GETTING IT RIGHT FIRST TIME

Oral and Maxillofacial update by Maire Morton

06 March 2017 (Last updated: 9 Mar 2017 13:30)

This project that is now being rolled out nationally across many specialities started with a pilot review of Orthopaedic services across England. The original report published in late 2012 suggested changes can be made to improve pathways of care, patient experience, and outcomes with significant cost savings. It was followed by a more in depth approach that reported in 2015. The pilot project was led by Prof Tim Briggs who was subsequently appointed as the National Director for Clinical Quality and Efficiency and now leads the GIRFT Project across all the specialities.

Getting Right First Time is a national programme supported by NHS Improvement. The methodology involves deep dive visit to units where peer to peer discussion and review of the dataset for that unit can be presented encouraging the development of evidence based best practice. The dataset allows benchmarking against other units and will drive quality improvement. In addition the remit of GIRFT has expanded to look at areas such as infection rates, use of equipment such as single use equipment and procurement procedures.

There are marked differences between OMFS and orthopaedics. The latter had established quality dashboards and data sets such as the National Joint Registry with consultant level data. This together with HES data allowed the GIRFT team to pull together hospital level data which was used when the deep dive visits to hospitals took place. In OMFS the first problem that we came across was that many Trusts, where I knew there was a Maxillofacial unit, failed to submit any HES data under the Maxillofacial speciality code!

In addition we do not as a speciality have any nationally reported outcome measures. The only data we have is the DAHNO head & neck data base, the last report was in 2014 based on data from 2012/3 so is not really very up to date. We are of course now waiting for HANA.

However despite this we  have managed to develop a data set based on areas of clinical practice that most units will be involved with:

• Dentoalveolar Surgery
• Head & Neck Cancer including Facial Skin Cancer
• Maxillofacial Trauma
• Orthognathic Surgery

Some colleagues have expressed regret that we have excluded other areas of practice such as Salivary Surgery, TMJ surgery and Thyroid. I am sorry we have not managed to include everything but this project will be going on so there is time to include additional datasets in the future especially if we can see the benefits in the areas we have included.

The Maxillofacial project is now up and running. The datasets have been produced. We made a trial visit to a unit at the end of January as a result of that some additional data tweaking is taking place. The full programme of deep dive visits will be taking place over the summer starting at the end of March. I look forward to meeting some of you at these visits.

If you want to contact me about the project please do I would be delighted to hear from you.

Maire Morton

Maire.Morton@elht.nhs.uk

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