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A System Leadership approach to Quality Improvement and Joy in Work

Project to implement a systems leadership approach through coproduction aiming to increase Joy in Work, promote and improve integration, improve patient outcomes through Quality Improvement (QI).

Read comments 6
  • Proposal
  • 2019

Meet the team


  • G Arnold DGS CCG
  • B Millar East Kent CCG
  • T Rouse Medway CCG
  • Dr V Short GP, Lead Primary Care Research for CCGs
  • Dr S Hotham, CHSS Kent
  • Heads of Quality

What is the challenge your project is going to address and how does it connect to your chosen theme?

The main challenge for the system with increasing population demands is how to release time to care for our patients  leading to Joy in Work.   As outlined in the Long Term Plan the system needs to change radically to address this.  The critical success factors for outstanding patient delivery indicates that the dynamic environment and culture created through the introduction of QI plays a major part in successful and sustainable system change by:

  • Increasing face to face patient interaction through the reduction of low value work
  • Enhancing organisational capability around improvement through a training and dosing plan
  • Developing a common language and approach to change across providers with the added benefit of building relationships, trust and ultimately improving patient outcomes.

This project will create a common language and methodology to address the challenge of cross-organisational working.  We will be using tools such as Life QI and Hexitime to support this cross-boundary work.

What does your project aim to achieve?

We want to trial a collaborative systems leadership approach to Joy in Work through the introduction and embedding of QI within our STP footprint.  Essentially, we want to share our experience of introducing QI, share pitfalls and develop a package to meet the needs of busy clinicians within our region.  Incorporating Joy in Work is enabled through embedding a culture that promotes staff engagement and ownership of change and improvement. The aim is to embed a change culture that not only harnesses resulting improvements in patient outcomes but also leads to greater staff fulfilment.  This has been articulated in a driver diagram which identifies:

  • The project aim is to create a specific QI package by February 2021 to increase Joy in Work
  • Primary drivers as Engagement, Research Packages, Current status of Joy in Work
  • Secondary drivers as Development of package including options for online, face to face, etc.

It is expected that change ideas would form part of the project itself.

How will the project be delivered?

We have undertaken work in the local health economy to train and develop partners in QI methodology.  This has included participation by Commissioners, STP, and Trusts in our QI programme based on NHSI’s, Service Improvement and Redesign (QSIR) approach.  This partnership will be rolled out to mentor and work with STP, PCN Clinical Directors, CCG colleagues to grow improvement capability and co-produce a tailored package to facilitate access to the tools and techniques to improve Joy in Work.

Partners include GPs, patients, STP,  and CHSS Kent Uni.  which is involved in the national evaluation of how QI is implemented across QOF.  We will make use of expert advice from NHSI and wider QI Community including Q Community, ACT Academy, PCNs and Kent Surrey Sussex AHSN who can share insights and expertise on making good ideas spread, provide thought leadership and support with strengthening partnerships through their collaborative approach and region-wide improvers network.

What and how is your project going to share learning throughout?

Project is focussed on shared learning and development of QI.  We will use:

  • A robust QI approach to share learning with a clear aim, measures to show impact. Making use of relevant tools and techniques such as change management.
  • The model for improvement including PDSA.
  • Our publically accessible QI website where all our projects are displayed using a standardised one page approach which includes learning.  We will utilise this web resource and have a specific section relating to this improvement project.
  • Existing governance and communication channels including reporting to commissioners via our internal weekly bulletins, external partners magazines, governance meetings and boards and our innovation network.
  • Our annual QI conference, sharing impact and learning. All members of the local provider organisations attend.  Our recent conference generated inspiration and touched nearly 300 delegates.
  • Social media to spread the inspiration and learning wider

How you can contribute

  • Comments and suggestions on the systems leadership approach.
  • Input from PCN Clinical Directors and GPs advising on best ways to engage with time-challenged primary care staff.
  • Input from STP colleagues on potential PCNs to approach.

Plan timeline

2 Dec 2019 Stakeholder Mapping and Comms Plan
28 Feb 2020 Hold first engagement event
30 Apr 2020 Produce first draft of package
29 May 2020 Review package - Stakeholders
30 Jun 2020 Amend package
31 Jul 2020 First PDSA ramp
31 Aug 2020 Analyse 1st PDSA ramp. Plan 2nd, 3rd, etc., ramps if needed
26 Feb 2021 Lessons learnt
26 Feb 2021 Roll-out finalised package within system
30 Jul 2021 Present project at annual QI conference
31 Aug 2021 Review progress and agree changes


  1. Good to see you want to look across the system and engage with PCN Clinical directors. I think involving them early and looking at the priorities for them would be helpful.  Re time constraints some meetings might need to be virtual and via a platform and could link to work they would be starting already.

    1. Guest

      Dawn Nortman 2 years, 11 months ago

      Thanks Elizabeth - we are lucky to have their engagement and enthusiasm at this early stage.  Definitely agree that we are going to have to do some of the work virtually.

  2. Hi team,

    have you seen the other STP/ICS ideas on the exchange? May be worth linking up if you haven’t already??

    Also are you aware of NHSI’s culture and leadership programme? There’s great resources on their website, like a leadership survey for instance that you may find interesting.

    Good luck

    Best wishes


    1. Thanks Anna - will take a look.

  3. Hi both

    Are you aware of the work that started in Bradford 15s30m? If you haven't it's worth a look as I think it could fit really nicely with what you are trying to do.

    1. Thanks Lisa.  We love 15s:30mins but hadn't made the link re system leadership.  Will take a look.

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