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2020 will see the development of a new framework for improvement in the NHS in England. Inspired not least by work in Scotland, it will seek to use the quality management system concept to encourage a balanced approach to quality planning, control and improvement.

In December, Q members were given an exclusive opportunity to learn more and start to feed in views. 122 members joined the webinar with Hugh McCaughey, National Director of Improvement and NHS England and NHS Improvement. If you missed it, you can watch the recording. Matt, Q’s Insight, Evaluation and Research Manager, has summarised the poll findings and comments in an accompanying report. In this blog, I share the themes that struck me from all that Q members shared.


Those of you who joined the webinar told us you see plenty of potential in the proposed framework, particularly as a way of encouraging organisations and systems to be more joined up and aligned.

There’s passion in the community for achieving a better balance between improvement and quality planning and control.

There’s passion in the community for achieving a better balance between improvement and quality planning and control. However, some voices questioned how the introduction of this framework would play out in practice. Might there be a risk that it becomes used as a tool for assurance? Or might it be ignored or misinterpreted by those Boards it is perhaps designed to reach, who may miss the principles on which the work is founded and ignore it unless it is linked to external judgement?
When those who of you on the webinar were asked about what you thought is most important in encouraging people to take a more improvement-focused approach, the clear front runner was ‘creating an aligned and enabling culture that supports those on the frontline to improve’. Looking across your responses, one of the key messages for me is that context and the way in which this is approached really matters.

As is often the case in improvement, the very reasons why it might be important to introduce something, may also make it challenging. As Will highlighted, in a system so geared towards external assurance, even things conceived differently may be interpreted in ways that are not intended.

In a world where improvement leaders are calling out for better alignment, it may prove particularly tricky to make all the connections – and bring in all the voices – needed for success. The aspiration is that this framework becomes something that is collectively owned and genuinely useful to teams and organisations seeking to understand what good looks like and where they would like to improve. For this to happen it will need to build on what is already happening, with creative thinking about how implementation will be supported.

It was brought through strongly in Hugh’s vision for the work that the Q community could play a key role in helping to develop and indeed make a success of this new framework.

It was brought through strongly in Hugh’s vision for the work that the Q community could play a key role in helping to develop and indeed make a success of this new framework. A core component of Quality Management Systems, and this proposed framework, is a learning system with a vibrant community of individuals helping to spread ideas and build understanding across disconnected fields of activity. For the NHS in England, Q – along with other networks – could, and I believe should, play that role.

There will be opportunities to get involved in this work during the spring. Let’s keep the conversation going! Please share any thoughts in response to this blog, or email the team at Q@health.org.uk.

Comments

  1. I do think that a framework for improvement is a good thing. A key element is missing from the proposed framework and that is Process Management. Juran was mentioned a number of times; Process Management is also a key element of his trilogy.

    The Q Community must understand the what the word 'quality' means in a Quality Management System because it's not the same meaning as the word 'quality' in the NHS's Quality Improvement initiative.

    I'm looking forward to discussing this proposed framework further within the Q Community.

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