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I’ve just got my Q badge – Health Foundation staff finally having the chance to apply to Q in the last round of recruitment. It’s set me thinking about how far we’ve come since the first discussions about Q a couple of years ago. Since then we’ve run the largest co-design process in the history of health care improvement, recruited 1353 members (and counting) and put in place an offer for members based on what we heard from our founding cohort and those who have joined since the 2015 co-design. There are currently nearly 20 different elements to Q, plus lots of activities started by members or led locally.

We’ve come a long way, but it’s still early days. And, yet (in my role at least) it’s also time to think ahead to what will come next.

Thanks to the everywhere-evident momentum behind Q, we’ve been asked to work up ideas for how we can build on what we have, and make sure Q is set up in a way that can be sustained long term. We’ve been thinking back to what we’ve learnt from members so far and we’ve started speaking to our 18 partners and others to identify some initial ideas.

Our first priority needs to be ensuring our core offer and connecting infrastructure iteratively improves over time and in response to the needs of the community as it grows. People have told us they want easier ways to connect and share online and we’re developing a strategy for gradually building our still-nascent website. But we know technology alone isn’t enough to ensure Q comes alive with the activities, resources, evidence and stories. We need to develop a culture and a set of habits and informal roles within the community so that it’s easy and expected that people contribute.

But we know technology alone isn’t enough to ensure Q comes alive with the activities, resources, evidence and stories. We need to develop a culture and a set of habits and informal roles within the community so that it’s easy and expected that people contribute.

We are thinking about how easier ways are needed to navigate what’s available so that the experience of being in Q makes sense even when there’re a couple of thousand members. And we are thinking about how we can best support member-initiated and local Q activities.

While feedback so far suggests Q can add great value through supporting people with their existing work, we are also hearing a consistent message that people want Q to do more. Perhaps surprisingly in our busy world, members are saying they want to spend more time on Q than they are at the moment. The huge interest in the Q Lab project suggests appetite for people contributing to achieving more visible collective impact.

So, we’re developing a proposal for ways in which Q might introduce more substantial opportunities for members to get involved in work on a couple of key themes each year. This could be a way in which Q taps into deeper seams of new members and ideas. It will also help us understand and demonstrate the value that our collective wisdom and energy is bringing to the health and care sector, which in turn will influence the level of support as a movement we can get from organisation and national leaders.

As well as Q lab projects, we could perhaps think about ways in which Q can support calls to action to help spread change in a few key areas.

We aim to further strengthen our links to organisations active in improvement and reach out more purposefully to mainstream change initiatives. Beyond a few iconic examples of community action, how can we support Q evolve into an essential part of how strategic change is achieved?

If we’re really ambitious and willing to challenge ourselves as much as the system of which we’re part, we need to think about how Q can help shift improvement to the mainstream: really talking to the big challenges facing health and care

One of the problems Q was set up to address was the often peripheral nature of improvement. If we’re really ambitious and willing to challenge ourselves as much as the system of which we’re part, we need to think about how Q can help shift improvement to the mainstream: really talking to the big challenges facing health and care.

So, what do you think? What do you think our priorities should be for the next stage of developing Q? There will be various ways members can get involved in this work over the coming months. For a start:

  • I’ll be hosting a WebEx on Wednesday 9 August from 12.00pm to 1.00pm to introduce and discuss our current ideas. Registration is available via the Q website.
  • We’re setting up a ‘black hat’ group – volunteer members who will specifically help to identify risks and mitigation measures. Please email us to join.
  • We will also be keeping you regularly updated via monthly Q-municate newsletter and also posts on the website.

I’m excited to be going to my first Q activities as a member, but for me Q has always been for the long term. I’ve spent my whole career in or alongside the NHS and I’ve worked in three of the five national organisations in England supporting improvement that have come and gone over the last two decades. I’ve had the pleasure to be involved in many different improvement projects – often we achieved great things (though just as often what was learnt and the connections made were lost as things moved on). We must make sure Q is not just another initiative or a QI club, but becomes something people across the system see as an essential part of how we achieve the major changes we need to make.


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