Evidence about successful quality improvement indicates that
the method or approach used is not the sole predictor of success,
but rather it is the way in which the change is introduced.

Quality improvement made simple    The Health Foundation (2021)

Building improvement skills and knowledge at every level, from the top tiers of organisations, through to front-line staff


  • The role of improvement during the response to COVID-19 (The Q Community, 2021): a 25-minute insight report which outlines the key lessons for improvement from the earlier stage of the pandemic.
  • The habits of an improver: thinking about learning for improvement in healthcare (The Heath Foundation, 2015): a 30-minute thought paper that considers the attributes individuals need to foster to be able to succeed with bringing about change and improvement in the quality of care and services.
  • Quality improvement made simple (The Health Foundation, 2021): a guide that takes around 35-minutes to read summarising the elements everyone should know about quality improvement.
  • Think of healthcare as an ecosystem, not a machine (BMJ, 2018): a 35-minute podcast interview with Jeffrey Braithwaite, professor of health systems research and president elect of the International Society for Quality in Health Care, explaining how complexity science offers ways to change our collective mindset about healthcare systems, enabling us to improve performance that is otherwise stagnant.
  • Determining the skills needed by frontline NHS staff to deliver quality improvement – findings from six case studies (BMJ, 2021): a 25-minutes read detailing the skills frontline staff use to improve care, offering boards an insight into the many nuanced and mutually supporting technical, learning and soft skills needed. Useful for reflection and conversation at board level on what is required by frontline teams in terms of acknowledgement, time, resource and support to enable successful improvement.


Creating a workplace culture conducive to improvement


  • Recovery and then renewal – the innovation imperative for health and care (King’s Fund, 2021): a five-minute blog exploring how to replicate, support and sustain the conditions that enabled innovation during the pandemic, including meeting the ABC core needs of staff (autonomy, belonging and contribution).
  • Developing people, improving care: a national framework for action on improvement and leadership development in NHS-funded services (National Improvement and Leadership Development Board, 2019): a 15-minute summary
    of a framework to guide actions on people development aimed at creating systemic solutions for the long term.
  • Culture and behaviour in the English National Health Service: overview of lessons from a large multimethod study (BMJ Quality and Safety, 2014): this 15-minute read highlights the importance of clear, challenging goals for high-quality care and how organisations need to put the patient at the centre of all they do, get smart intelligence, focus on improving organisational systems, and nurture caring cultures by ensuring that staff feel valued, respected, engaged and supported.
  • Association between organisational and workplace cultures, and patient outcomes – systematic review (BMJ, 2017): 30-minute read that underlines why it’s important to create a positive environment and the evidence for links to enhanced outcomes.
  • Did you know? Being fair – supporting a just and learning culture for staff and patients following incidents in the NHS (NHS Resolution, 2019): a 40-minute read and 30-minute webinar, both setting out the argument for organisations adopting a more reflective approach to learning from incidents and supporting all staff.
  • Passing the peaks – longer term support for colleagues after COVID-19 (NHS Providers, 2021): a 60-minute webinar where experts and board members share learning on how to be prepared for the longer-term impacts of traumatic events on staff, successful strategies used during other extended crisis situations, and how you as leaders can apply them to support your workforce as the pandemic evolves and the service recovers.
  • Civility Saves Lives: a self-funded, collaborative project with a mission to promote positive behaviours and share the evidence base around positive and negative behaviours. Full of useful research and infographics that explain and evidence the impact of incivility on performance.
  • Learning from excellence: a collective capturing and studying peer-reported excellence in healthcare since 2014, evidencing the role this plays in creating a safer system, with a site full of open-access resources and ideas.


Giving everyone a voice and bringing staff, patients and service users together to improve and redesign the way that care is provided


  • Getting more health from healthcare: quality improvement must acknowledge patient coproduction (BMJ, 2018): a ten-minute essay by Paul Batalden, professor emeritus, paediatrics, community, and family medicine, in which he shares his knowledge from ten years’ studying change. He explains how modelling healthcare as either a product or a service is an over-simplification and neglects essential aspects of coproduction between doctors and patients.
  • Staff and patient experience as the driving force behind improvement (NHS Providers, 2021): a 60-minute webinar in which board members from two trusts at different stages of pursuing a trust-wide approach to improvement, Northumbria Healthcare NHS Foundation Trust and Central London Community Healthcare NHS Trust, reflect on the personal journeys taken at a board level to accept and adapt to a new approach. They also share what they wish they’d known as they started out.
  • What we need now – recommendations (National Voices, October 2020): drawn from National Voices Our Covid Voices platform, which asked people to contribute their personal experiences and stories, and features some co-produced recommendations as to how people would like to be treated, and how they would shape services.
  • Framework for involving patients in patient safety (NHS England and NHS
    Improvement, 2021): guidance on how the NHS can involve people in their own safety as well as improving patient safety in partnership with staff: maximising the things that go right and minimising the things that go wrong for people receiving healthcare.
  • NHS Complaint Standards (Parliamentary and Health Services Ombudsman, 2021): how organisations should approach complaint handling, this aims to support organisations in providing a quicker, simpler and more streamlined complaint handling service, with a strong focus on early resolution by empowered and well-trained staff. They also place a strong emphasis on senior leaders regularly reviewing what learning can be taken from complaints, and how this learning should be used to improve services.
  • Can pizza lead to sustainable quality improvement in the NHS? (NHS Providers, 2021): A short, three-minute blog that outlines the importance of connecting diverse professional groups for regular and informal interaction. Professor Nicola Burgess, reader in operations management at Warwick Business School, explains how social network analysis can help boards identify the level of connectedness in their staffing body, to aid conversations on how knowledge exchange and collaboration can be better nurtured.


Flattening hierarchies and ensuring that all staff have the time, space, permission, encouragement and skills to collaborate on planning and delivering improvement


  • The importance of psychological safety (King’s Fund, 2020): a three-minute video where Amy Edmondson, Novartis Professor of Leadership and Management at the Harvard Business School, explains how leaders can create an environment where staff feel safe to speak up, share new ideas and work in innovative ways.
  • Psychological safety as a cornerstone of improvement (NHS Providers, 2021): a
    three-minute read, in this blog, chief executive of Mersey Care NHS Foundation Trust Joe Rafferty, discusses the paradigm shift in mind-set, behaviour and practice that is necessary to achieve their ambition to become a best provider and best employer.
  • How a culture of improvement powered health systems’ response to COVID-19 (HSJ, 2020): a three-minute article outlining the impact a culture of continuous improvement had at The Leeds Teaching Hospitals NHS Trust and Surrey and Sussex Healthcare NHS Trust during the pandemic, including the role of empowering staff and the need for leaders to move from solving problems to being problem framers.
  • Open organisational culture: what does it entail? (BMJ, 2021): this 20-minute read outlines the important elements of an open culture, what it entails, and the conditions required. It also details how to use this insight as a practical tool that facilitates dialogue.
  • The power of giving away power (Great Podversations, 2021): a 30-minute podcast in which former US ambassador to the UK Matthew Barzun discusses the potential of distributed leadership with Amy Edmondson, Novartis Professor of Leadership and Management at the Harvard Business School.
  • Encouraging a sense of psychological safety through board leadership and role modelling (NHS Providers, 2021): a 60-minute webinar featuring trusts who are focusing on the role of leadership culture and behaviours, in recognition of its importance to relationships, creativity, engagement and performance, and how this relates to high quality care and their approach to board assurance.