What is improvement?

Improvement can involve saving time, saving money or being more efficient. It can also be about simplifying a task, making the experience of something more positive or improving productivity. With an improvement mindset approach, the right methods and tools, and working together with people using services based on what matters, we can improve the quality of care and health outcomes.

By identifying improvement opportunities, we can help tackle the problems we face in our everyday lives as healthcare staff in NHS England.

There are often many demands on our roles and whilst our work can be challenging, it is critical that we can manage change and look to maximise improvement opportunities.

Quality improvement

Quality improvement is a systematic approach to solving a simple or complex issue, involving those closest to the issue in understanding it deeply, developing ideas, and then testing these out using rapid cycles of testing, utilising data to learn and adapt.

It helps meet the ‘quadruple aim’ of ‘better health and wellbeing for the whole population, better quality care for all patients and sustainable services for the taxpayer alongside the reduction of health inequalities.

1. Improving health – local community

• mortality rates
• reduced inequalities
• improved wellbeing

2. Best possible care – service users

• safe
• effective
• efficient
• timely
• equitable
• patient-centred

3. Joy and pride in work – staff

• morale
• wellbeing
• workforce development

4. Value for money – taxpayers

• efficiency
• productivity
• financial Balance
• reduction of waste

Why is improvement important

We operate in a constantly evolving environment which makes improvement a necessity. At NHS England, we strive to deliver high quality services for all, but high-quality services in 5 years’ time will not, and should not, be the same as what we consider this to be today.  A combination of multiple small, localised improvements alongside large scale, transformational improvements will enable the NHS to achieve this ambition.

Crucially, the first step in improvement is noticing that there is an opportunity to make something better. The next step is taking action to do something about it, recognising the value of collaboration in driving change forwards, and improving with people with lived and learnt experience. The ultimate goal is found in the impact of that change – the value added.

Lastly, the evidence base is clear. The best healthcare organisations across the world, including in the NHS, invest time and effort to build an improvement culture. It is at the heart of how they operate and means that every member of staff is encouraged and supported to improve the work they do every single day.

Developing an improvement mindset

To understand the value of improvement, it is helpful to develop an ‘improvement mindset’. An improvement mindset involves both a way of thinking and behaving so that improvement becomes embedded into our roles and ways of working.

Here are three key steps in developing an improvement mindset:

1. Be curious and motivated

Is there something at work that could be done better or more efficiently and if changed would it be better?

Can you help play a part in creating a supportive team and team culture where collaborative improvement is valued and encouraged?

2. Empower yourself and others to make improvements

Being empowered to make improvements is everyone’s responsibility, individually and collectively, and we need to aim to make our area of work the best it can be.

Share change ideas and listen and act upon the change ideas of others.

Collaborate with people who deliver and receive services to make improvements together.

3. Have confidence to make improvements a reality

Identify places where we can share and generate new ideas to show how improvements have been made.

Understand and share with others what works and what doesn’t – its ok to make mistakes, that’s how we learn.

Collaborate with others to make changes – building confidence together and testing ideas in a safe space.

How to get started

To start your improvement work, we recommend following these steps:

• identify the issue you wish to improve, collaborate with those affected
• analyse the problem with your team to understand it and ensure you are addressing the root cause
• design your improvement, including defining your aim, measures and the change ideas you can test
• test ideas rapidly on small areas
• implement the ideas that have made a difference

Complete the NHS IMPACT Self-Assessment.

How to get involved

NHS IMPACT FutureNHS workspace

Join the NHS IMPACT FutureNHS workspace where you can find out more, keep up-to-date and get involved with NHS IMPACT. We welcome new members from across the NHS who are looking for more information or support. Please join this network where you can access regular evidence scans, blogs, updates and a discussion forum.

Our forum has now been launched, we encourage you to use this space to connect with peers, contribute to the discussion and share your learning to support others on their improvement journey.

NHS IMPACT bulletin

Subscribe to our monthly NHS IMPACT bulletin which provides the latest news and resources for improving patient care and includes updates from the National Improvement Board.

Find out more

If you would like to know more about this work or have a query please email the team on england.improvementdelivery@nhs.net.