Impact and evaluation

The Q community is a thriving network of people sharing their improvement experiences. We support the community to learn and spread knowledge within and beyond the membership. 

Our theory of change [ref] Q theory of change. February 2023 [/​ref] joins the dots. It describes how what we do at Q is expected to enable a culture and practice of improvement which leads to better health and care for people across the UK and Ireland. 

It shows how the activities that we deliver or support create two key outcomes:

1. Thousands of Q members being better equipped to deliver positive change and amplify this impact through their networks.
2. Senior leaders creating better conditions and cultures for improvement and boosting capacity for improvement work across organisations and the health and care system

If you’d like to be sent an accessible version of our theory of change, please email qcomms@health.org.uk

Importantly, our theory of change describes a set of measurable outcomes at individual, organisational and system levels. This helps us to assess the value added by individual activities, as well as the difference we make overall. It informs the choices we make about what we work on and the approach we take to deliver. 

Our theory of change was developed in the early days of the community by reviewing existing evidence and working closely with members. We review and update it periodically, informed by emerging evidence and priorities.

We are committed to monitoring and understanding our impact. We invest in high-quality internal and external evaluation to stay accountable and guide our ongoing development. 

Our first external evaluation, published by RAND Europe in 2020 [ref] RAND EUROPE. Strengthening the contribution of improvers to UK health and care? An evaluation of the Q Initiative 2016–2020 [/​ref], generated three key findings:

• Q is a respected and appreciated home for people working to improve health and care services. 
• Q has helped build a confident community and raised the profile and understanding of improvement. 
• Q supports practical knowledge mobilisation on the ground, leading to tangible impacts.

The evaluation made the following recommendations to help increase utilisation of Q, and realise its full potential. 

• Engage system leaders more actively with Q. 
• Maximise collaborations with different agencies across the UK. 
• Make impact from Q Lab more visible.
• Review the Q infrastructure.
• Examine the use of member resources.

An internal evaluation, published in 2023 [ref] The Q community. Realising Q’s contribution to improving health and care. Impact and learning report. August 2023 [/​ref] , found that:

• Q benefits and activities have enabled or supported members to deliver health and care improvements that have benefited patients
• Q is perceived by around half of member respondents to be making a positive impact on the quality of health and care overall and to be increasing the visibility, credibility and profile of improvement at national level
• Q is still an underutilised asset, yet to realise our full impact at scale. 

The findings are a continued call to action for us to realise and sustain impact and to make a clearer contribution to core system priorities. This has shaped our strategic priorities for 2023–25.

Q has commissioned international charity Picker to undertake a two-year independent evaluation of our impact. The findings will play a key role in informing Q’s strategic development beyond 2025. 

We encourage all members to share their views and experiences to help Picker understand:

• the impact that the Q community and its  activities has for members, organisations and the wider health care system
• what factors create this impact and how they interact
• how can Q’s impact be increased beyond 2025?

The Independent Evaluation team (including people from Picker and their partners, ResPeo and Health Care Priority Solutions LTD) outlined how they will deliver this evaluation in their plan, known as a research protocol. They are using a combination of qualitative and quantitative evaluation approaches. Through interviews, case studies, workshops, desk research and surveys the team will:

• explore if and how specific Q activities lead to positive change
• assess the value for money of Q
• explore the different journeys members take in interacting with the community and Q activities, and how that supports them to create impact in their settings.

Email us for an accessible version: qcomms@health.org.uk

In response to themes that emerged in the early stages of data collection, the work has expanded to include additional workshops, interviews and specific evaluations of Q Exchange and Q Labs. This extra data and analysis will be integrated into the final evaluation.

The work of the Independent Evaluation team is being guided by an Evaluation Advisory Group, which includes some Q members.

Picker and Q will invite members to take part in a number of ways over the course of the evaluation. 

Look out for these opportunities, as well as evaluation updates, in your emails, the Q‑municate newsletter and on our social channels. 

A final report detailing the findings will be published in summer 2025. 

If you have any questions about the evaluation, please contact:

Amy Tallett, Head of Research at Picker

+44 (0) 1865 208115

Amy.Tallett@PickerEurope.ac.uk

Molly Blackwell, Senior Research Associate at Picker

+44 (0) 1865 208111

Molly.Blackwell@PickerEurope.ac.uk