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UK-wide Q community event 2019 – Live blog

A live blog from the annual UK-wide Q community event 2019. Get involved by commenting on the blog or on Twitter (@theQCommunity #QEvent2019)

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Hello and welcome to the live blog from the UK-wide Q community event 2019! We’ll be keeping you updated all day from the King’s Place, London so stay tuned, follow us on Twitter and get involved using #QEvent2019.

Make sure that you take advantage of the livestream where you’ll be able to watch key sessions on topics such as organisation and system-wide approaches to improvement, technology in health care, the wider determinants of health and finally the all-important announcement of the winners of Q Exchange 2019!

Now in its second year, we’ll be awarding upto £30,000 to 20 projects across two themes:

  • Building improvement capability across boundaries
  • Understanding alternatives to traditional outpatient appointments.

Find out more about the process of Q Exchange 2019 and why not take a minute to remind yourself of the shortlisted projects?

We’re expecting over 400 Q members from across the UK to be joining us. The event is an excellent opportunity for the community to come together, make connections and share experiences from their individual improvement worlds.
Through the live blog we’ll be capturing the spirit of the day, bringing you insights from breakout sessions and lightning talks, as well as sharing discussions. We’d love to hear your thoughts in the comments below or on Twitter.

09:00 – And we’re off

Good morning from King’s Place! We’re kicking off #QEvent2019 with breakfast, coffee and networking.
A few words from Q Initiative Director, Penny Pereira on what she’s most excited about for the day.

We’ve got lots of our most popular improvement related publications available to take away. If you’re not at the event, these can be ordered or downloaded directly from the Health Foundation website!

The first informal networking session of the day is well underway!

10:00 – 10:30 Opening plenary – Collaborative improvement: 3 ways to increasing our impact

Watch on the livestream!

Penny Pereira, Q Initiative Director, takes to the stage to open #QEvent2019 with partying, personal stories and inviting the community into the depths of professional self-doubt.

“I think it’s right we start in the party mood, because we’re celebrating a further 10 years support for Q agreed by the Health Foundation and our country partners in Wales, Northern Ireland, Scotland and, from next year, Ireland.”

Read Penny’s blog Q: long term plans agreed with partners for more information.

Sharing a personal story of a recent experience of being a service user, Penny reflects on the early stages of her career.

Over the next few days, I thought back at how I had approached the task of redesigning outpatients

I tackled it with all the enthusiasm of someone just out of university, armed with some – really very useful – toolkits from the NHS Modernisation Agency.

I was pretty good at bringing to the problem my newly developed process mapping, capacity and demand modelling and scheduling skills. I’d done some role and facilities redesign, and lots of staff engagement.

But the work we did to understand the patient and carer experience was pretty superficial. We knew patients said they wanted a choice of dates for their appointments and had a clear rationale for introducing the changes – but there wasn’t really the expectation or perhaps tools to follow through to make sure the detail of the experience we were designing met their needs.

My point for today is not that we need to incorporate service user perspectives more into our improvement work – though it is often an area that’s far behind where it should be. When I actually attended the packed clinic with my daughter we arrived at 2pm and only got the reassurance we needed from an exhausted consultant just before 7pm. I was reminded that if I’d just focused on experience and built the service solution around what the medical secretaries and patients said without applying some of the rigour of operational design, it would have been equally lop sided.

With 1000s of members in every part of health and care, we can help draw together different skills and perspectives and align action at all levels. This means we can all be confident the resources, time and passion we invest in improving care will deliver real and sustainable benefits. And we can build in ways to learn and spread as we go, making the most of the thousands of connections that are forming between us.

Taken together, prioritising action in these three areas could pave the way for a profoundly more collaborative approach to learning and improvement.

With long term backing from Q’s partners, we as a community are well placed to be leading the way.
Q’s infrastructure is here to help and here to stay. Q Lab and Q Exchange provide focused ways for us to demonstrate new approaches to spread. Q’s learning and development offer, not least today’s event, provide ways for you to tap into what’s known in key areas.

And the organic networks that are developing in Q are also a critical part of the picture, even if the way they lead to change is often subtler.

