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

We train by rotating through varied settings. However, once we qualify, opportunities for ‘experiential learning’ in different organisations rapidly diminish.  It becomes hard to identify willing exchange partners, and to be granted ‘time-off’ to participate in a work exchange.

Health and social care organisations also frequently work in silos. This results in missed opportunities to find joint solutions to problems in common and to successfully integrate care for patients.

To address these challenges, and in order to build improvement capabilities and insights across boundaries, we are seeking Q Exchange funding to develop, test and nationally pilot a mobile app, ‘Exp-Ex’.

This will enable health and social care professionals to connect 1:1, organise spending time in each other’s work place, reflect on what they have learned, evidence this for their professional development and share their learning with others to improve patient care. We will build on existing exchange programmes.

What does your project aim to achieve?

The exchange programme will enable people working in health and social care to typically spend between half-a-day to two weeks shadowing one another in their respective workplaces.

The known benefits of exchanges for participants include:

– better understanding of one another’s roles and responsibilities;

– strengthened relationships across disciplines and organisations, breaking down insular barriers;

– increased self-perception of knowledge and abilities;

– increased opportunities for learning about patient safety and QI in everyday practice through discussion on near misses and methods

Feedback completed at the end of each exchange and data obtained by the back-end of the app will provide information on what objectives have been achieved and how.  Benefits of the exchanges to employers and patient care will be evaluated and reported on. The literature suggests these are likely to include improved communication, teamwork, leadership development opportunities, and holistic patient care.

How will the project be delivered?

As a general practitioner and health policy researcher, we are well placed to successfully implement this project. Together we have over 25 years of experience working in and studying national and international in healthcare organisations.

We understand the current limitations of professional development opportunities, and how work exchanges could address these. We have studied the non-adoption of technology and are therefore familiar with the risks and how to mitigate these.

We have designed a prototype for the app, which is now ready to be built. This has been the result of iterative conversations, surveys, structured interviews and feedback from over 100 potential users and organisations in the past six months.

We will work with Q members, existing exchange programmes (e.g. GP-consultant exchanges), NHS England, university departments, and leading non-NHS organisations (e.g. think tanks, consultancy organisations) to become pilot sites and early adopters of the app.

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

The goal of this project is to share learning between exchange participants and their respective organisations. Exchanges will span the NHS and supporting health and social care organisations.

There is substantial research evidence regarding the value of experiential learning and work-based shadowing experiences to improve skills and increase workforce morale. There is also a body of evidence about the importance of networks and strong intra- and inter-organisational relationships to improve the quality of care we provide for patients.

As the exchange programme expands we envisage evaluating the benefits, and challenges, for participants, employers and patients and sharing these finding to improve the programme. Long-term we envisage using data from the exchanges, with participants’ consent, to identify common gaps in knowledge, to improve participant ‘matching’ and to share learning with key stakeholders, such as NHS England/Improvement and Health Education England.

How you can contribute

  • We welcome feedback on the idea form the Q community.
  • We would like to involve Q members in testing and developing the app, and we would look to Q members and their organisations to be early adopters of the app.

Plan timeline

31 Dec 2019 Identified pilot exchange programmes and end-users
31 Jan 2020 Refined product spec and wireframe with stakeholders
28 Feb 2020 Undertaken competitive selection process for tech developer
30 Apr 2020 Attended Q Network events to share progress
29 May 2020 Built MVP via up to 3 cycles of iterative end-user testing
29 May 2020 Built relationships with pilot sites and their organisations
31 Jul 2020 Evaluation and feedback to iteratively adapt user experience
31 Aug 2020 Piloted MVP with two to four organisations or networks
30 Oct 2020 Sought sustainable business model to scale up Exp-Ex app
13 Nov 2020 Shared findings with Q Network


  1. I think this is a really valuable idea and something that has even more resonance across inter-professional, cross-organisational and cross-sector boundaries.

    We have had a fair bit of experience of running these sorts of programmes (without the support of a brilliant sounding app like this!! - so a fair bit of manual work) which I would be more than happy to share so please do get in touch.

    Some info, a video or two and also a quite detailed toolkit if you search for 'paired learning imperial'

    Lots of other Trusts have done some great work on a similar basis; this from Jo Ward at GSTT is one that i always think has been really impressive:

    I will really look forward to seeing this progress


    1. Bob, thanks so very much for your support and the links you shared. We briefly heard about the various exchange programmes you've been involved in on the recent Q Exchange webinar - and would really value hearing more. We'll email you asap, as well as keep you in the loop as we progress. Your feedback would be extremely helpful as we take our next steps to turn our prototype into a fully functional app. Many thanks again.

  2. Guest

    Maria Ceurstemont 1 year, 9 months ago

    This is a great idea, we are trying to arrange similar exchanges in Coventry and anything that makes this easier to organise would be very welcome.   This would definitely fulfil requirements of study leave for doctors and HCP in general practice.

