Intended for healthcare professionals


Reducing national variations in care

BMJ 2017; 359 doi: (Published 01 December 2017) Cite this as: BMJ 2017;359:j5574
  1. Cat Chatfield, quality improvement editor
  1. The BMJ
  1. cchatfield{at}

Getting It Right First Time is an important step towards common standards

Getting It Right First Time (GIRFT) is a new initiative in England aimed at reducing unwarranted variation in care. Interventions to understand how healthcare delivery and outcomes vary are not new. Since the first report on variation in the NHS almost 30 years ago,1 concerted efforts like the NHS Atlas of Variation series2 have sought to understand where, and how, care provision differs from an acceptable norm.

What’s new?

The new idea behind the GIRFT programme ( is to put performance data from multiple sources directly in the hands of clinicians through supportive peer to peer visits, allowing departments to interrogate the data alongside the programme’s leads. Early reports from the pilot, and subsequent scale-up within orthopaedics, indicated potentially huge benefits to the NHS, such as annual savings of £300m (€341m; $404m) just from reducing deep wound infections after joint replacements.3

The full evaluation …

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