UKAS’s project to support the ‘Getting It Right First Time’ (GIRFT) initiative

UKAS is supporting NHS England’s ‘Getting it Right First Time’ (GIRFT) initiative established to improve patient care across all areas of healthcare, from diagnostic testing to treatment advice. Specifically, UKAS has worked with the team that undertook the review of pathology and is committed to implementing the relevant recommendations from the national report last was published last year. UKAS is progressing a project with the aim to investigate how UKAS supports GIRFT principles and recommendations via the assessment of medical laboratories against the requirements of ISO 15189 and, where appropriate, ISO 22870.

The GIRFT Initiative

The initiative aims to identify variations in the quality and cost of care across NHS England and make recommendations to improve efficiency and effectiveness. GIRFT has now been implemented in over 40 surgical and medical specialties, including pathology.

The GIRFT initiative is based on five principles:

1. Centre our focus on the patient – right test, right time.
2. Prioritise quality from end to end, such as improving governance of delivery of services, quality assurance, and accreditation mechanisms.
3. Support best clinical working practices, making it easier for clinicians and patients to choose and use the most effective tests.
4. Build a single-service mutually supportive team.
5. Future-proof pathology with strong data and digital foundations.

The GIRFT initiative aims to ensure that every aspect of patient care is improved, assured, and understood by applying these principles.

Issues highlighted in Medical Laboratories

The “Pathology GIRFT programme National Speciality Report” (authored by Dr Tom Lewis, Dr Marion Wood and Dr Martin Myers) identified several areas for improvement for medical laboratories with regards to test request and sample management. These issues include:

• Collecting samples correctly and labelling samples appropriately.
• Stabilising samples.
• Transporting samples correctly, appropriately, and in a timely manner.
• Correct registration and storage of samples.
• Using quality assurance to minimise error.
• Minimising error in low-volume tests.
• Processing results in a clinically relevant timeframe improving lab oversight of Point of Care Testing (PoCT).
• Results – describing normality for that patient – reference intervals, help define next actions clearly and reported in a timely manner.
• Making quality at the heart of the whole process, making greater use of External Quality Assurance and Proficiency Testing.
• Improving accreditation for PoCT.
• Data and digital delivery.
• Internal lab systems.

UKAS’s recommendations and objectives

Recognising the important role that UKAS accreditation has in providing confidence in healthcare diagnostics, UKAS is now considering how the GIRFT recommendations  can be included/ reflected in UKAS assessments and reporting.

UKAS has identified members of its Medical Laboratory Technical Advisory Committee (TAC) and formed a subgroup to work with the GIRFT project team.  As per the GIRFT recommendations, UKAS will progress this work utilising oversight from the National Pathology Board (NPB) in England. UKAS will also liaise and seek input from the healthcare science leads in the devolved administrations to ensure actions are relevant and appropriate for the whole of the UK.

You can find out more about the Getting It Right First Time initiative on the NHS website or by contacting our team via [email protected]