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

Too often, patients with chronic, debilitating conditions such as migraine and other headache conditions are struggling to access the right advice and treatment when they need it. Across SW London, too many of these patients therefore present at A&E or endure long waits for outpatient appointments which add little value. Variation across our system is considerable and good practice in some areas is not replicated in others.

Our SW London Acute Provider Collaborative programme sets out a vision for borderless collaboration using the headache pathway as a model to create the cultural conditions and capabilities for simple, smart and sustainable ways of working for the benefit of our patients and our staff.

We believe this pathway encapsulates our wider system challenges and that building a skilled team of quality improvers will enable us to genuinely bust the traditional health care silos which cause duplication, delay and inconsistent care.

What does your project aim to achieve?

The project aims to establish system level leadership and quality improvement skills that enable our headache pathway teams to break through professional, organisational and technology barriers that define our current ways of working.

The APC programme has already defined a 5-step improvement approach from staff engagement to sustainment of new ways of working. This project focuses on the cultural and technical quality improvement skills development covering:

– Use of a single improvement language and methodology across all locations

– Development of improvement skills that allow staff to work anywhere within the system to enable effective and sustainable change
– Creation of a cohort of improvers who actively influence and challenge key stakeholders to support a system approach to change
– Use of a single modelling and evaluation process that considers benefits beyond the borders of any one organisation
– Prioritises benefits for patients/staff across the system above any one organisation

How will the project be delivered?

Using the headache pathway as our model for understanding & developing capability, the project follows our 5-step process:

– Define & Enable: what is the focus, why and who needs to be engaged?
– Diagnose: what is the current state data & experience for patients & staff
– Collaborate & Design: using representatives from across our system to design a future state vision and agree key enablers for change
– Test & Improve: providing staff with the skills to make small tests of change, learn in real time & establish a framework for continuous engagement, collaboration & improvement
– Measure & sustain: making the new ways of being and working business as usual

We believe a key enabler of future success will be a greater understanding and use of behavioural science techniques to deliver simpler, smarter and sustainable cultural change across our system. We would use potential Q Community funding to employ specialist resource to build capabilities, based on learning from the headache pathway

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

The project team actively prioritises time to share learning using a number of proven improvement tools/approaches:

– After-action reviews for key project meetings/workshops
– Sharing of plan, do, study, act improvement cycles
– Workshops facilitated by improvement experts drawn from the local system and Q Community
– Site visits and shared learning from other systems
– Use of social media to publicise key events and encourage ongoing conversations and feedback across a wider audience
– Use of patient stories and direct patient engagement

We believe a key enabler of future success will be a much greater understanding and use of behavioural science techniques to deliver simpler, smarter and sustainable cultural change across our system. We would use potential Q Community funding to employ specialist resource to build capabilities, based on learning from the headache pathway. We will scale up the approach by using the team to support other specialties through coaching and mentoring.