Letters to the editor

Editor – we read with great interest the opinion piece concerning consultant job planning for a 7-day service authored by Dr Matthew Lewis in last issue of Future Hospital Journal.¹ We were each previously medical directors, with a combined experience totalling some 25 years, and found the examples of how to plan for 7-day services both clear and compelling. Lewis’ conclusion that ‘effective job planning allows finite resources to be used to the greatest effect’ is one with which we entirely concur. Managing the way our workforce is deployed to ensure their skills are applied to best effect will ensure we are able to offer high-quality care to our patients in the most efficient way. This fundamental principle underlies the implementation of a number of the 15 recommendations of Lord Carter's report into unwarranted variations in the performance of NHS acute trusts in England.² Evidence of such variability has emerged previously in the report of the British Orthopaedic Association authored by TB.³ This ‘getting it right first time’ (GIRFT) philosophy has led to real improvements in surgical outcomes within elective orthopaedics services and, for the first time, a fall in litigation claims – an important surrogate for quality. The GIRFT programme has now been funded to expand to more than 30 specialties. Each has a national lead, usually a clinician of national or international stature, and access to data that will ensure we know ‘what good looks like’ in terms of both outcomes and service delivery. Clinically conceived, clinically led and delivered by clinicians, hospital visits are already underway, at which the GIRFT leads engage face to face with the consultants and other clinical staff responsible for delivering each service ‘on the ground’. This ensures they adopt best practices as defined by royal colleges and specialist societies, which have without exception expressed their support for the programme. Matching job plans for medical and non-medical clinical staff (eg allied health professionals, pharmacists) and those providing diagnostic services will be crucial to ensure best practice can actually be adopted and thereby meet the (7-day) needs of patients, the demands of actually providing the service and to maximise the beneficial impact of the NHS’ physical (eg operating theatres, imaging equipment) and human resources.

Conflicts of interest

The authors have no conflicts of interest to declare.