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My first blog for the Q community was a My Improvement Journey, back in March 2018. I joined Q in mid-2017 after becoming a Research Fellow at the University of Birmingham (UoB), Institute of Applied Health Research, on a three year contract which was extended for another three years in September 2019. My research topic is Process Management in the NHS.

As a Chartered Engineer I’m a member of the Healthcare special interest group of the Institute of Engineering Technology (IET) and as a Chartered Quality Professional I’m helping to establish a Healthcare special interest group of the Chartered Quality Institute (CQI). I regularly contribute to healthcare related discussion and activities in these two Institutions. This has further increased my understanding into the working of the NHS from a different viewpoint and has given me access to a greater range of workshops and conferences and, particularly over the last 12 months, webinars.

So, what have I learnt about Process Management in the NHS after over four years of research at the UoB, my work with the IET and CQI, and over three years as a member of the Q community?

Through all this, one thing that I have not managed so far is to find any examples of Process Management Systems in the NHS

I’ve certainly met lots of very interesting people who are working hard to improve the performance of the NHS. I’ve read many of the vast number of reports produced by the many organisations that have an interest in the NHS. I’ve produced six Q Exchange ideas and, though I’m disappointed that none were funded, I have been pleased with the support and encouragement that I’ve had from Q community members for all these ideas. I’ve been an active member of both Q Lab projects, and started two Special Interest Groups (SIGs) alongside joining and contributing to a number of SIGs. Additionally, I’ve taken part in Q Visits and Randomised Coffee Trials and have found both to be of good value. All of this activity has given me a great insight into the working of the NHS – I almost forgot Hexitime, a skill exchange time bank, which I’ve also been involved with.

Through all this, one thing that I have not managed so far is to find any examples of Process Management Systems in the NHS. This is a great disappointment, particularly with the numbers of ‘never events’ in hospitals currently averaging six every week and the number of Trusts currently in special measures.

My key learnings from my research to date are that the NHS would benefit from Process Management, and that the reports mentioned above create confusion in the NHS around understanding ‘process’ as opposed to ‘Process Management. My research hypothesis is: ‘If the NHS introduced Process Management this would have many benefits not least of which is Patient Safety’, and thus far, my research is in support of this. I would love to be able to prove my research hypothesis but am unable to manage this without NHS collaboration.

Two things that my research has shown are that the NHS needs Service Re-design and Process Management. The NHS Long Term Plan (LTP) supports this although we differ on how this will be achieved. The LTP and NHS Scotland in their Discussion Paper, introduced at the Q community event 2020, pin their hopes on QI projects. I do not agree that QI is the way to re-design services. The paper has since been shared in the recently created Service Design SIG and I shared comments on the document laying out why I don’t believe QI is the way to redesign services, which you can read in more detail in the group space.

What about my hopes for the future of this subject? I have less than two years left at the UoB and I’m not planning on a further extension to my contract. It’s possible that I’ll be involved in a project within the NHS where process mapping and continuous improvement will be key elements of the project. I’ll be sharing the insight and learning from my ongoing research via the two SIGs I convene: Process Visualization in the NHS (Note: visualisation is a first step to Process Management) and the more recent group mentioned above; Service Design. Join these groups to see updates on my research and to share your thoughts; it would be even better if you could help me to prove my research hypothesis.

I’ve had many years of hands on experience in design and Process Management and have certainly gained an appropriate education. I will continue with my efforts to help the NHS but am also keen to hear from others in the NHS that could help me in this task.

Do you have questions on Process Management in the NHS or experience to share in this area? Join the Service Design SIG and share your insight.


  1. Hi Thomas,


    I am a neonatal consultant with QI and Human factors expertise.  Id be interested to know more and see how I can get involved in your idea.




    1. Claudia, It would be good if you did get involved. Please join the Process Visualisation SIG. I'll send an invite. Particularly look at my post on a proposed Q Exchange project for 2022. I think human factors play such an important part in quality management. The focus of all the process maps that I design is 100% on tasks undertaken by humans.

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