GiRFT-pathways and documents

A new ‘hysterectomy hub’ set up by the Getting It Right First Time (GIRFT) programme is now available to support NHS providers to carry out more hysterectomy operations as day surgery.

The latest addition to the hub is GIRFT’s Best practice day case hysterectomy delivery guide, which is co-badged by the British Association of Day Surgery (BADS) and Royal College of Anaesthetists (RCoA), and supported by the Royal College of Obstetricians and Gynaecologists (RCoG).

The guidance draws on the learning of teams who are successfully delivering a day case hysterectomy pathway – sharing details of their processes, outlining potential steps, and offering practical guidance and advice for those trust who wish to increase their own rates.

It is accompanied by a range of appendices and resources – including example trust documents, clinical protocols and patient information – all gathered together for convenience in the hysterectomy hub.

You can also view the guidance on our website here.

Eleven pathways have been developed or refreshed – including seven pathways co-badged by the British Association of Day Surgery - and can now be viewed and downloaded from the GIRFT website or the GIRFT FutureNHS workspace.

The pathways offer guidance from referral through to discharge and follow-up, including best practice for preoperative assessment, surgical planning and safe discharge protocols.

GIRFT ENT clinical lead Jeremy Davis said: “These pathways have been developed to support ENT teams to optimise their services, providing efficient, high-quality, patient centred care.”

The seven pathways co-badged with BADS are:

Myringoplasty and tympanoplasty pathway: supporting ENT teams in delivering effective and consistent care for patients requiring surgical repair of the tympanic membrane and middle ear, guiding the full patient journey from referral and diagnosis to discharge, emphasising suitability for day case surgery and aligning with best practice standards.
Mastoidectomy pathway: supporting teams delivering care for patients undergoing mastoid surgery - typically for chronic ear disease or cholesteatoma - the pathway offers a clear approach from initial referral through to post-operative recovery, supporting day case surgery where clinically appropriate and improving consistency across units.
Stapedectomy pathway: supporting ENT teams to deliver safe, consistent and effective day case stapes surgery for patients with conductive or mixed hearing loss, including otosclerosis.
Submandibular gland excision pathway: created to guide clinicians in delivering consistent, safe, and efficient care for patients undergoing excision of the submandibular gland, typically for sialolithiasis or chronic sialadenitis, this best practice pathway provides a clear, evidence-based structure from referral through to discharge, supporting day case delivery where clinically appropriate and ensuring optimal surgical planning, risk mitigation, and follow-up.
Parotidectomy pathway: a structured, evidence-based pathway supporting ENT teams in the effective and consistent management of patients undergoing parotid gland surgery. The pathway outlines each stage of care -from referral and diagnosis to discharge - optimising the safe delivery of parotidectomy as a day case procedure where appropriate.
Day case paediatric adenotonsillectomy pathway: this pathway offers an approach from initial referral through to discharge, enabling same-day surgery where appropriate and ensuring robust pre-operative assessment and post-operative planning.
Adult tonsillectomy pathway: supporting ENT teams in delivering safe, high-quality, and standardised care for adult patients undergoing tonsillectomy, the framework runs from referral through to discharge, ensuring appropriate selection for day case surgery and enhancing post-operative recovery.