To:
- All national, regional, integrated care board (ICB) and trust:
- Chairs
- Chief executives
- Regional directors
- National directors
CC.
- Regional, ICB and trust:
- Directors of improvement
- Directors of performance and improvement
- Directors of system transformation
Dear colleagues
As Chair and Deputy Chair of the new National Improvement Board, we are writing to update you on NHS IMPACT and the difference we believe it can make to your organisation and system and therefore, crucially, to patients.
The Board held its first meeting on Tuesday 12 September. It is made up of ICB and trust chief executives, clinicians, improvement experts, and key national leaders.
NHS IMPACT has been established to promote the spread of continuous improvement throughout the NHS. The aim is to secure demonstrable improvements in health outcomes and inequalities, quality of care, use of resources and the retention and wellbeing of staff.
This is a long-term vision, but we are all aware of the many pressing challenges which the NHS currently faces, including how we can best assure and improve patient and staff safety.
An improvement led approach can’t solve all our problems overnight, but we are convinced that it can begin to make a positive contribution in the here and now and support a far-reaching transformation in the years to come.
The evidence base is clear. The best healthcare organisations across the world, including in the NHS, invest time and effort to build an improvement culture. It is at the heart of how they operate and means that every member of staff is encouraged and supported to improve the work they do every single day.
NHS IMPACT is not a “one size fits all” model. There is no intention to propose a standard NHS improvement method. Trusts and systems are encouraged to innovate and to develop their own local approaches. However, NHS IMPACT does urge the consistent adoption of five practices which research has shown form the DNA of an improvement culture. These are:
- A shared purpose and vision which are widely spread and guide all improvement effort.
- Investment in people and in building an improvement focused culture.
- Leaders at every level who understand improvement and practise it in their daily work.
- The consistent use of an appropriate suite of improvement methods.
- The embedding of improvement into management processes so that it becomes the way in which we lead and run our organisations and systems.
The NHS IMPACT team has codesigned a self-assessment tool and a maturity matrix for these five domains. The self-assessment is designed to stimulate a discussion and debate. It will provide a starting point and enable an action plan to be developed to embed the five components of NHS IMPACT.
We strongly urge all boards and chief executives to engage directly with the self-assessment, to reflect honestly on where you are currently as an organisation and to develop a plan to move you forward. More information about this will follow on.
NHS England plan to bring Chairs and Chief Execs together region by region during the early part of 2024 to focus on the importance of their role and expectations on implementing NHS IMPACT.
To support the shift towards an improvement-based approach, plans include a Board-level competency framework, including key messages on improvement in staff induction, using selected staff survey questions to measure progress (e.g., line manager behaviours, staff ability to make improvements) and an engagement plan for regular networking. More will be shared on this over the coming months.
At the National Improvement Board, we discussed our ambition to build local systems and culture so that in five years’ time every place and system will have its own management system and culture, and all staff are focused on improving their work – with a robust methodology behind it.
Our objectives are to:
- Promote NHS IMPACT vision, aims and framework
- Inspire and encourage trusts, places and systems on improvement journeys
- Strengthen delivery of key priorities (including safety) using an improvement led focus
- Mobilise network of support partners
- Engage, support and encourage NHS England’s improvement journey
We will shortly start an NHS IMPACT bulletin to issue after each Board meeting. This will include the headlines from our discussion and what we are recommending as priorities for this work over the next six months as we establish NHS IMPACT. Please subscribe to receive these updates.
Finally, NHS IMPACT will only succeed if it is embraced and championed by leaders right across the NHS. So, we’d like to hear from you. Do send us any questions or reflections you may have to england.improvementdelivery@nhs.net. Let us know what kind of support is most needed. Tell us if you and your teams have experience, expertise and learning that you’d be willing to share with others.
We look forward to hearing from you, and to working with you to improve patient care together.
Best regards
David Fillingham CBE, Chair, National Improvement Board and Chair, Lancashire and South Cumbria NHS Foundation Trust.
Professor Andy Hardy, Deputy Chair, National Improvement Board and CEO, University Hospitals Coventry and Warwickshire NHS Foundation Trust.