Getting It Right First Time, 28 November 2018
- The GIRFT review into oral and maxillofacial surgery across England outlines the need to centralise services and build on existing hub and spoke networks for the specialty, especially in the treatment of patients with head and neck cancer and those needing corrective jaw surgery. This configuration will enable central hubs to focus on in-patient work, while outlying spoke hospitals take care of day cases and out-patients, which form a high proportion of oral and maxillofacial work.
- The report also urges providers to consider allocating dedicated oral and maxillofacial theatre time for emergency cases, which in turn will help prevent out-of-hours operations and the cancellation of planned procedures, and reduce pre and post-operative length of hospital stay.
- It further calls for a standard protocol to be introduced across the country to reduce unwarranted variations in the number of hospital follow-up appointments after surgery. In the most straight-forward of cases, eg; dental extractions, the report suggests a target of zero follow-up appointments.
Recommendations fall within four key themes:
- To improve methods and techniques for data collection to ensure better analysis going forward.
- To look at why more simple surgery, such as wisdom tooth removal, isn’t being done outside of hospital, helping to free up resources.
- To develop local networks, such as ‘hub and spokes’, across the country, giving patients access to the most appropriate care for their needs. This is especially beneficial in care for head and neck cancer patients and those needing orthognathic (jaw) surgery. In support of this, GIRFT will work with NHS England on the development and implementation of the revised head and neck cancer service specification.
- To optimise the secondary care pathway by reducing the number of follow-up appointments required, especially for dentoalveolar surgery and releasing capacity to focus on other areas.
