Built to last: Developing an infrastructure for continuous learning and improvement

Today NHS England published Next Steps on the NHS Five Year Forward View. Just as Next Steps looks to find ways that the NHS can improve the way it delivers care, we at the Health Foundation also grapple with how to ensure our grant-giving has a long term impact for patients. In this newsletter, we describe how, as well as developing people working in the health service, and funding improvement projects on the ground, we are increasingly aiming to build more sustainable assets – ones that can contribute to developing an infrastructure for continuous learning and improvement in the UK.

The most visible example of this approach is our largest single grant to date, announced this week, which we will be making to the University of Cambridge to establish a new improvement research institute. The funding, worth around £40 million over a 10-year period, will support Cambridge and its partners to strengthen the evidence-base for how to improve health care. Under its Director, Professor Mary Dixon-Woods, the institute plans to produce practical, high-quality learning about how to improve patient care, as well as grow capacity in research skills in the NHS, academia and beyond. Such research will be vital in addressing challenges facing the service, helping to develop a deeper and more widespread understanding of how sustainable and replicable improvements to patient care can be made. Work to establish the institute is just beginning and we’ll keep you posted on progress in future newsletters.

Another important feature of a system that can continually learn and improve is the ability to gather, analyse and interpret data. The Improvement Analytics Unit, our partnership with NHS England, provides rapid feedback and analysis on progress being made by local health care improvement projects in England. Our Director of Data Analytics, Adam Steventon, reflects on progress to date, including the results of the unit’s first study. It looks at the impact of enhanced support for care home residents in Rushcliffe, Nottinghamshire, developed by Principia, a local partnership of general practices, patients and community services.

Our Q community, in partnership with NHS Improvement, aims to enable better connection, sharing of learning and collaboration between thousands of people working in quality improvement. Its mission is to foster continuous and sustainable improvement in health and care. Recruiting throughout the UK this year, Q is open for application in Scotland, Yorkshire and Humber, UCLP, the West Midlands and North West Coast until 10 April. Recruitment opens in May and August in other areas. We interviewed Q member Dominique Bird of Public Health Wales, who offers her perspective on how Q is supporting people to lead improvement across the UK.

The members of Q offer an invaluable source of intelligence and expertise about how to improve care. Over recent months we’ve been developing a new initiative to harness this collective intelligence through our newly created Q Improvement Lab. The pilot lab will provide space for people, from both Q and beyond, to work together on high-priority challenges facing health and care, which many stakeholders want to solve. It will draw on the best of what is known about a given topic, using a blend of design and improvement methodologies to seek solutions that will work in the complexity of the real world. Tracy Webb, Head of Q Labs, reflects on the journey the Q Lab team has taken to grow the seed of an idea to a working Lab.

We are also evolving our grant programmes to support scale and spread. Our Scaling Up Improvement programme, which offers grants of up to £500,000 to test how ideas that have been successful at a small scale can be put into practice at a larger scale, will open on 3 April. We spoke to Tony Panayiotidis, project manager for PINCER, a pharmacist-led intervention, funded through this programme, to improve safety in primary care prescribing, which is now in more than 350 general practices. As well as encouraging bids from teams looking to scale a particular intervention, this year’s Scaling Up Improvement programme will be open to teams who want to scale up an approach or platform for making change.

We are also interested in generating learning around new methods for supporting the spread of improvement. Until 13 April, our Exploring Social Franchising programme is open for expressions of interest from teams who want to test whether their work would be suitable for spreading via franchising or licensing techniques. These are methods common in many sectors of the economy but relatively under-tested in health care. Franchising enables another team to deliver a proven intervention to agreed standards under a franchise agreement, while licensing involves turning an innovation into intellectual property that can be licensed for use by others. We are looking for teams or organisations who want to develop their innovations for social benefit. The work will be evaluated to help understand the potential for these approaches to be adapted for a health care context.

We’re committed to sharing what we learn from these different initiatives, which we hope will contribute to supporting continuous learning and improvement across the UK over the coming years. You can register for alerts to be kept up to date on key developments.

Will Warburton (@will_warburton2) is Director of Improvement at the Health Foundation