Quality Improvement Fellowships: the ripple effect for leadership and improvement

To drive quality and efficiency in our health service, it is crucial that healthcare leaders know how to encourage and nurture improvement within their organisations. Since 2004 the Health Foundation’s Quality Improvement Fellowship (QIF) programme has been helping to build a cadre of skilled and knowledgeable leaders who can do just that.

The programme identifies talented clinicians and helps them to develop a high level of improvement expertise. The scheme is relatively small (only four people join the fellowship every year), but the ripple effect is starting to have a major impact on the UK health system.

Participants spend a year at the Institute for Healthcare Improvement (IHI) in Cambridge, Massachusetts. Here they take part in a personalised development programme and research their chosen area of healthcare improvement. They are given intensive training in improvement skills, including a programme from the Harvard School of Public Health, and have access to a dedicated mentor.

While the learning packed into the year is impressive, it’s what the fellows do when they return home which is really important to the Health Foundation. 

Back in their day jobs, fellows integrate learning into their organisation’s processes and procedures, introducing innovation and encouraging a supportive environment for continuous improvement. Many have gone on to shape national, regional and professional debates on quality improvement. 

Penny Pereira, Assistant Director at the Health Foundation, agrees the effects are wide reaching:

‘There is now a unique network of 27 informed, specialist fellows working across the UK. Each has used his or her experience to influence and inspire positive change in clinical leadership for improvement, making our health service stronger and more dynamic.’

We caught up with a few of the fellows to see what they are doing now and ask what the fellowship means to them. We plan to profile more fellows in future issues. 

Jason Leitch (2005/06 fellow)

Jason was previously Clinical Lecturer in Oral Surgery and Sedation at the University of Glasgow Dental School. His fellowship focused on patient safety and applying improvement to oral health. Upon his return to the UK, Jason was selected to lead the Scottish Patient Safety Programme. He was subsequently appointed Scotland’s National Clinical Lead for Quality in 2010, tasked with putting Scotland among the best in the world in terms of delivering high quality healthcare. In January he became the Clinical Director of the Quality Unit of the Scottish Government.

He says: ‘The fellowship was a genuinely career-changing experience. The opportunity to learn with colleagues from around the world and see improvement in healthcare in action was unique. Since returning in 2006 I have had the chance to apply my learning to NHS Scotland in ways I couldn't have imagined.’

Dr Kevin Stewart (2009/10 fellow)

Kevin, a consultant geriatrician, was previously Medical Director at Winchester and Eastleigh NHS Trust. His fellowship investigated how clinical leaders can best support the quality and safety agenda. Specific work looked at how leaders respond to a serious clinical crisis, ensuring the safe passage of older patients through acute hospitals, and how disruptive behaviour can compromise patient safety. He is now Clinical Director for the Royal College of Physicians’ Clinical Effectiveness and Evaluation Unit.

He says: ‘It’s not a cliché to say that the fellowship really has been a life-changing experience. It’s given me the confidence, knowledge and skills to influence decision making at the highest level and so make a real difference to patients. There’s now such a strong cohort of fellows in the UK in influential positions that it feels like we really are able to change the whole agenda in healthcare.’

Read more about Kevin Stewart

Dr Tricia Woodhead (2010/11 fellow)

Tricia is a consultant radiologist and was previously Executive Medical Director to Weston Area Health Trust. During her fellowship she examined models of chronic disease management, looking at ways to deal with increasing resource demands due to demographic change. She is now the Director of Quality, Safety and Innovation at Weston Area Health Trust.

Tricia says: ‘During my fellowship I gained a unique opportunity to see and hear great leaders at work. This served to develop my own skills in bringing the best out of people and systems so as to deliver excellence in healthcare. I have been back in the NHS for a year but have been able to develop and support junior and senior colleagues, as well as extend the way in which I work with others to inspire and motivate them to aim high.’

Read more about Tricia Woodhead

Elizabeth Bradbury (2009/10 fellow)

Elizabeth trained as a nurse specialising in emergency care, and has led improvement programmes at regional and national levels and acted as an improvement consultant for NHS Scotland. During her fellowship Elizabeth focused on system integration and large scale capability building. She is now Director at AQuA (Advancing Quality Alliance), a quality improvement agency supporting 55 NHS member organisations.

She says: ‘The QIF year was refreshing, stimulating and 100% enjoyable and it rekindled my commitment to NHS healthcare for the 21st century. I use learning gained during the fellowship daily in considering where to focus AQuA’s work, how to gauge our effectiveness and how to shape and develop the organisation. The QIF alumni network and the contacts I made as a fellow also mean I now have a global network to guide, advise and share ideas.’

Read more about Elizabeth Bradbury