Evaluating Getting It Right First Time – a programme to improve NHS orthopaedic care in England


Commissioned by NHS England, the Getting it Right First Time project (GIRFT) aims to deliver improvements in quality and reductions in the cost of orthopaedic care in England. The programme consists of three principal implementation tools: (1) feedback of performance data to providers; (2) tailored written feedback to underperforming providers; and (3) commissioning levers to change behaviour. The GIRFT approach will in due course be rolled out across thirty-seven other surgical specialities.

We are using formative and summative methods to conduct a mixed methods evaluation of the planned changes to orthopaedics, to identify lessons to inform future efforts to improve the organisation and delivery of services. Qualitative methods, including stakeholder interviews, documentary analysis and non-participant observation, are being used to understand the programme theory underlying the GIRFT approach and study the effect of different ‘implementation tools’ intended to promote changes in practice. We are also exploring patient perceptions of the planned improvements to care. Quantitative methods are being used to examine ‘what works and at what cost?.’

Using patient information

Part of our work involves requesting confidential patient data for a group of patients who have undergone elective orthopaedic surgery between 1st April 2009 and 31st March 2018.  The data we would like to use include Hospital Episode Statistics (HES), a database containing details of all admissions to NHS hospitals in England and data from the National Joint Registry, which records details of joint replacement operations in order to monitor the results of surgery and protect patient safety.

Read about how we will securely store and process patient information; about the use of your data in this research study; and requesting that your confidential patient information is not included in this study

Patient Opt Out

Principal investigator: Dr Helen Barratt, University College London

Other project team members:  Dr Sarah Jasim and Dr Jean Ledger, University College London;

Start date and duration: June 2016