Q community member, Sid Beech, shares the latest on the Q Exchange 2019 project Quality Coach Development Programme and how you can get involved.

The appetite for QI is growing exponentially, perhaps more so in light of COVID-19 and the innumerable changes that health care professionals have implemented and experienced in order to continue to meet patient needs. As the appetite for improvement grows, our community and leaders must consider how we will meet the increasing demand for specialist improvement support.

Within our organisations we cannot continue to employ more and more improvement specialists in order to support bottom-up improvement work.

Currently, various NHS organisations provide QI support to their staff members through a centralised improvement team. Staff within these improvement teams are trained and experienced in improvement concepts, tools and methods and use this knowledge to support front-line teams with improvement work.

Whilst the current approach works, it is not sustainable. Within our organisations we cannot continue to employ more and more improvement specialists in order to support bottom-up improvement work. Indeed, we may have already reached ‘peak QI team in many NHS organisations.

How can we meet this growing need for improvement support?

Upskill and train staff

One avenue is to up-skill and train all staff members in an organisation on the essential concepts of improvement and change. With this foundational knowledge base, staff are more able to independently test and implement change. In this approach the dedicated improvement team deliver training on QI concepts, tools and methods and serve as an expert resource to access when needed. Many organisations in England are working towards this approach using NHS Improvement’s QSIR programme, or similar local teaching materials.

Train a network of frontline staff about advanced concepts

Another option to meet the increased demand for QI support, is to train a network of front-line staff in the more advanced concepts of improvement, as well as coaching techniques – i.e. a Quality Coach (aka Improvement Coach, QI Coach). This is the model outlined in the NHS Improvement report Building capacity and capability for improvement, modelled on the Dosing Model proposed by Robert Lloyd. Quality Coaches serve as the first line of support for improvement within their service. This model has been used by a few organisations in the NHS including ELFT, Royal Free, Gloucestershire Hospitals and NHS Lothian, with considerable success in some locales.

The Quality Coach Development Programme

The term ‘Quality Coach’ currently means vastly different things to different people. Variability of the roles and responsibilities of coaches remains high and the level of development is similarly variable. The expense of some coaching programmes are costly and may act as a deterrent to move in this organisational direction. Our hope is that this Q Exchange project can re-dress some of this.

The Quality Coach Development Programme is part of a 2019 Q Exchange project that aims to develop a free-to-use teaching resource and programme to support the development of skilled coaches for quality improvement. The aim is that members of the Q community will use this resource to further develop improvement capability and capacity at a local level within their organisations, as well as at a system-level.

We are co-designing the Quality Coach Programme with Q community members, pooling our experience and expertise in the interrelated fields of improvement, coaching, leadership, measurement and change management in order to design high-quality teaching materials.

Currently, more than 20 of Q’s members have collaborated on the broad design of the Quality Coach programme, including an agreement on the role of a Quality Coach, the expected pre-requisite knowledge, the key learning for participants on the programme and a broad structure for the programme. Unsurprisingly things had been on hold during the midst of the first wave of COVID-19, however, we are now gaining considerable traction in the development of the programme, in readiness for a pilot.

In the coming months, Q community members will be using their subject matter expertise to develop teaching materials on the five main topics of the programme:

1. Deeper understanding of quality improvement
2. Leading change
3. Self-reflection
4. Coaching skills
5. Working with groups

We are hoping to pilot the programme in at least one location in early Spring 2021, making any adjustments to the materials after completing the pilot.

If you’re interested in supporting the design and development of this programme, including the production of teaching resources, then please contact me.