‘So what kind of improvements do you fund?’ Two years into my time at the Health Foundation, you’d have thought that I’d be quite good at answering this question. But how do you capture a 12 year history of improvement and some three hundred projects from across the UK, in fifty words or less? With some difficulty, at least in my case.

Luckily, I’ve always been able to point people interested in our improvement work in the direction of our website. It includes information about most of the projects we’ve funded, going right back to 2003 when we launched our first major improvement programme, the Safer Patients Initiative. One of the first things that strikes you is the sheer range of the work we’ve supported.

Much of our improvement work is based in hospitals, but over the years we’ve also funded a large portfolio of projects in different care settings. Several teams have focused on the transition between hospital and the community with a view to improving people’s experience and making it a safer and more reliable process. In this newsletter we’ve captured some of this variety with stories of projects in diverse areas such as maternity and mental health.

REST is a primary care based project, which has had a remarkable impact since its small scale beginnings as part of one of the Health Foundation’s first improvement programmes. REST developed better resources for effective sleep treatment. It has had a major impact on the care of people with sleep problems, both nationally and internationally. It started out as an improvement collaborative involving 16 GP practices in Lincolnshire and led to the development of an e-learning resource now being used as far away as New Zealand. Some of the research generated by the project has even been cited by NASA - an example of truly ‘stellar’ impact.

Looking back at some of our early programmes is a good reminder of how long it can take to implement and spread an improvement concept. In some cases the full extent of a project’s impact only becomes apparent years later.

The success of our Flow Cost Quality programme, which aimed to match capacity with demand along the emergency care pathway in two foundation trusts in England (Sheffield Teaching Hospitals and South Warwickshire) also shows the importance of context. Sheffield’s Discharge to Assess Model, which arose out of the programme, is featured in this newsletter. South Warwickshire’s Discharge to Assess Model, meanwhile, was included as a supporting case study for Monitor’s recent guidance on Moving Healthcare Closer to Home. But while they share the same name and some of the same attributes, they were conceived and set up in different ways and are both carefully tailored to meet the needs of their respective health and social care communities

In short, there is no such thing as an ‘off the peg solution’ that can be quickly and simply implemented in any context. It is for this reason that many of the project descriptions on our website focus as much on how and why teams went about improvement as on what they did. It follows that caution should apply when looking at replicability of the projects featured on our website.

In capturing the stories of hundreds of improvement teams since the early 2000s, we think our website provides an important service for everyone with an interest in improvement. To make the site easier to navigate, we’ve now added an improved search function which means you can look for projects in particular clinical areas, settings, areas of the UK, or by project focus. So please do take a look and, of course, do let us know what you think.

Bryan is a Policy Manager at the Health Foundation

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