Manchester – 22/6/20 – New research published in the British Journal of Anaesthesia has shown significant improvements in the safety and quality of care for patients with a tracheostomy, potentially saving up to £275million for the NHS. A guided Quality Improvement Program, funded by the Health Foundation, saw interventions from a from the Global Tracheostomy Collaborative implemented into 20 diverse NHS hospitals around the UK.

Tracheostomies are temporary tubes inserted into the necks of 15-20,000 NHS patients annually to help breathing. They are lifesaving for about 10% of patients admitted to Intensive Care Units; often the sickest and most complex patients. There has been a worldwide surge in patients requiring a tracheostomy due to the COVID-19 pandemic. The Global Tracheostomy Collaborative brings together patients and healthcare staff from around the word to find new ways of improving care. Best practices at individual hospitals had been shown to streamline care and improve safety and quality, but this is the first study to show at scale that a comprehensive Quality Improvement Program can deliver better care when applied to a national healthcare system.

 “We reduced harm in this vulnerable group by 55% over the 3 years of the project,” said Dr Brendan McGrath, National Clinical Advisor for Tracheostomy & Intensive Care Consultant at Manchester University Hospital. “This translates into 170 lives per year that could be saved if this program was adopted nationally and we saw a similar impact1. Safer care led to a 20% reduction in length of stay in the ICU and in the hospitals, and an independent economic analysis estimated huge savings for the NHS of up to £275million per year if all sites adopted the QI program.2

The project brings together work from surgeons, anaesthetists, intensive care staff, nurses, physiotherapists, speech & language therapists and importantly, from patient groups. Recognising the importance of the work, the project has been rolled out nationally through NHS England and NHS Improvement’s National Patient Safety Improvement Programme’s ‘Safe Tracheostomy Care’ adoption and spread workstream, with similar plans in NHS Wales.

The Health Foundation is delighted to have funded this work through our small-scale innovation funding at four sites in Manchester, through to larger-scale funding of 20 sites across the UK,” said Gill Clayton, Programme Manager at the Health Foundation. “It has been fantastic to see the impact the work has had on the quality and safety of care for tracheostomy patients – to implement change at this scale requires a huge amount of determination. We are pleased that the initiative will now be rolled out more widely across England and Wales, supporting our ambition as an organisation to create the conditions necessary for successful improvement in health and social care.”

The paper is published on-line in The British Journal of Anaesthesia.



  • Based on the Lives Saved Tool (LiST) using the NCEPOD 2014 On the right Trach? report as national baseline
  • McGrath et al. Improving tracheostomy care in the United Kingdom: results of a guided quality improvement programme in 20 diverse hospitals. British Journal of Anaesthesia 2020; 125(1):e119-12

Further details

Infographic with headlines:

Open access link to journal paper: 

The Health Foundation is an independent charity committed to bring about better health and health care for people in the UK

The National Tracheostomy Safety Project (NTSP) is a charity that partners with staff and patients to improve care through education. Staff and patients volunteer their time to develop resources and programmes to improve care. Multidisciplinary resources for staff and patients have been developed since 2010 and are housed at

The Global Tracheostomy Collaborative works together to ensure the best possible care for every tracheostomy patient.



For more information (press only)

Contact: Dr Brendan McGrath NTSP Chair, GTC European Lead and NHS England National Clinical Advisor for Tracheostomy

Phone: 0161 291 6420


National Tracheostomy Safety Project (NTSP)