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

For instance, in Gastroenterology we know that demand for services is increasing and there is no additional capacity. As a result, there are long waits for first assessment and a growing number of patients receiving regular follow up for long term conditions.  The Q member would work with the identified Gastroenterology clinical leads to apply QI tools to understand the current condition and to facilitate the development and delivery of cross-system solutions.

What does your project aim to achieve?

Historically, the arrangement of ‘primary’ and ‘secondary’ care services has led to actual and perceived boundaries between GPs and Consultants. As a consequence relationships are strained, bottlenecks are created and patients experience inadequate services. The aim of this project would be to ‘bring down the barricades’ through an alignment between primary and secondary care. That is, a Consultant and a GP (either a PCN lead or a GP with a specialist interest) would be partnered to focus on a Specialty. These clinical pairings would collaborate to shed light on the blockages and wastes in the existing pathway and illuminate opportunities to create flow – either through improved communication or through changes to the arrangement of services to better meet patient need.


  1. I think this project potentially has significant learning to share. I wondered about the current relationships between primary and secondary care clinicians and the appetite to explore working in this different way?  I am reminded of the difficulties of elective care work across these boundaries and radially different cultures with enhanced recovery work!

    there is a strong opportunity for patients to be involved in this work to contribute to the understanding of the current state as well as co-designing potential improvements. Do you plan to involve this aspect of QI in the project?

  2. Great idea. I wondered what methods your leads will use to build on relationships between the wider GP practice/specialty department colleagues. Will they receive any coaching as they explore how best to improve the current conditions? It made me think of the relationship mapping we did in our Gen Q Leadership Forum 2 Sarah, and how that may be a good tool to start with.

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