Q’s focus is building a thriving community of people working to improve health and care. Key to our success is attracting thousands of people from different settings, roles and backgrounds and inspiring and engaging them in our multiple offers. We need members to commit their time and, where possible, to lead community activity.

Our work has a long-term focus. We have stable funding and an infrastructure that is co-designed and co-delivered with members and partners, and complements the work of improvement initiatives elsewhere. Q adapts to the changing context we operate in. As part of this we share and amplify learning with members, system leaders and others that responds to system needs and priorities.

Q offers a wide range of high-quality activities, or offers, including:

• opportunities to connect with others, both in-person and virtually
• events, workshops, visits and access to a range of learning resources
• convening those responsible for change across large systems, in supportive peer learning spaces
• innovative, participatory funding programmes, such as Q Exchange, that support members to develop improvement projects together
• a Lab network that tackles complex health and care challenges
• projects that generate and share actionable insights from across and beyond the Q community.

But Q is much more than a set of central offers. Our activities are supported by a digital platform that enables member-led activity and engagement at scale. Through this we support community-led activity and thriving smaller networks. These activities are all underpinned by communications and a recognised brand that inspires members to actively engage. Our reputation and member engagement helps secure buy-in from system leaders: this supports member participation and achieves Q’s overall aims and objectives.

What makes Q distinct is how the community activates people’s expertise, experience, and energy. It is a place to participate with purpose, to make progress on individual, organisational and system needs. This is enabled through five interconnected mechanisms that are present across our offers:

• connecting: diversifying links across and beyond the community
• sharing: spreading knowledge and evidence
• supporting: providing a home for people working to improve health and care, where different perspectives are valued
• learning: developing individually, collectively and passing on to others
• collaborating: mobilising and delivering improvement together

Crucially, change is achieved by the five mechanisms interacting and reinforcing each other. Members will experience some of these mechanisms in action in other places too.

Through these mechanisms we enable change by two mutually reinforcing routes to impact.

First, thousands of members are better equipped to bring about positive change in their work as individuals, in their teams and organisations.

Second, senior and system leaders are supported and influenced to create better conditions and cultures for improvement. The coming together of these two routes leads to both outcomes for members and outcomes for the health and care system.

Equipping members to bring about change in their work means they can implement more effective and sustainable improvement on the ground.

As part of Q, members have:

• stronger relationships and collaborations
• more energy and inspiration to share and apply learning
• greater confidence and sense of agency to lead change
• better skills to put things into practice
• increased knowledge of what works and how to apply it in their context

This impact is also multiplied by members ‘passing it on’ and influencing the work of their teams, organisation and networks.

Wider system outcomes are achieved through Q’s direct work at this level, which includes convening and influencing leaders and our insight work. But it is also supported by our work with individual members. At sufficient scale, this can add up to significant change at the collective and system level.

Through the two routes to impact there is:

• increased visibility and credibility of improvement
• enhanced improvement capabilities at every level of the system
• more compassionate and empowering leadership
• better spread and implementation of good ideas, evidence, and successful interventions
• a more joined-up system where a broader range of staff, patients and care recipients contribute fully.

This boosts the capacity of organisations and the system to achieve more effective and sustainable improvement work.

Through our inputs, activities, mechanisms, routes and outcomes at different levels, Q ultimately contributes to better health and care for people in the UK and Ireland. Together our members and partners enable care that is safer, more effective, more caring, well-led, sustainably resourced and more equitable.

Along with our established activities, over the coming years we will direct some of our work around core themes, aligned with identified member needs. They will allow our offers to achieve greater cumulative impact and make a clearer contribution to system priorities.

Our vision is for collaborative improvement that is shaped and owned by those who deliver and receive care. Within this, we will focus on three themes:

1. bringing improvement and digital together for sustainable change
2. reducing waits in a way that supports broader transformation goals
3. enabling integrated improvement across sectors

The theory of change sets out Q’s long-term vision for change. We will continue to adapt to changing needs and context and what we learn from our members, our ongoing evaluations, and the wider evidence base.