Getting It Right First Time (GIRFT) national report for adult critical care
30th Sep 2021
The Getting It Right First Time (GIRFT) national report for adult critical care is authored by Dr Anna Batchelor, consultant anaesthetist and intensivist at Newcastle upon Tyne Hospitals NHS Foundation Trust.The report is based on visits to more than 100 critical care units in England before the pandemic hit, but is informed by insights gained from caring for COVID patients from spring 2020 onwards. It outlines a new model for critical care services which could help the NHS cope with future surges of the pandemic.
The report can be accessed on the FutureNHS platform here: GIRFT national report for adult critical care
You will need to register to download it but access is granted quickly, even to stakeholders without an NHS address.
A summary is included below:
GIRFT critical care report outlines steps to help the NHS cope with future COVID-19 surges
The latest report from the Getting It Right First Time (GIRFT) programme outlines a new model for critical care services which could help the NHS in England cope with future surges of the COVID-19 pandemic.
Staffing and equipping units to provide more ‘enhanced care’, including non-invasive ventilation, as well as funding and developing transfer services to enable adult patients to be moved more easily, are among the measures in the national GIRFT report designed to ease some of the pressures on critical care services and ensure patients have equal access wherever they live.
The GIRFT report – written by Dr Anna Batchelor, a consultant anaesthetist and intensivist at Newcastle upon Tyne Hospitals NHS Foundation Trust – is based on visits to more than 100 critical care units in England before the pandemic hit, but is also informed by insights gained from caring for COVID-19 patients from spring 2020 onwards.
The data-driven review found variation in bed numbers and workforce levels between hospitals, with capacity, culture and resources affecting local decisions on who can be admitted to critical care. There is a need for more beds generally, but the report acknowledges that increasing the number of highest level beds (Level 3, offering advanced respiratory support) on standby for severely ill patients during COVID-19 surges is not practical.
Instead, a series of recommendations in the report aim to maximise the capacity in units to help cope with future waves, and avoid the need to delay or cancel surgery for other patients. These include:
Developing more ‘enhanced care’ areas – hospital wards staffed and equipped to provide flexible enhanced care, including non-invasive ventilation, can be used for post-operative care and to help the transfer of patients back from critical care to other wards, but can also be switched to care for COVID-19 patients during surges.
Establishing and funding adult transfer services – developing transfer services at a system level can ensure equal access for all patients, especially those in rural and remote areas, and allow regional cohorting of COVID-19 patients so that critical care units can maintain a ‘normal’ service.
Increasing hospital outreach – identifying patients from across the hospital whose condition is at risk of deterioration and taking steps to stabilise their condition can prevent organ failure and admission to critical care. This can lead to better patient outcomes and helps free up critical care beds for other patients.
Dr Batchelor said: “The COVID-19 pandemic has highlighted critical care services like no other event in the last 20 years, and staff working in units across the UK have gone above and beyond, under extreme pressure, to cope with this unprecedented crisis.
“During the first surge an amazing collaboration of ‘can do’ NHS workers prevented the service from being totally overwhelmed, but it would be inappropriate and inadvisable to expect this to happen again in the same way. By developing enhanced care services, and putting in place a competent workforce of doctors, nurses and allied health professionals (AHPs) to support them, a viable buffer can now be created.”