Quality improvement in general practice

Quality improvement in general practice: what do GPs and practice managers think? | The Health Foundation

There is growing recognition of the importance of quality improvement in general practice. But what is the extent of knowledge and use of quality improvement tools and approaches in general practice across the UK?

This new report explores the level of quality improvement awareness, appetite and activity in general practice across the UK, through a survey of over 2,300 GPs and 1,400 practice managers, alongside qualitative interviews.

The report finds a high level of agreement from GPs and practice managers about what helps or hinders their work to improve quality. It also sets out how national and local system leaders can support those working in general practice to improve the quality of services they provide.

Full report: Quality improvement in general practice: what do GPs and practice managers think?

Developing an organisation-wide approach to improvement

The Improvement Journey. Why organisation-wide improvement in health care matters, and how to get started | The Health Foundation

This new report from The Health Foundation is a practical guide to developing an organisation-wide approach to improvement. It shows why this approach is critical to becoming a high performing organisation and delivering the NHS Long Term Plan.

Drawing on learning and insights from the Health Foundation’s work in quality improvement and beyond, the report shows how a sustained approach requires corporate leadership and investment in infrastructure, staff capability and culture over the long-term.

Key points

  • Building an organisation-wide approach to improvement is a journey that can take several years.
  • An essential early step is securing the support and commitment of the board for a long-term programme, including their willingness to finance the skills and infrastructure development needed to implement it.
  • The report includes case studies of three English NHS trusts with an outstanding CQC rating that have implemented an organisational approach to improvement.

Full report available at The Health Foundation

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

Improving quality and cost

Approaches to better value: improving quality and cost | The Kings Fund

  • The NHS is increasingly focusing on how it can improve the value of its services, to deliver the highest quality health outcomes for patients at the lowest possible cost.
  • This report shares learning and insight from three NHS hospital trusts that have developed organisation-wide strategies for value improvement. It draws on interviews, roundtables and site visits with senior leaders in the NHS who are committed to developing better value services.
  • The report suggests a wide variety of approaches are being taken to improve value in the NHS. These include top-down programmes that focus on a wide range of clinical services from their inception, to value improvement strategies that are more organically grown from a few individual services until they cover a wider breath of hospital-based care.
Image source: http://www.kingsfund.org.uk
  • While there are differences in how organisations are approaching value improvement, there are also several common conditions for success. These include fidelity to a clearly defined strategy that brings the various strands of value improvement work together; recognition that value improvement is a long-term commitment that will require considerable staff time and resources; and a new leadership approach that requires continuous engagement with frontline clinicians and managers.

Full report: Approaches to better value: improving quality and cost

Summary available here

Primary care quality assurance – South Nottinghamshire

NHS England | September 2018 |Primary care quality assurance – South Nottinghamshire

A new case study on the Atlas of Shared Learning shows how a  consistent quality assurance approach is being established  by Nurses in a CCG team in Nottinghamshire. This arose as nurses within the Quality Team identified unwarranted variation within primary care practices in the broad areas of quality, safety, clinical effectiveness and patient experience, where there was no uniformed process to review effectiveness and safety across GP practices across the CCG area.


The implementation of a quality assurance and improvement framework enabled the CCG nurses to target resources and support towards GP practices that needed greater support to achieve effective and safe practice, which is driving improvements and enhancing safety within the practices.

Read the full news story at NHS England 

Evaluation of the Second Phase of the Q Initiative 2016–2020

RAND Europe| September 2018 | Independent evaluation of the Q Improvement Lab

RAND Europe has published its interim report on the evaluation of the second phase of the Q Initiative. The Q initiative is led by the Health Foundation and supported and co-funded by NHS England. It aims to connect people working in quality improvement across the healthcare system throughout the UK, to make it easier for them to share ideas, enhance their skills and thus bring about a change that benefits patients.

Image source: rand.org

RAND Europe carried out an independent, embedded evaluation of Q during its first phase from spring 2015 to January 2016 (Garrod et al. 2016). Subsequently, RAND Europe was commissioned to provide an independent evaluation of Q, starting in 2016 and reporting in early 2020. This is the interim report of that evaluation, documenting progress towards two overarching evaluation aims:

  1. To provide evidence and analysis to support strategic decision-making and inform the ongoing design and management of Q.
  2. To assess the impact that Q has, primarily on members, but also on their organisations more widely and to understand how this contributes to improvement in health and care quality across the UK (Source: RAND).

The full report will be published in 2020.


Independent Evaluation of the Q Improvement Lab 

Embedding quality improvement skills

NHS Improvement| September 2018 | Embedding quality improvement skills with Pedro Delgado

NHS Improvement have produced a short series of videos with Pedro Delgado the Head of Europe and Latin America region for the Institute for Healthcare Improvement (IHI), to help you build improvement capability and embed quality improvement skills in your organisation. In 2017  NHS Improvement  partnered with the Institute for Healthcare Improvement (IHI)to publish an improvement guide called Building capacity and capability for improvement: embedding quality improvement skill in NHS providers. 

 Pedro Delgado shares his thoughts on what has worked well in terms of building improvement capability in NHS organisations (Source: NHS Improvement).


How can leaders help the transition from ‘measurement to judgement’ to ‘measurement for improvement’?

What level of expertise should NHS staff have in relation to quality improvement?

What role does leadership play in creating a culture that allows quality improvement to flourish?

What inspired you to become an advocate of quality improvement?

What advice would you give to NHS providers starting on their quality improvement journey?

Each of the foci have an accompanying video see NHS Improvement for full details

The NHS saves over £300 million in a year by switching to better value medicines

NHS Improvement | July 2018 | The NHS saves £324 million in a year by switching to better value medicines

NHS Improvement have released figures that show how the NHS has made savings of £324 million using biosimilar medicines, a biological medicine highly similar to another biological medicine.  These better value biosimilar and generic medicines, which are just as safe and effective as the more expensive original biological versions,  an example being the Biosimilars of trastuzumab, breast cancer drug prescribed in place of the branded medicine Herceptin. They are also being used to treat conditions including rheumatoid arthritis, some forms of cancer and inflammatory bowel conditions.

pill-1884777_1920Further details of savings can be found at NHS Improvement 


The King’s Fund From lab to bedside: ensuring new medicines are available in a cost-effective and timely way