Over the years, Penny has encountered excellent examples of people and organisations redesigning outpatient services.

But to bring us back to the party analogy, you need to turn up and throw yourself into it if you and we are going to get what we need.

Q is diverse and relaxed, much more eclectic and freestyle than strict dress code.

But this is a party where you are expected to bring something – your ideas, examples and energy.

10:30 – 11:30 Break out sessions

Now that we’re in the party spirit with some food for thought about ways that we as a community of improvers can increase our impact, it’s time for the first set of breakout sessions.

Breakout session 1A Building organisational and system-wide approaches to improvement

Watch on the livestream!

Many of the UK’s best performing NHS trusts and boards have developed an ‘organisation wide approach to improvement’. Drawing on the learning from the Health Foundation’s report, The Improvement Journey, this session is exploring the infrastructure, resources, culture, governance and leadership needed to create and embed such an approach. We are also hearing from Amar Shah and Neil Goulbourne about the improvement journeys of their organisations – East London NHS FT and Guy’s and St Thomas’ NHS FT.

For more on this check out The Improvement Journey or download the poster.

Breakout session 1B Lego serious play: building a new model of outpatient care

What is so great about using Lego? Well we have found that by using playful, fun approaches to tackling old challenges we can generate fresh perspectives and clarify complexity. Often in traditional meetings it is difficult to keep everyone engaged with the topic the whole time. People who are shy or naturally introverted may not feel able to fully participated and their contributions may get lost. By transforming our meetings into playful LEGO workshops we are able to create a more democratic environment in which people can express their thoughts and ideas in an authentic way and we can fully engage all minds in the room.

For more details check out the Serious Play website.

Breakout session 1C Confronting the big issues: improving the environmental sustainability of the NHS

How can we apply current issues around climate change to tackle sustainability within the NHS, and what does the health care system contribute to climate change? This session will explore how quality improvers can play a role in tackling this issue, and members will leave with tools and practical ideas they can apply in their roles.

Momentum is key to sustainable practices becoming embedded within health care, add your voice to the Sustainable Healthcare SIG.

Breakout session 1D Co-producing improvement

Bringing together people who are enthusiastic about working collaboratively to improve care, this session will allow members to share their experience of co-producing improvements with patients, service users and communities. We will explore practical tips and learning that can be used by teams and organisations to ensure that improvements in care are co-produced. We will also provide space to consider how Q members and the Q community can (individually and collectively) build momentum and enthusiasm for co-production as a core element of all improvement work.

Interested in learning more about co-production? Join the Special Interest Group.

11:30 – 12:00 Break

Time for a well-deserved break – members have the opportunity to network over coffee and yoghurt bowls!

12:00 – 13:00 Breakout sessions

Now that everyone has re-energised and made some connections, we’re straight back into the action with our second set of breakout sessions.

Breakout session 2A The technological revolution in health care: the role for improvement in enabling effective use in practice

Watch on the livestream!

In our session on digital technology the panel explain the importance of co-design, iterative testing and QI methods for successful adoption. For example, in Scotland, Plan-Do-Study-Act test cycles (over 100 of them!) have helped to embed the #NHSnearme service.

Find out more about NHS Near Me.

Breakout session 2B Design ideas and skills for improvers

Applying a design mindset to quality improvement can unlock potential and place patients and staff at the centre of the improvement process. There are a number of approaches and models that can be applied to the improvement process.

  • user focus using research and continuous learning to understand user needs, data and assets.
  • reframing to solve the right set of problems
  • creativity to generate a stronger and more diverse set of ideas and opportunities
  • cheaper/iterative testing and learning in order to design, implement and scale the right solutions
  • continuous improvement using shorter feedback loops and hypothesis-driven design

Read more about the benefits of thinking about design led change: The ROI od design-led change from FutureGov.

Breakout session 2C Improving care, collaboratively and creatively, across mental and physical health

Using a creative method (Appreciative Interviews from Liberating Structures) the Q Lab is helping people discover and build the root causes for success when working collaboratively in health and care. Drawing on people’s own stories, the activity is surfacing learning on what makes success possible and insights for positive change.

