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Q is committed to evaluating and understanding its impact both for accountability to our partners and members and to inform continuous improvements in our offers and services.

Evidence and impact

Q is an evidence-led initiative. When it was established in 2015, we drew on the recommendations of the Berwick review (2013) and the Health Foundation’s research into effective networks (2014) to shape the community.

Since then, Q has grown rapidly across the UK and Ireland – supporting people to develop connections, share ideas, skills and knowledge, and collaborate on more effective and sustainable improvement work.

Evidence on improvement, networks and collaboration underpins our work as well as independent evaluations that assess our impact and recommend developments. Most significantly, we commissioned RAND Europe to undertake an evaluation of Q between 2016 and 2020.

Their evaluation concluded that Q had successfully engaged and inspired thousands of members, helped raise the profile of improvement in health and care and made it easier for lessons and good practice to spread. They found many examples of this practical knowledge being mobilised on the ground to support ongoing and new improvement work that ultimately contributed to better care and outcomes for patients. However, they also concluded that Q is currently an ‘underutilised asset’ for the system and that we had not yet achieved impact at scale across health and care.

Continuing to learn

We continue to invest in evaluation to inform and assess Q’s ambitious growth and to help us achieve that impact at scale over the coming years. This is supported by the skills and capacity of our in-house evaluation team as well as external evaluation partners.

Our internal learning focuses most on understanding our members and their needs, the quality of experience they have when engaging with the community and the outcomes of our offers.

We work with external partners to help us more precisely measure our cumulative impact on improvement work, the quality of care delivered and Q’s wider contribution to the health and care system across the UK and Ireland.

We apply a range of approaches including surveys, interviews and case studies as well as more creative methods such as social network analysis, economic assessments, citizen ethnographies and discrete choice experiments.

Further Reading

Theory of Change

This theory of change sets out the core elements of what Q is trying to achieve, and how.

View the Theory of Change


Independent evaluation of Q, 2020

These reports by RAND Europe evaluate the Q initiative from 2016-2020, outlining key findings and recommendations for Q to support the contribution of improvers to health and care.

Download full document

Download summary

Download annexes


The journey so far, 2018

This report shares the Health Foundation and NHS Improvement’s progress and learning from developing the Q initiative.

Download The journey so far


Building Q, 2016

This report shares learning from designing a large-scale improvement community – looking at the first year of the Q initiative and the extensive co-design process used to create it.

Download Building Q

Learn with us

  • If you want to learn more about Q’s evaluation please contact Matthew Hill, Head of Insight, Evaluation and Research.
  • We are committed to involving members throughout our evaluation work including to steer our focus, as peer evaluators and interpreting the findings. Look out for opportunities to get involved throughout the year.
  • If you want a space to connect and share with other improvers on evaluation more generally, please join Q’s Evaluation Special Interest Group.