Vital Signs: an improvement practice

An initiative to support providers and systems in removing waste from day-to-day activities.

Launched by us in early 2018, Vital Signs supports providers and systems to transform and continuously improve patient safety, quality of care and capacity by removing waste from day-to-day activities.

The initiative is now run by our Improvement directorate. It draws on the principles of lean, which aims to optimise processes to remove waste and maximise value for patients through continuous improvement.

Vital Signs was created in response to requests from NHS trusts for an affordable lean programme. Developed for the NHS by the NHS, it helps trusts to develop organisation-wide quality improvement expertise, while adapting to their specific circumstances.

Our support offer

The Vital Signs team are all experienced in implementing lean, both in the NHS and in other sectors. Elements of the practice include:

  • executive coaching support to senior trust executives, from former trust CEOs who have delivered transformation in healthcare using lean-based principles
  • support with establishing trust continuous improvement teams
  • support with securing clinical buy-in
  • workshops, events and networking opportunities
  • a peer learning network
  • training programmes, tools and materials.

Cohort 1

Initially, the support is for three years and, in the short term, is only available to a selected number of NHS trusts who have met the criteria. Our Cohort 1 trusts are:

  • The Hillingdon Hospitals NHS Foundation Trust
  • The Dudley Group NHS Foundation Trust
  • Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust
  • East Lancashire Hospitals NHS Trust
  • University Hospitals Plymouth NHS Trust (partnering with Livewell Southwest)
  • Derby Teaching Hospitals NHS Foundation Trust
  • Royal Surrey NHS Foundation Trust.

The practice is a paid-for service, but is delivered at cost to make it more accessible to NHS organisations.

The aim is that, after the three years of support, organisations will be self-sufficient in applying continuous improvement in their areas.

Cohort 2 and further information

We will soon be looking to recruit NHS organisations and/or systems into a second cohort of Vital Signs. More information will be published on this web page in due course.

In the meantime, if you are interested in finding out more about the initiative, please email the Lean Transformation Programme Team at