Q member Kay Stevenson is sharing learning on how her organisation has been working with the Q Lab and Mind, to develop and test practical ideas to improve care across mental health and persistent pain. Keele University and Midlands Partnership NHS Foundation Trust, are one of five organisations that have been working with the Q Lab and Mind since March as ‘test teams.’ Find out more about the projects and the process.

Read the Q Lab Essays for insights and learning so far on mental health and persistent back and neck pain.

Breakout session 2D Navigating power and politics in health and service change

Political skill is essential to improvement, and getting things done, but we tend to learn it – often painfully – by trial and error. Prof Justin Waring, Will Warburton and Dr Cheryl Crocker say we could do better.

Check out The Open Business School’s publication Dancing on Ice for further reading.

13:00 – 14:00 Lunch and refreshments

We are breaking for lunch and have lots of opportunities for attendees to continue their conversations sparked by breakout sessions, or learn more about what’s going on with Q more generally.

Firstly, eight of Q’s Special Interest Groups are having meet ups across the lunch hour. You can find out more about each one below.

Communities of Practice

The group aims to bring together people who are interested in setting up Communities of Practice, or have already set them up, to share their experiences and knowledge.

Join the SIG

Reimagining Health & Care

This Reimagining Health and Care Special Interest Group is for people actively working to explore how we might reimagine our health care system to recognise individuals and communities as health producing. Inspired by the success of organisations like Buurtzorg the group will address how we can connect people to purpose, welcome the whole person at work and reinvent the structures and systems to support this change.

Join the SIG

Lean health care

Lean continues to become increasingly popular in health. This group will exchange information on current thinking and discuss ideas on the application and adaption of Lean thinking to the health care sector. Join the debate on Lean in health.

Join the SIG

Allied Health Professions in QI

We are hoping to raise the curiosity and profile of AHPs in Quality Improvement. We are looking for the inquisitive, the enthusiast and the improvement gurus to share the possibilities and experiences of quality improvement in the health and social care system. This special interest group will be focused on the experience of AHPs in QI, considering awareness, involvement and leadership. We’d like to create an opportunity for AHPs to share practice, develop skills and a support network to empower relationships.

Join the SIG


The Q Community includes many people who are realising that there are other ways to record what you learn at events – a more visual form of taking notes known as Sketchnotes.

Join us as we explore the world of QI with each other, learning how to use our creativity to capture information and experiences from meetings, masterclasses and conferences.

And don’t worry if you don’t think you can draw! Let’s try something new…

Join the SIG

Learning from Excellence

Whilst it is important to learn from events where things have not gone well, the majority of healthcare interactions go safely. Despite this, we have focus the much of our learning about safety from adverse events, where by definition, safety has been lacking.

‘Learning from Excellence’ is an innovation that focuses on capturing and learning from episodes of excellence in healthcare in an attempt to further improve the quality and safety of care that we provide. It also provides an opportunity to thank and recognise staff for excellence, which may improve resilience, culture and morale. This group will offer the opportunity to share ideas, experience, support, innovations and learning from what has gone well and what has been challenging!

Join the SIG


In co-produced health care, organisations work with people who use services, carers and communities in equal partnership. It’s easy to do it wrong and quite hard to get it right, but it isn’t rocket science, and brings huge benefits to everyone involved. Why don’t we talk about it?

Join the SIG

Liberating Structures in health care

This is a place to share tips, tricks, challenges, plans, ‘strings’ and more around using ‘Liberating Structures‘ for health and care improvement. This follows on from a successful Q community immersion workshop in ‘Liberating Structures’ with Keith McCandless and Fisher Qua.

Join the SIG

We’ve got some of last year’s Q Exchange winners sharing their learning as well as the Q Visits team. Check out their stands to find out more about the projects and what they’ve been up to since winning funding or more about the Q Visits programme.

