who needs convincing!

Walter   07/08/2017 at 16:32

Get It Right The First Time? Between the authors of the plan, their supporting bodies and the Secretary of Health still leaving in his inebriating cloud of arrogance of 'building the safest system in the world' somebody should probably go back to the basics and recognize that this is far from the First Time and the great steps indicated are so empty and repetitive that they will go nowhere.

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