    1. Maria, so pleased to hear that you are working on setting up a local exchange programme. Over the last year we've connected with a few experienced exchange sites - would you be interested in chatting with them about their early steps? We can help arrange a few introductions. Although it seems other commenters on this page might be able to help too! Let us know if and when we can help.

  3. Guest

    Paul Sadler 1 year, 9 months ago

    The exchange idea is great, and I have seen work well between doctors and also across professions (e.g. doctor - hospital manager). This has been in response to areas of concern or conflict where spending time seeing what the other person actually did, the pressures they encountered, and the different priorities they may have, definitely helped improve a difficult situation. The idea of an App to help facilitate this is interesting and sounds good, though I would need to understand more exactly how this would work?


    1. Hi Paul, thank you very much for your comment. We would be really happy to walk you through a mock exchange using our prototype. This would give you a sense of the user journey. Email me and we'll set up a video call!

  4. Guest

    maggie woods 1 year, 9 months ago

    We know that most learning takes place in the workplace ,so the idea of an app that supports experiential learning is a great idea. I hope it will be linked to personal development / appraisal and include an area to record reflections/ learning

    1. Hi Maggie, really pleased to have your support! We are keen for exchanges to be used to fill training needs and gaps, and to have a section on the app for reflection that can be linked to CPD and PDP logs. We would love to get your feedback on our proposed plans, if you have some time. Email us when you have a moment. Many thanks.

  5. Guest

    Tracy London 1 year, 9 months ago

    We're hoping to launch our own role shadowing programme here in the Frimley ICS shortly.  We'll initially be running a pilot first with about 12 - 15 participants.  This will be across GP/Consultants/AHP's/Nursing across organisations across the Frimley patch.  The pilot will be evaluated & launched using qualitative data.

    Hopeful to launch our programme towards late Oct/Nov 2019.  We're excited to be thinking about "walking in each other's shoes" and the benefits that will bring for our system and our patients.


    1. Tracy, we would be really interested to hear about your programme as it continues. If you have any public launch events, please let us know, we'd love to attend.

      On a related note, we have gathered literature from a scoping review that you might find helpful for your evaluation, as well. Send us an email when you have a moment. I'm also starting a PhD in rapid qual methods in September, and could share some evaluation reading/advice, if that would be helpful.

      Finally, we would be looking for feedback on Exp-Ex as it is developed, and would value the thoughts of your shadowing programme participants. Let's keep in contact over the coming months to see how we both progress!

  6. Guest

    Sonali Kinra 1 year, 9 months ago

    This is a brilliant idea. We are currently managing in Consultant-GP Twinning scheme facilitated by LMC and are seeing initial positive outcomes from the scheme. Bearing in mind  a futuristic view we will be keen to progress this to GP-social care setting and also practice nurse- community nurse twinning scheme. Having a better understanding and different perspective of working environment will help towards improving patient journey, appreciate the challenges of each other workload and primarily being kind to each other which will all contribute towards improving patient outcome and staff experience

    1. Hi Sonali, thanks v much for the comment. Great to hear that your twinning scheme is going well. It would be really helpful to hear more about the outcomes you've been seeing so far, and to have your group test out the app when we get to the early building phases. Let's keep in touch!

  7. Guest

    Pritti Aggarwal 1 year, 9 months ago

    This is an absolutely brilliant initiative and dovetails nicely into the GP Consultant exchanges we have been doing in Wessex. We have been actively generating trusting relationships to increase collaborative working across the primary secondary care interface. Having a national platform would just be so amazing in sharing ideas, reduce duplication by replicating things that genuinely work, the possibilities and opportunities are endless! Genius app.

    1. Thanks for the positive feedback Pritti. We hope that GP-consultant exchanges like those in Wessex would be willing pilot sites for user testing to make sure we develop an app that best meets users' needs.

  8. Guest

    Jessica Watson 1 year, 9 months ago

    This sounds fantastic, we really need to build more networks and break out of our Silos or 'Ivory Towers'. Locally we have a 'researcher in residence' post at our CCG, which has been mutually beneficial for University and Clinical Commissioning Groups; it would be great to upscale this sort of thing at a national level.

    1. Thanks for this Jess. Our aim is to upscale this nationally. We want the exchanges to help cross boundaries between clinicians and non-clinicians working in health and social care, including researcher and policymakers!

  9. As a doctor in training, particularly when I worked in medical specialties it would have been really helpful to have had this opportunity. I expect that it would be possible to use study leave for such an experience.

    1. Hi Zoe! Agreed. I encountered this challenge as a trainee too. We'd hope that exchanges would be recognised as part of training and CPD, and therefore that study leave could be used.

  10. This sounds like a really interesting project and worthwhile app. We have done a handful of half day exchanges within some of our speciality groups within our Trust (AHPs, nurses, medics) and we really benefitted from these. Having a national platform for this is a great idea to help connect local and national healthcare professionals.

    1. Thanks Gillian! Great to know your Trust has been running exchanges already. We know exchanges currently take place in many settings, but they are often run manually and restricted to specific organisations or locations. We hope Exp-Ex could help existing programmes run more smoothly and expand opportunities for participants.

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