14:00 – 15:00 Lightning talks

For the next hour, Q members are attending an array of lightning talks covering all manner of different topics including;

  • Making sense of complexity with Dr Maxine Power
  • What it means to be a positive deviant with Elisa Liberati
  • Citizen Science as a tool for improvement with Graham Martin
  • Scaling and Spread: key factors for spreading innovation and improvement with Dr Amanda Begley
  • Learning from Excellence (LfE): a positive approach to safety and QI with Adrian Plunkett and Alison Jones
  • Developing a ‘Lean’ culture of continuous improvement: evaluation of 5 NHS trusts partnered with the Virginia Mason Institute with Nicola Burgess
  • Recognising the softer signs of deterioration with Sarah Fiori and Mel Johnson
  • Hexitime with Hesham Abdalla
  • Skills for collaborative and creative problem solving with Anindita Ghosh (Q Lab)

15:00 – 15:20 Break

All this inspiration and networking is thirsty work! Q members taking the opportunity to catch up over a cuppa before heading into the final round of breakout sessions.

15:20 – 16:20 Breakout sessions

The final breakout sessions for the day are taking place, with lots of learning to be had.

Session 3A Health is much bigger than the NHS: Using improvement methods to address the wider determinants of health

Watch on the livestream!

Exploring two case studies, this session will tackle some of the remaining challenges in quality improvement and consider how improvement methods may need to be adapted to be suitable for addressing the wider determinants of health. We will think about methods that have been used, and provide a space to discuss and debate how this field can move forwards. This session will help members think about how quality improvement methods can be used to address the wider determinants of health and how established or current methods used may need to evolve when tackling this agenda.

Session 3B Building improvement capability across boundaries: what are we learning together?

As a community we’re learning a lot about what it takes to build improvement capability across boundaries, not least through Q Exchange. In this session, we’ll be aiming to share 50+ stories in the room. Bridging all kinds of boundaries: professions, sectors, geographies, disciplines. Please do share your experience with us over Twitter: what have you done and learnt?

Session 3C Transforming outpatient care: Learning together

Transforming outpatient care is a key system priority in each country of the UK. There is also increasing focus on how to modernise services and give patients greater flexibility and control over how they receive care. Yet, progress at scale has been difficult. This session will advance thinking on overcoming key system challenges including ensuring staff buy-in, developing appropriate infrastructure and measuring what matters.

Find out more about the findings from Q’s Insight Survey on improving outpatient care.

Session 3D Is it time to celebrate learning from failure?

Attitudes towards failure in teams and organisations have a direct impact upon patient safety, and our ability to learn. Find out what practical steps you can take to improve safety in your own organisation by driving out fear and embracing failure as an inevitable part of learning, improvement and innovation. This engaging and interactive session builds upon insights gained from an exploration of failure that started with a visit from Sweden’s Museum of Failure, to the North West.

16:20 – 17:15 Closing plenary and announcement of Q Exchange

Watch on the livestream!

Q members are gathering for the closing plenary session of #QEvent2019. Q Initiative Director, Penny Pereira is joined on stage by Health Foundation Chief Executive Jennifer Dixon and National Director of Improvement, NHS England and NHS Improvement McCaughey to close out the event.

We started today talking about how Q enables a more collaborative approach to learning and improvement, making it easier to bring together all the perspectives and skills needed, align action at all levels in the system, and scale what works in a dynamic and organic way.

Q Exchange is great example of this.

It’s the moment of truth … Jennifer Dixon and Hugh McCaughy are about to announce the winners of Q Exchange 2019! The top two-thirds of teams with the most votes in each theme will receive funding.

First up is Jennifer to reveal the Understanding alternatives to traditional outpatient appointments winners. They are:

Now it’s Hugh’s turn to reveal the winners under the second theme: Building improvement capability across boundaries. They are:

Head over to the Q Exchange web page to have a look at them all.

We’re delighted to announce our exclusive Q member webinar with Hugh McCaughey on 9 December.

Q member webinar: In conversation with Hugh McCaughey, National Director of Improvement, NHS England and NHS Improvement

17:00 And that’s a wrap on #QEvent2019!

Congratulations once again to all of the winning Q Exchange projects as well as everyone who submitted an idea, commented on a proposal or voted! We’ve had a fantastic day and can’t wait to see what you pledge to do as a result of attending the day.


  1. Guest

    But I wouldn't recommend staying here throughout
    program trip. Lots of of "duty free" shops at the border.
    It's what I suggest to friends who come visit me in Bangkok as the unofficial tour guide.

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