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

Shared Governance/Shared Decision making (SG/DM) is a model of leadership that creates culture change and places staff delivering clinical care at the heart of the decision making process. This initiative recognises staff as the experts and offers a structure of support to promote autonomy for change, communicating directly with senior leaders. At NUH we have a strong SG/DM programme, with over 80 councils that are operated by frontline staff who are innovating and demonstrating impact on patients, their carers and staff. As part of the SG/DM initiative, each frontline member of staff that gets involved is given QI training. This is fundamental to building QI capability within frontline staff. This work is now being replicated across the UK, building improvement capabilities across boundaries. Currently this extensive portfolio of work and resources are difficult for frontline staff to access and are unavailable to other Trusts. It is necessary to connect these groups together.

What does your project aim to achieve?

Frontline staff tell us it can feel isolating and difficult when innovating, so it is important to ensure there is peer support and coaching to maintain momentum and highlight to the councils/individuals they are part of a wider community. Our proposal is to create a platform through an App or webpage (potentially adapting existing platforms) that links the individual networks with each other, across trust boundaries and through the local system. Having a platform that is focused on the SG principles of autonomy, equity, partnership and ownership for frontline staff members will encourage people to share their personal experience, QI projects and how this has supported their own personal development. Sharing work and collaborating through the wider network will be easier and will create a stronger evidence base for changes that are being made. The platform will be designed where people can share ideas, evidence and create an opportunity for people to support and coach each other.

How will the project be delivered?

Scoping exercise, using an Appreciative Inquiry approach, will take place between other trusts and NUH councils to understand what is needed and how the platform will be used

Tweet chat will continue every month to maintain  momentum, timely feedback and ongoing support from the NUH Shared Governance team

Taking a co-production approach, an MDT project group will be formed that includes representatives from the ICS and other Trusts/organisation

We will work with the group and a company that has the specialist knowledge ( and technology) to produce, test, roll out

Evaluation will be undertaken to show the impact of the platform and new network; has this potentially increased the momentum of innovation or/and the quality of the work being done? Is shared governance a mechanism by which improvement capability from frontline staff across boundaries can be increased?

Launch of the platform and collective showcasing of SG/DM work at a celebration event for council members and the Q community

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

Direct links with participant trusts/organisations

Presenting of the work/platform being created to ensure continued input throughout the creation of it

Presenting the finished product locally and nationally at showcasing events and through ongoing work

The showcasing event to be filmed to share the experience to the wider community

A brief summary of initial findings to be shared including how you might evaluate locally

Publication of how the platform has impacted on innovation and links across boarders on conclusion

Staff that are using and involved in projects will be supported and encouraged to present/write up and discuss their work locally and regionally

The set up of a platform that will provide ongoing peer support and capture the innovations from SG/DM councils that can be shared and replicated

How you can contribute

  • Join the working group and participate in the project
  • Networking within your areas and feeding back how the platform will need to look and function
  • Provide ideas on differing platform options
  • Suggestions on how to evaluate the impact of the network
  • Ideas on how to evaluate culture change with organisation supporting SG/DM
  • Ongoing support and spreading the SG/DM work and ethos

Plan timeline

2 Sep 2019 Initial scoping exercise and recruiting of other trusts
2 Sep 2019 Start monthly tweet chat on SG/DM to guage continuing status
23 Sep 2019 Create a working group with national representatives
1 Oct 2019 Initial workshop to plan work and discuss platform options
4 Nov 2019 Workshop to evaluate SG/DM so far and needed culture change
11 Nov 2019 Write a brief summary for the Q community. Initial feedback
2 Dec 2019 Platform development- ? Q community page or NHSI framework
2 Mar 2020 Workshop- user testing of the platform
6 Apr 2020 Adjustments to be made to platform from user testing
10 Jun 2020 Launch and celebration event with Q community and SG/DM
13 Jul 2020 Publication of Q comjunity project and findings


  1. Sounds like a great idea. A platform to share across boundaries to learn and support improvement projects would be hugely beneficial to local improvement projects like ours with the local Quality improvement hub in Oxford.

    All the best

    1. Thank you Mridula,

      Do you have Shared Governance/shared Decision making at your organisation? We would love you to join the potential working group on this project.




  2. Hello All,

    Any suggestions on how we could develop this and anyone that would like to support this project please get in touch. This needs to be a tool that is fit for purpose for all within healthcare.

    We are often asked how we can link staff (Shared Governance/shared Decision making) and their projects together on a wider scale and believe this will provide with the start of this.



    Rachel Houghton

  3. Hi Anna,

    yes we are looking to publish definitely and are working with some of our council members to also publish about their experience as part of shared governance/shared decision making.

    It would be great to hear about your work on patient and staff engagement. There is always more learning to be made from one another, thank you for your support.

    Best Wishes,


  4. Dear Rachel and Louise,

    I was hearing about your great work on Monday! I think it’s a really interesting way of getting distributed leadership into practice and creating s culture of improvement. I would love to keep in touch and hear more about your work as you carry on evaluating the impact of this way of working. Are you planning to publish? It may be that some of our work at Northumbria about patient and staff engagement may be of interest to you too. If so then do message me and we can have a chat.

    good luck

    best wishes


    1. Hi Anna

      Thanks, happy to catch up and chat more about the work @teamnuh .We have lots of evaluation projects looking at impact and are developing some impact case studies to demonstrate the value of this approach.



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