Quality improvement using the principles of the Leading Change, Adding Value framework

NHS England | January 2019 | Quality improvement using the principles of the Leading Change, Adding Value framework 

A new case study on NHS England’s Atlas of Shared Learning looks at how the Senior Development Team  nurse undertook a programme  of quality improvement (QI).


The programme has supported the continued professional development of nursing staff to carry out a series of improvement projects, all targeting quality improvement and leadership.

The senior development team nurse collaborated with colleagues from across their organisation to identify  principles of the Leading Change, Adding Value framework (LCAV) which could be embedded in practice. They supported colleagues to be aware of and understand these principles, as well as aligning quality improvement projects with the ten aspirational commitments embedded in Leading Change, Adding Value framework (LCAV).

A nursing development conference was hosted by the Trust to launch the programme including 70 key stakeholder nursing colleagues from across the Trust.

The senior development nurse helped to create a culture shift in approach to quality improvement through empowering staff at all levels to lead change and add value (Source: NHS England).

Read the full, unabridged case study at NHS England 

Supporting young people through transition into adult care services (Sheffield Teaching Hospitals)

NHS England | November 2018 | Supporting young people through transition into adult care services 

Nurses at Sheffield Teaching Hospitals Foundation Trust (STHFT) recognised unwarranted variation in practice within the Trust where children were being transitioned between services, recognising gaps within coordination, information available to children and families and in some clinical specialist service areas, leading to delays in care.



This led to the creation of a new role: the Children and Young People Lead Nurse  to  transition between children’s and adult services, offering support to all clinical specialist areas within the hospital. The Children and Young People Lead Nurse engages with families, children and young people with complex needs and provides specialist advice and support to staff to ensure prompt, safe transition into adult services. This role also aimed to support the development of pathways and standardised practice to ensure high quality care at transition was available to all complex needs children within the Trust.

The Lead Nurse developed the role by working seamlessly with the transition team at Sheffield Children’s Hospital and establishing a dedicated caseload of children and young people, to give a clear overview of the transition work being carried out by each clinical specialty. They provide education and training sessions for staff and partner agencies in understanding the needs of adolescents, as well as those with complex needs.

This yielded:

  • better outcomes
  • better experience
  • better use of resources  (Source: NHS England)

Full case study is available from NHS England’s Shared Atlas of Learning 

Advice line for GPs saves hours of travel for patients and £100k to be reinvested back into NHS

NHS England | November 2018 | Advice line for GPs saves hours of travel for patients and £100k to be reinvested back into NHS

The Walton Centre in Liverpool – the only specialist hospital trust in the UK dedicated to providing comprehensive neurology, neurosurgery, spinal and pain management services-   runs an advice line which means GPs in the Cheshire and Merseyside area can call neuro consultants for fast advice any weekday reducing extra patient appointments. 


So far the service has received 181 calls 37% were resolved by the GP saving £51,698 which over a year saves around £100k.

Programme Director Julie Riley said: “We want to deliver services closer to home and when patients do come into hospital, support them so they can recover and go home quicker. From a patient point of view, we want to work in partnership with them. We, our consultant colleagues and GPs want to support them in self-management, where appropriate – rather than taking a paternalistic approach.”

Read the full case study at NHS England 

Nurse leadership in providing a virtual community placement for nursing students

NHS England | August 2018 | Nurse leadership in providing a Virtual Community Placement for nursing students

A recent addition to NHS England’s Atlas of Shared Learning is a case study of a nurse leadership in providing a virtual community placement for nursing students (NHS England).

A Quality, Health and Innovation Lead in the Nurse Development Team at Bradford District Care NHS Foundation Trust (BDCFT) has developed a new placement model for  first year nursing students, to address variation in the experience and opportunities available to them.

Read the full case study at NHS England 

Of interest:

NHS England | District nursing students lead change to reduce pressure ulcers in care homes

Improving asthma and COPD in primary care

NHS England | August 2018 | The Atlas of Shared Learning 

A new case study on NHS England’s Atlas of Shared Learning shows how asthma and COPD in primary care can be improved.   Following training for level 6 COPD and asthma care, the practice nurse at a Northumberland general practicerecognised the unwarranted variation between best and current practice within her GP surgery and addressed this by changing how their respiratory conditions were managed with more focus on patient empowerment and self-management, which is having a positive effect on patients ( Source: NHS England).


The case study looks at how value can be added, changes and lessons learnt

The full case study is available from NHS England 

Driving improvement: Case studies from GP practices

This publication from the Care Quality Commission looks at 10 GP practices that have achieved a significant improvement on their rating.

Key themes

Image source: http://www.cqc.org.uk

The practices in this report faced similar challenges. They all showed an impressive commitment to improve their service to patients. To achieve this they shared common experiences:

  • strong leadership from a practice manager with the time and skills to lead the practice team
  • addressing staffing and training issues such as poor recruitment or training practices
  • making sure every member of the practice team understood their own and others roles and responsibilities
  • involving the whole team in running the practice
  • involving patients and the local community
  • using external support to help improvement

Their experiences show that improvement in GP practices is possible. The case studies highlight some clear actions that other practices can use to help them learn and improve.

Full report: Driving improvement: Case studies from 10 GP practices