2983: Getting It Right the First Time (GIRFT) (TB Services)
This project will bring together data and evidence from a range of sources that will support a programme of work with trusts to drive quality improvement and consistency in how TB services are delivered. data packs will be prepared for every acute trust with a TB service.
About the project
What the project aims to do
NHSE (Prevention and Long Term Conditions, Medical Directorate) are delivering a programme of work to build an understanding of the organisation, staffing and delivery of tuberculosis (TB) services across England.
The overall scope of the work is to bring together data and evidence from a range of sources that will support a programme of work with trusts to drive quality improvement and consistency in how TB services are delivered. Data packs will be prepared for every acute trust with a TB service. A subset of trusts will be offered a clinically-led GIRFT visit, which will be used to review good practice. This good practice will be summarised in a national report that will explore variation in how TB care is delivered.
The objectives of the work are as follows:
- bring together a range of datasets and sources to quantify variation in practice and outcome for TB services in England
- brovide recommendations to individual providers on how to implement quality improvement in the delivery of TB services
- develop a national report, assessing variation in the TB services and providing recommendations for quality improvement
Why this project is important
Although rates are lower than historic levels, TB remains a substantial health burden in the UK, with more than 4,000 cases in 2021. Between 2011 and 2021, there was an overall downward trend in TB notification rates in England. However, the rate of reduction has slowed in the last 4 years. The rate of reduction needs to accelerate substantially in order to achieve the WHO End TB goal of a 90% reduction from 2015 to 2035.
TB is treated through services across the country. There exists the opportunity to improvement the management and treatment of TB through learning from each of these services and the consistent implementation of best practice. NHSE GIRFT is a national programme designed to improve the treatment and care of patients through in-depth review of services, benchmarking, and presenting a data-driven evidence base to support change. It has been successfully implemented across 40 surgical and medical specialties, as well as a broader range of areas such as community and primary care. At the heart of the GIRFT methodology is rigorous review of data.
Who the data is about
All patients with:
- a recorded notification (including subsequent denotifications) for Tuberculosis (ICD 10 A15 to A19) received by UKHSA
- resident in England or treated in England for Tuberculosis (ICD 10 A15 to A19)
- where the Notification Date in the National Tuberculosis Surveillance system (NTBS) dataset is the 1 April to 31 March 2023
How the data will be used
The data contained within the NTBS is the richest single dataset on the activity, flow, delivery and outcomes from TB services in England. Having access to this data will provide the bedrock of the data packs, the clinical visits and the national report. No other dataset is available to provide this level of richness or consistency. Data will be transferred to NHSE by UKHSA. On receipt, it will be encrypted and stored on NHSE secure centralised data repository the Unified Data Access Layer (UDAL) platform. Data processing will take the form of data cleaning, aggregation, manipulation and visualisation. No attempt will be made through the data processing to re-identify individuals within the dataset. No artificial intelligence (AI) or machine learning techniques will be applied to the data.
The data will be communicated to TB services through data packs to support clinically-led visits and nationally through a national report. The presentation of data within both the data packs and national report will be aggregated chart and tabular outputs. Clinical Leads will use the data to identify and understand unwarranted variation in the delivery of TB services and will discuss this variation with individual service leads.
How often data is needed
Non-standard: request-response basis for the duration of the Data Sharing Contract
How this project will benefit public health and the public
The project will deliver direct and indirect benefits to both patients and the wider NHS.
Benefits to patients
Benefits to patients include:
- support for the implementation of best practice treatment and management of TB – this will be delivered through recommendations including, but not limited to: improving access to services, faster diagnosis and treatment, improved contact tracing, improved management of latent TB
- improved health outcomes, as well as improved experience of TB services, including reduced waiting times and delay
- the review specifically targeting health inequalities, by ensuring that all services have access to the same best practice recommendations – the scope of the review includes specific data collection and discussion of service provision in hard-to-reach and under-served populations
- recommendations on contact tracing and management of latent TB, which will also help to reduce the spread of TB and therefore decrease the likelihood of an individual contracting TB within the UK
Benefits to the NHS
The review will not just focus on health outcomes, but also the processes, services and patient flow in delivering TB services.
Recommendations will therefore also support TB services to be delivered more efficiently and sustainably, releasing capacity and resources for the NHS.
The review will specifically cover workforce, including staffing levels and skill mix. The recommendations at a national and local level from this element of the review will benefit the NHS through more efficient use of scarce resource through defining best practice staffing models. NHS staff themselves will also benefit from identification of the right skill mix and training required to deliver TB services.
Planned project outputs and communication
Outputs will be communicated to individual services through service-level data packs. These data packs will be supported through individual clinically-led peer-to-peer visits. The conversations during these visits will help to communicate the outcomes and recommendations from the data analysis. A publicly-available national report will also summarise conclusions on best practice.
Lawful processing of personal and special category personal data
The data needed for this project is not personal data.
Legal basis for using personal data (Article 6)
Not applicable
Legal basis for using special category personal data (Article 9)
Not applicable
Common law duty of confidentiality
The data needed for this project is not confidential patient information.
How is the duty of confidentiality set aside
Not applicable
National data opt-out
Opt-out preferences will not be applied.
This is because the national data opt-out does not apply to anonymised data.
Digital object identifier
Not assigned to this release.