How did you first get involved in improvement, and what has been your journey since then?

I first got involved in improvement work in the NHS in 2005. I got introduced to NHS service improvement when I started working at the NHS Institute for Innovation and Improvement. I worked for six months in the organisation’s Patient Public Involvement and Products Development Directorate. This involved working with the leaders in the NHS for improvement and working on the development of products and improvement initiatives such as productive wards. My time at the NHS Institute for Innovation and Improvement involved being trained and learning on a weekly basis from the leading thinkers, developing/researching service improvement methodologies.  Every Wednesday afternoon we would have University style ‘lectures’ and discussions.

The different techniques and methods that I learnt about are still with me and used in my work today.

One of the great thinkers that I was able to work with was Helen Bevan, Strategic Advisor at NHS Horizons.

Then I worked for several years at the West Midlands Strategic Health Authority on bespoke improvement programmes with the acutes, community services, mental health, and learning disabilities service providers. We also supported the roll out of productive wards, productive community services. Later on, I also supported some practices with Productive General Practice, which is a programme designed to help general practices continue to deliver high-quality care whilst meeting increasing levels of demand.

I have been employed directly at acute trusts, community service trusts and at mental health trusts to lead programmes of service and quality improvement.

What most inspires you professionally?

One thing that inspires me the most about the work that I do in service and quality improvement, is that I can see how the improvement will lead to improving the lives of patients and/or improve the way that services are delivered to patients. I am always thinking of how the work that I am doing can become sustainable and how I can equip the people I am working with to think about continuous improvement.

Can you share a hard-won lesson you’ve learnt about what makes for a successful (or unsuccessful) improvement project?

A lesson that I learnt quite early in my improvement career is that you must invest time to understand all the key people that will be implementing the improvement and the pressures that they face. We need to understand what will get them involved and what they want in order to work on a project. I learnt that to have a successful project it is always good practice to have the following in place:

• Buy in from key executives of an organisation (at least an email, if not written then sign up to the project).
• Highlight reports on a regular basis on progress to key stakeholders.
• Establish a project team and regular catch-up sessions.
• Establish a project board / steering group with key stakeholders to meet fortnightly or monthly.
• Utilise project management tools, plans, templates, and techniques to ensure project is on track. Where appropriate escalate risks and issues.
• Develop metrics (where possible using existing metrics) or proxy measures that will show that the change you want is being delivered.
• Have a mechanism in place to keep track of improvements when project closes.
• If appropriate have the right workforce, finance and performance leads involved in the project from the beginning.

A project that I have been involved in, which had less favourable outcomes are the projects that have not had the right people signed up to be involved and do not have the project as one of their priorities.

The project should not start or rely on assumptions and given assurances (verbally) that it is priority.

You will see that they are not viewing this as a priority when they do not fully engage in meetings and/or workshops.

What change could we make that would do most to embed continuous improvement in health and care?

One thing that we need in the NHS to embed continuous improvement in health and care is that it must be part of the job descriptions and requirement of everyone’s role in the NHS.

Why did you join Q, and what have you learnt so far?

I joined the Q community to learn about the latest developments in quality improvement and to be part of a community of people interested in quality improvement. I have learnt new techniques from their webinars and improvement tools from workshops.

Can you tell us about something you’re currently working on that Q members might be able to get involved with?

It would be useful to know if anyone in the Q community is involved in developing a provider collaborative and how they are implementing a quality improvement approach in a collaborative way.

Want to learn more about Jatinder’s work? Get in touch.