Further Faster Programme

Further Faster overview

The GIRFT ‘Further Faster’ programme has been set up to deliver rapid clinical transformation with the aim of reducing patient waiting times and particularly 52-week waits.

The work brings together hospital trust clinicians and operational teams with the challenge of collectively going ‘further and faster’ to transform patient pathways and working to reduce unnecessary follow-up outpatient appointments and to improve access and waiting times for patients.

Clinical transformation groups have been established across 25 specialties, involving clinical leads from across the trusts as well as national speciality leads, and other key stakeholders. These groups seek to foster cross-organisational learning and provide a network and collaborative for trust clinical, operational and programme leads to gain peer support, share experiences and lessons learned, as well as the more practical aspects such as sharing of standard operating procedures (SOPs) and project documentation.

The programme aims to support adoption of outpatient improvement guidance, and GIRFT’s ‘high volume, low complexity’ (HVLC) standardised surgical pathways, including day case pathways and the use of elective surgical hubs.

GIRFT support offer

The biggest opportunities for reducing long waiting times are likely to be found in the outpatient part of the pathway (where the highest number of patients are waiting). Ensuring only the right patients are referred, effective management of referrals, DNAs, clinic capacity, follow up (including PIFU) and discharge can have a huge impact on reducing the burden in this area.

Chair of the GIRFT programme, Professor Tim Briggs, has met with the 42 ICBs to discuss their elective recovery programmes. What is clear is that in every trust there are elements of exemplar practice, which trusts and clinical teams can learn from and embed quickly to accelerate the reduction of waiting lists, especially in outpatients.

Further Faster specialty handbooks

GIRFT is producing handbooks for each of the specialties, and providing resources in the form of best practice guidance and ‘checklists’ for action across a number of important metrics and pathways for different specialties to help clinical teams on the journey to go further and faster towards eliminating 52-week waits.

Support includes:

▪ Regular SRO meetings with shared learning.

▪ Virtual review of PTL and theatre scheduling processes.

▪ Mutual aid and capacity identification.

▪ Speciality clinical support from GIRFT clinical leads.

▪ Case studies and links to providers who have overcome similar challenges.

Further Faster 20

A further cohort of 20 trusts, and their integrated care systems (ICS), are being given support to improve and streamline pathways for patients and spread good practice in areas with high levels of economic inactivity.

In some areas, long-term sickness has reached a record high with common conditions keeping people out of work including musculoskeletal issues like back pain, and other conditions such as diabetes, hypertension and cardiovascular disease.

The Further Faster 20 (FF20) cohort focuses on both reducing waiting times and enabling people to return to work. It extends the Further Faster (FF) programme to identify elements within the patient care pathway that have significant opportunities to improve access to treatment. This includes: improving the interface between secondary and primary care and community services such as MSK services; reducing missed appointments which are higher in deprived areas; and making use of elective surgical hubs which help to increase surgical capacity .

Click to see which trusts are taking part in Further Faster 20 >

Further Faster 20 evaluation >

Further Faster UEC

GIRFT has expanded its on-the-ground support to NHS trusts through the GIRFT Further Faster Urgent and Emergency Care (UEC) programme.

Through a team of colleagues with practical experience of delivering improvement and change within the UEC pathway – including clinicians, operational colleagues and nursing colleagues from emergency medicine, acute medicine, geriatric medicine and mental health services – the programme is supporting 20 acute providers in England.

GIRFT is working closely with these providers to build on their existing efforts and strengthen UEC pathways ahead of the winter period, with a particular focus on:

improving Category 2 ambulance response times;

enhancing 4-hour emergency department performance;

reducing long ED waits;

shortening length of stay to improve patient flow.

Click to see which trusts are taking part in Further Faster UEC >

Further Faster Follow-up Collaborative

GIRFT’s Further Faster Follow-up Collaborative is supporting trusts to reduce unnecessary outpatient follow-up appointments which are contributing to longer outpatient waiting times.

Unnecessary follow up appointments can restrict the capacity available for new outpatient appointments, and it is recognised that many routine follow-ups add limited clinical value to patients.

There are 21 trusts involved in the collaborative, working to deliver standardised follow-up pathways and protocols to improve flow and increase outpatient capacity for new and complex referrals.

The work is focusing on developing condition and specialty specific standard protocols across six specialties initially:

ENT
Gastroenterology
Gynaecology
Urology
Orthopaedics
Spinal surgery

It is estimated there is an opportunity to achieve between one and two million additional outpatient slots using standardised clinic templates alongside risk stratification and models such as patient-initiated follow up (PIFU), digital interventions to support outpatient follow up (DIFU), and clinical-initiated follow up (CIFU).

GIRFT support includes:

Clinical leadership – nationally recognised specialty leads and GIRFT clinical fellows to co-design and support implementation.
Operational expertise – support to translate redesigned pathways into practice, aligned with planning guidance.
Digital enablement – collaboration with FDP & Products & Platforms teams; access to tested digital tools (e.g. Isla, NHS App/Wayfinder).
Data & insight – prospective audit support, enhanced Model Hospital views, gap analysis vs GIRFT best practice.
Shared learning network – regular cohort sessions, peer learning, and published guidance from pilots.
Collaborative platform – to enable flexible engagement at pace with effective collaboration beyond meetings.

Access the Further Faster handbooks and best practice resources here:

Click below to access the Further Faster master handbooks for each of the 25 specialties…

Watch our video to learn more about Further Faster and how to get involved

Contact england.furtherfaster.girft@nhs.net for further information