Annex one: methodology

To inform this work, NHS Providers engaged directly with trust leaders to explore perspectives on QMSs across the NHS provider sector. This engagement was prompted by the proposed content of the national Quality Strategy, which highlighted the growing importance of QMSs in driving continuous improvement and accountability.

Our aim was to understand how trusts are approaching QMSs in practice, what enables effective implementation, and where challenges or gaps may exist.

We conducted semi-structured interviews with 16 trust leaders, including medical directors, nursing directors, chief medical officers and quality improvement leads.

Participants were drawn from a diverse range of trusts across key sectors, including acute, community, ambulance and mental health and learning disability, representing various geographic regions and organisational sizes. This was to ensure a breadth of experiences and insights reflective of the wider provider landscape.

Interviews took place virtually between March and July 2025, and the insights shared in these interviews are the basis upon which this briefing has been built.

This work is qualitative in nature and intended to reflect the range of experiences shared – not to offer a representative sector-wide picture, but rather to highlight recurring themes and insights that may be useful to system leaders, regulators, and provider organisations seeking to strengthen their own quality approaches.