To what extent have key recommendations from the Getting It Right First Time programme for urology in England been implemented?

Abstract

Objectives: The Getting It Right First Time programme was set up to reduce unwarranted variation in healthcare practice and outcomes in England. The aim of this study was to investigate early changes in practice in urology based on the recommendations made. Subjects and methods: Data were extracted from the Hospital Episodes Statistics database from January 2014 to December 2019. The dates of visits by members of the Getting It Right First Time team were taken as the intervention point. Interrupted time series analysis was used to identify trends pre and post intervention. Results: Following the Getting It Right First Time visits, there was evidence of a significant increase in the proportion of patients seen as day cases for transurethral resection of bladder tumour and decreased use of stents and increased use of ureteroscopy or extracorporeal shock wave lithotripsy on first presentation with ureteric stones. However, there was no significant change in waiting times for surgery to treat patients who had an emergency presentation with urinary retention. Conclusions: There is evidence that the recommendations made are already having an impact on clinical practice. The reasons why some recommendations appear to be harder to implement requires further investigation. Level of evidence: 2b