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

Ambulance services are uniquely positioned to improve health and care for our patients, and determine their experience of the healthcare journey. The ability and contribution of ambulance services to improve the wider urgent & emergency care system has led to high activity in improvement initiatives, projects, and programmes across the UK.

In recent years, Quality Improvement has empowered frontline colleagues to significantly contribute to making improvement happen. Yet, across the UK ambulance services there remains variance in improvement capabilities & capacity, and challenges in effectively scale, spread and transition of improvement ideas.

The project will build improvement capability and awareness across specialist and frontline ambulance staff groups, whilst operating across UK Ambulance Service boundaries.

What does your project aim to achieve?

The Q Exchange funding will aim to achieve two goals:

Spread awareness and engagement across frontline ambulance staff, in improvement opportunities and initiatives, and the Ambulance Q network.

This will provide benefit to frontline staff in being able to make change happen at the frontline. This can be measured through NHS staff questionnaire responses (related to ability to influence change at work); measured at service level through staff interactions & engagements, and through increased activity & membership of the Ambulance Q special interest group.

As the Ambulance Q community, establish and develop UK-wide collaborative work streams that create wide-spread improvement and an environment to tackle shared challenges collaboratively.

This will benefit patients and service users through service developments, seeking to ensure effective, safe, and positive patient experiences. This can be measured through the growth in collaborative work streams, joint-working initiatives and projects.

How will the project be delivered?

The project will be delivered through the collaboration of the Ambulance Q community, and associated colleagues involved in ongoing collaborations. The Ambulance Q group have established a coherent and passionate group, keen and able to progress this project. Through the Ambulance Q group, Q members are encouraged to actively participate in the project delivery; whilst other specialist members may wish to contribute to specific improvement project work streams.

The project will be delivered through the co-ordination and facilitation of frontline ambulance staff ‘exchanges’. This will enable shared learning and experience of contrasting organisations. Secondly, a conference will be held focusing on shared learning & future collaborations in improvement areas. Finally, the project will spread key messages and learning across UK ambulance staff through the use of video-cast, pod-casts, and other digital & media tools – ensuring improvement messages can be shared UK wide.

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

The Ambulance Q community is a collaborative group able to coordinate and share learning into the wider UK ambulance organisations. This will complement traditional means of sharing learning throughout the project life cycle.

In addition to this, the proposal ensures sharing experience, initiatives and learning is fundamental to achieving the project aim. Our ambitions to create a system of sharing digitally, using engaging visual-audio media to spread messages across the UK ambulance sector.

Finally, the project will be evaluated and the learning shared across the Q community and other interested parties.

How you can contribute

  • Supporters - Help spread the awareness of the initiative.
  • Contributors - Can you add value to our ambulance systems and processes? Please get involved.
  • Lessons Learnt - Have you experienced a similar initiative? Please help us learn from past lessons.

Plan timeline

3 Nov 2019 Commence 12 month project
10 Nov 2019 Purchase & commence training
15 Dec 2019 Early communication for staff exchange opportunities
12 Jan 2020 Develop system for 'exchanging' improvement ideas/outputs
12 Jan 2020 Open staff exchange initiative
16 Apr 2020 Ambulance Q Conference

Project updates

  • 28 May 2020

    The impact of Covid-19 has been felt significantly across the project team, and associated organisations.

    At the start of the year the project commenced, with high energy and consideration to stakeholder management. Time was invested in on-boarding the community and establishing strong links with key stakeholder groups – namely the Directors’ of Quality national Ambulance Group ‘QGARD’. This group of senior stakeholders were positive and engaged with the Q Exchange project, identifying many area for collaboration.

    Planning continued, with provisional venue and date set of the UK Ambulance Q conference in September 2020, and links made to establish the technology platforms to continue further ‘digital engagement’.

    Unfortunately, Covid-19 impacted directly on the work of project team members and the potential stakeholders of the project. Many colleagues across the ambulance sector were tasked to focus on core delivery of services, including redeployment into front-line services/other services to support. Many QI functions and teams have supported the delivery of critical functions, assisting in large scale transformations required to keep patients and staff safe.

    In all work streams, the Q Exchange project paused to enable the response to Covid-19. Sadly, this has impacted the timescales of this work.

    In May 2020, the Q Exchange team reconvened to explore ‘how’ and ‘when’ the project should recommence. This discussion was continued with a wider engagement session of the Ambulance Q SIG in late May. Fundamentally, the energy and ambition for the project remains. There is an appetite to ‘pick it the momentum’ and ascertain which elements of the project can commence, whilst understand which may need to change.

    It is likely that a revised project plan is now required, which subsequent changes to planned spending. This is now being explored, with an intention to inform the Q Exchange management of the proposals – which may include a virtual conference, and revised ‘staff exchange’ programme timeline.

    Overall, the project has been dramatically impacted by Covid-19, yet the fundamental ambitions for the programme remain – with existing & new Q member keen to share, learn and improve from key and impactful experiences of recent months.


  1. Guest

    Rachael Hosznyak 2 months, 1 week ago

    I would be really interested to hear more about your revised project once you are able to re-instate this piece of work.  I would also be willing to help in anyway that i can.  My PhD is focussing on quality improvement and implementation science in paramedic practice.

  2. I suspect covid will also have lowered some of the barriers to integrated working that many of your colleagues in ambulance services want to work on using QI, so you may find people are keen to work on this, once they've had a chance to recover from recent strains. Good luck.

  3. Really enthusiastic about this idea! There is a social movement growing amongst Ambulance Improvers and we would really benefit from this support to help us grow!

  4. Hello

    Happy to help if I can.

    Studied complex network theory, I have been running an evaluated CoP for practice pharmacists for nearly 5 years and I am on secondment soon supporting ED's.

    You've got my vote.



  5. Great idea! Have you seen Becky Malby’s work on networks and the great Source for Networks website? It allows people to connect and share resources. Could it help with your ideas for a platform??

    Good luck

    best wishes



  6. I like this idea because you are tapping into a valuable resource that is simply sitting there waiting to be used.

    NHS staff are the best resource the NHS has - let's keep using them and providing better care.

    I am sure you will hear some simple, easy to implement solutions for some genuine issues,

    I hope it will also be an opportunity for staff to feel their opinions matter and are valuable.


    I hope you get funding and enjoy doing the interviews





  7. Hi Jonathan,

    I'm really interested to hear more about this idea. My PhD study explored how advanced nurse practitioners in the Emergency Department negotiate professional boundaries, particularly in relation to clinical decision making. I'd be keen to find out how you plan to explore the insights of ambulance crews.

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