NHS IMPACT (Improving Patient Care Together)

This year the NHS in England marks its 75th year. In 1948, founded on three core principles, the NHS was the first universal health system to be available to everyone, free at the point of delivery and based on clinical need, not ability. It’s incredibly important to consider the astonishing and ground-breaking improvements which have taken place over those years. Changes to our health care which wouldn’t have even seemed possible all those years ago.

These changes came through innovation, technology, advances in medicine, breakthroughs in research, improved understanding of diet and lifestyle, and so much more. Change was also made by those who delivered, needed, and received care and these experiences, of learning to bring about change, is what we refer to as improvement.

The NHS continues to regularly touch all of our lives, treating over one million people every day. Can you imagine the number of daily improvements that take place? Our interactions with patients, nurses, doctors, administrators, other clinicians, porters, cleaners, carers, and volunteers all generate opportunities to progress health and care for the current and future generations.

NHS IMPACT (Improving Patient Care Together) is a single improvement approach and has been launched to support organisations to shape their strategy to share best practice and learn from one another. NHS IMPACT will help put management systems and processes in place quickly in order to pursue improvement at pace and with purpose.

The improvement movement isn’t just about having an improvement team or running a few plan/do/study/act cycles.  It’s about leadership behaviours, creating a shared, widespread vision throughout systems and organisations and defining the culture of the organisation.

However, there are short term opportunities to align and enable existing improvement capability around the biggest ‘here and now’ challenges in parallel with changing culture.

We all know that changing working culture takes time. We know our workplaces differ, and how things are done in one place are different to how they are done in another. This magnitude of change begins from the top of the organisation; culture is created by boards and executive teams and leaders.

For leaders, continuous improvement means moving away from being problem-solvers and telling people what to do. We want leaders to become problem-framers, and this starts at board level.  This creates a system in which staff are able to collaborate and solve complex problems which matter to them and matter to their patients.  Let’s build up their skills, capability and the space in order to do that, and let’s build that into the operating model, policies, procedures, data reports, language and behaviours.

In parallel with the longer-term ambition, there is a need to align assets and come together around these absolute priorities: elective care recovery, urgent and emergency care recovery, primary care recovery.

Through embedding a single improvement approach, we will improve patient care together. Systems and organisations, regions and national teams can build on the principles underpinning NHS IMPACT, rather than being instructed to use one prescribed improvement methodology.

Find out more about NHS IMPACT at

John Ashcroft

John is currently Director of NHS IMPACT and Pathways at NHS England. John has held a number of posts in both the NHS and private sector healthcare and was previously Chief Executive of Manchester Royal Eye Hospital and University Dental Hospital of Manchester Trust. He has also worked at Great Ormond Street and the Royal Free London hospitals. John has expertise in leadership, strategy and operational delivery both within and across organisations in health and care.