Our trust-wide improvement programme, supported by the Health Foundation, has proven popular despite the challenging context. As operational pressures continue to mount, trust leaders know that new ways of working are urgently required to support both staff and service recovery, to tackle the immediate pressures of the backlog of care, and to capitalise on the opportunities of working in provider collaboratives and across systems.
Most trusts have some experience of quality improvement, usually within specific services and divisions. However, the largest and most sustained benefits come when a whole organisation approach to improvement is taken – many of the trusts rated as outstanding have established trust-wide improvement approaches in place.
Evidence also shows us that senior leadership is vital to the success of improvement. As well as ensuring that teams have the resources and capability they need to plan and deliver, board members can help to unblock barriers and give teams the time and space to test and refine their intervention. They also have a critical role to play in creating a positive organisational culture, which has consistently been associated with improved quality outcomes. Placing improvement at the centre of an organisational or system-level strategy and fostering a learning culture, in which front-line teams feel psychologically safe to question existing practice, report errors and try new methods, is central to this.
Within today’s deeply challenging context, the importance of rapid and robust problem solving has come to the fore even more. We know from the Health Foundation’s Q Community research that organisations with a well-developed approach to improvement prior to the pandemic were able to use these skills more effectively during the crisis and are now in a stronger position to build on the changes made. There continues to be an opportunity for organisations to protect and improve on their improvement capacity and skill, to make best use of this valuable resource to help in solving the big problems facing boards.
The clear appetite to take stock of learning from the pandemic, and how systematic approaches to organisation-wide improvement can help meet the challenges we face today and tomorrow, shows a strong commitment despite the pressures boards and their staff continue to face. The appetite to engage in our programme demonstrates how many trusts recognise that organisations with the skills, relationships and leadership to drive improvement will be best placed to react, respond and learn in this new era of unprecedented uncertainty, complexity and pressure.++The case for developing improvement capability at scale has been widely recognised for some time. It is a key component of the NHS Long Term Plan, and forms part of CQC’s Well-Led Framework. Continuous improvement is a key oversight expectation for quality placed on integrated care systems (ICSs) and their constituent parts by the National Quality Board, alongside the emerging expectation on provider collaboratives that they drive shared definitions of best practice and the application of a common quality improvement methodology.
There is a wealth of resources available world-wide. This resource seeks to help you navigate these by bringing together a selection of useful articles, reports, videos and podcasts to support conversations at board and quality committee level, to support you in decision-making and taking action.
The content aligns with the factors required to drive and embed improvements in a health care organisation or system, as highlighted by the Health Foundation in their guide Quality improvement made simple, recently updated. We also signpost to the current range of learning support available to boards.
In an ever evolving context, with an increasing focusing beyond the boundaries of a single organisation, we hope this guide helps towards the next steps in your improvement ambitions.
Miriam Deakin
Director of Policy and Strategy
NHS Providers