What this looks like in practice
- Identify or create an improvement methodology to use across your entire organisation, ensuring a local and systemic way of practising improvement.
- Give all people access to improvement training and support, so that everyone can run improvement projects and continuously improve their daily work.
- Determine how success will be measured at an early stage, use appropriate tools and frameworks, and include feedback from people working at the point of care and people with lived experience.
- Demonstrate the impact of co-producing quality improvements with people who use services as an integral part of daily work.
- Set an expectation that there is an organisational focus on data and all staff are empowered to make and track changes in their workplace.
- Create and embed a training strategy to increase improvement capability.
- Leaders attend teams daily huddle boards and work to unblock issues which teams are facing.
Examples of where this is happening in practice
East London Foundation Trust
East London NHS Foundation Trust identified the levels of quality improvement skills needed to deliver their strategy at all staff levels, including lived experience partners.
This includes training for those at board level (both non-executive and executive), and a basic introduction to quality improvement for all starters as part of induction.
All people in management or leadership roles are expected to undergo the six-month improvement leaders programme, to equip them to run and lead quality improvement projects.
Directorate leaders are responsible for assessing capability within their teams, and identifying which people need training. They have a variety of learning options for staff to access, in addition to the intensive 6-month course, alongside many refresher masterclasses, workshops and webinars.
Oxford Terrace and Rawling Road Medical Group
Oxford Terrace and Rawling Road Medical Group is a GP practice with a long history of embracing quality improvement (QI), enabling the practice to meet population need, including increased demand. One of its earliest QI projects built the improvement skills of practice nurses who were able to save 280 appointments per week by reducing waste. With a promise of longer appointments to manage long term conditions, the nurses used QI approaches to reduce failure demand with people who would have previously attended 20 times a year, now attending 3 times a year with better outcomes. Further QI activities in the practice saved 8 sessions of GP time, extending service provision to supporting 9 care homes.
Many members of the leadership team have participated in the NHS General Practice Improvement Leaders Programme, each member attending with a practice specific project, supported through mentorship from the practice manager.
This approach has also been extended to people working in the wider primary care network (PCN). The PCN pharmacist has recently undertaken a QI project for a standardised approach to structured medication reviews across the 3 PCN practices. Developing QI capability and capacity is enabling the practice to invest in people and build a culture of safety through reliable design. The practice has grown, is serving people better and thriving as a result.