As you may have read in my blog a couple of months ago, the Q team is working with our partners to develop proposals for the long term future of Q. This work builds on all we’ve heard from Q members and others over the last four years, as well as a workshop held in February that brought together a group of Q members who volunteered to help test early ideas.
The first key decision point is in July, when the Health Foundation Board will consider our proposals. Q represents a big commitment by the Health Foundation, NHS Improvement and Q’s partners across the UK and we expect there to be plenty of discussion and evolution of the plans over the weeks ahead.
As always, it’s key that Q members feed into this process – so, at the risk of sharing things that may well change, here’s an overview of what’s emerging so far. There will be a webinar on Wednesday 12 June where you can hear more and feed in your thoughts, but if you have any immediate reactions please do comment below.
Over the years ahead, let’s do more to make sure the benefits of Q reach out through your networks and organisations and Q in turn is connected in and benefits from other perspectives.
Emerging plans for Q
Overall, we’re asking for funding to continue Q for a further 10 years, with a review in 2025. Much of what you currently see from Q will continue – we will carry on providing a flexible menu of activities and resources, with increasing focus on making sure this helps members anticipate future trends. We want to repeat Q Exchange on an annual basis – meaning over 200 collaborative change projects might have been supported over 10 years. Q Lab will evolve and grow, with the potential for Labs in Wales and Scotland in the coming years.
The plan is to continue to grow the community, while making sure we also invest in a digital infrastructure and more support for groups and story-sharing so that it’s easy to find the people and information you want even as Q gets bigger. We are proposing to extend Q to the Republic of Ireland and to think about how Q can do more to reach into social care and local authority services and attract those working in digital change and across local and care systems. Overall, the aspiration might be to have 10,000 members in Q by 2030.
We know the fact that people need to meet a certain bar to join Q has always divided opinion. To address this while not eroding what it means to be a member, the plan is to promote and develop further what we’re provisionally calling ‘Open Q’ offers. There are already many opportunities for those from beyond the community to participate – Q Lab, Q Exchange and many of Q’s activities and groups involve those who aren’t members. Over the years ahead, let’s do more to make sure the benefits of Q reach out through your networks and organisations and Q in turn is connected in and benefits from other perspectives. Specifically in relation to service users, we’ve been thinking about how we can further boost Q as a force for co-production and partnership between patients and staff. Watch this space!
Q has built incredible momentum over the last four years, and we think now is the time to start thinking more about how to connect into and influence the wider system.
Q has built incredible momentum over the last four years, and we think now is the time to start thinking more about how to connect into and influence the wider system. A new element of Q is proposed, which aims to help those organisations leading change initiatives that span whole countries or regions. The aim is to make it easier for organisations like our country partners, regional organisations and others to learn from each other and from those working at the frontline.
As we’ve been speaking to people about what they’d like to see from Q over the years ahead, what’s been striking is that it’s not just the tangible development offers or funding and sharing opportunities they value. They see in Q the potential to build a fundamentally more collaborative approach to change. An approach that gets beyond the false dichotomy between bottom up or top down change, and the false choice between piloting and pushing out interventions or ‘letting a thousand flowers bloom’. An approach to change that brings together all the perspectives and skills needed to address the complex challenges we know we need to confront over the years ahead.
Thanks for all your input and support so far. Please do tell us what you think and join the webinar if you can.
Comments
Susan Bishop 17 May 2019
Great to read the proposals and full support them. Particularly, good to link regions/whole countries. Q Exchange is a real opportunity for us to share and learn also.
Penny 17 May 2019
Thanks Susan,
That's great to hear. The challenges facing the health and care sector are big, and we need to think big to make sure we're tackling issues at every level.
Watch this space!
Liz Angier 17 May 2019
Thanks Penny
I'd like to see Q looking at how to support primary care initiatives both QI and research and across system working. I'm not sure that the Health Foundation does yet fully understand the pressures and difficulties within primary care to get involved in these activities. I hope that they will consider this group as there is currently extensive change of health care delivery in the community. They are not well represented in numbers in Q and having voting systems for projects by all the members may not support them if primary care only represent a small number of votes.
Penny 17 May 2019
Thanks Liz,
Completely agree primary care is a top priority - we're very keen to attract more primary care staff into Q - any thoughts on how to get the word out very welcome! I wonder how the primary care Special Interest Group might help give more focus in this area?
We do try to design different ways for people to get involved in Q, reflecting the realities of the pressured lives of health sector staff. I'm sure there's more we should be doing on that front - so let us know what would help.
This round of Q Exchange will include a focus on building improvement skills across boundaries - hopefully a good opportunity for some cross-sector projects. From the pattern of the projects that won first time round, we're reasonably confident people don't just back their own sector.
Sarah Henderson 20 May 2019
Thanks Liz and Penny - agree that primary care is an important area for QI development and the pressures facing staff make it particularly challenging. Outside Q, the Health Foundation is working in partnership with RCGP and others to support initiatives to increase continuity of care in general practice - although the teams are all in the early stages of their projects, we are already learning lots about how to support QI. We'll share our learning with the Q primary care special interest group - let me know if you'd like to find out more
Elizabeth Beech 20 May 2019
Hi Penny - I support the issues Liz raises and having worked with GP Practices on 2 specific QI schemes an aware how hard it is to get engagement in primary care. The learning was that the AHSN led scheme failed to get engagement due to ask of regular out of practice time to join the workshops. The learning from the CCG led scheme was that embedding QI within the CCG prescribing incentive scheme did work, and GP practices did attend 2 workshop events held in the local area. However it was clear the CCG had little QI expertise and it was due to a Q member that this was able to happen and work in a productive way. So: Q champions in commissioning can influence the ask of primary care, and growing Q champions in primary care networks needs to happen (whoever they may be as PCN will be very multi disciplinary).
Becks Fisher 22 May 2019
Absolutely in agreement. Making sure that QI is properly embedded within PCNs is clearly vital - but also likely to be a challenge in some localities. I suspect it'll also be interesting to see how the inclusion of QI within QoF does or doesn't feed in to this (particularly if in future the included domains were more at network than practice level).
liz angier 23 May 2019
Thanks, Penny, Sarah, Elizabeth, and Becks,
Penny, we appreciate the support to the primary care SIG group I think we need to look at how we work moving forwards. I agree with Sarah, Elizabeth, and Becks. Sarah, I am interested in the RCGP work thanks for your offer to share.
Penny perhaps the presence of HF Q at GP meetings such as SAPC, community Q members linking in with THIS Institute academics, presence at the open access UK GP meetings such as PRIME might get more coverage and help with networking and shared support. I think we need to acknowledge the challenges and have a meaningful offer or framework in the new systems for integrated care PCNS etc and that places for QI support are fragmented and a roadmap with collaborative working might be helpful.
Penny, I don't know whether you or other HF workers have spent a day in primary care or at a CCG but maybe that might help with insight into the current pressures on the systems and give some opportunity for further discussion.
Liz fisher 23 May 2019
Hi everyone
Delighted with response Penny. As you know I am stepping away from Q PC SIG but am so pleased that everyone is there to move forwards in PC.
Perhaps a Tcon with the SIG members to brainstorm?Liz