Classification: Official
Publication reference: PRN01435

To:

• Integrated care board:
  • chief executive officers
    • medical directors
• chief nurses
• All NHS trust and foundation trust:
  • • chief executive officers
• chief operating officers
  • medical directors
  • chief nurses
• NHS England regions:
  • regional directors
  • regional medical directors
  • regional chief nurses
  • regional chief operating officers

Dear colleagues

NHS IMPACT Clinical and Operational Excellence Programme: Learning and improvement networks and improvement analytics and working guides

As many of you will be aware, and as announced by Amanda Pritchard at the NHS ConfedExpo conference in June, as part of NHS England’s improvement work (NHS IMPACT) colleagues across the organisation – including ECIST and GIRFT – have been working with colleagues from across the NHS to develop a series of improvement guides and supporting infrastructure.

The purpose of this work is to bring together and codify the best clinical and operational practice from across the country, to support further local improvement. We write to share an update for all colleagues on this work.

Improvement guides and analytics

We are now able to share initial versions of improvement guides covering the following topics:

• improving flow through the emergency care pathway (reducing avoidable admissions and optimising admitted care)
• generating greater value for patients from theatres, elective surgery and perioperative care
• generating greater value for patients from outpatient services
• improving medical consultant job planning

They are accompanied by new improvement analytic compartments in the Model Health System, which will allow you to use data to identify opportunities, show how you compare to other areas of the country, and track your improvement progress over time.

These guides have been created, informed and tested with NHS staff, and we want to thank all those who have contributed to them up to this point.

We now want to understand how these resources work with your teams, and how we can further develop and improve the guides to ensure they are as useful as they can be in supporting local improvement programmes.

Therefore, we do not consider them ‘final’ documents – our intention is that they will be refined, developed and updated as we learn what works through you and your teams.

Feedback can be provided by email to england.clinops@nhs.net, or through your local learning and improvement network, details of which are set out below.

Learning and improvement networks

As discussed at the national NHS leadership meeting earlier this month, alongside these resources we have established 16 learning and improvement networks (LINs).

Led by chief executives and operating on a regional footprint (see Annex A), the LINs will provide an opportunity to bring clinical and operational leaders together to learn from each other and share best practice.

Over the coming weeks, the chief executives leading the relevant LINs will be in contact with you and to discuss how your respective organisations and systems can best get involved.

For clarity, while the LINs can access support from NHS England’s regional and national teams if required, they do not replace existing improvement programmes or operational delivery arrangements, or form part of oversight or performance management.

Some areas will inevitably move more quickly than others and build on their own approaches to improvement. The LINs will therefore share what works with NHS England on an ongoing basis, both to contribute to future national improvement programmes, as well as for dissemination across the other LINs where appropriate.

Next steps

The first of the improvement guides focus on acute hospital-delivered care. We are committed to extending the scope to ensure we are providing similar support to colleagues delivering improvement programmes across mental health, community and primary care.

We are also looking for a limited number of proposals to test at scale the use of an improvement approach to deliver best-practice ideas in elective and urgent and emergency care. We have asked the LIN lead chief executives to work with local partners to work up these proposals.

We hope this combination of improvement guides, analytics and networks, and the further resources we intend will follow over the coming months, prove useful – and we look forward to continuing to benefit from your leadership and expertise in delivering the best and most effective care possible for our patients.

Please do not hesitate to contact us via england.clinops@nhs.net if you need further information on the above.

Yours sincerely

Sarah-Jane Marsh, National Director of Urgent and Emergency Care and Deputy Chief Operating Officer, NHS England
Vin Diwakar, National Director of Transformation, NHS England

Annex A

*Note: In North East and Yorkshire, the 2 lead chief executive officers will initially work together to support the mobilisation of both UEC and elective care networks, before confirming ongoing lead arrangements.