Flow Coaching Academy The Flow Coaching Academy (FCA) programme empowers health and care staff to improve patient flow in the health care system, through spreading a common purpose, language and method for quality improvement.

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  • The Flow Coaching Academy (FCA) programme was developed and is led by a team based at Sheffield Teaching Hospitals NHS Foundation Trust.
  • The FCA curriculum is an action learning course teaching improvement science and the team coaching skills required to achieve sustained improvement.
  • In five years, 10 local FCAs have been set up, and nearly 400 coaches from more than 30 NHS trusts and health boards across the UK have been trained.

The FCA programme is based on the rationale that patients typically experience care in condition-based pathways, and how they move along these pathways has considerable implications for patient experience, care outcomes and pressure on staff and resources.

The programme builds on learning about care pathway level improvement and training improvement coaches from two previous Health Foundation-funded programmes: Flow Cost Quality and the Sheffield Microsystems Coaching Academy.

Flow Coaching Academy curriculum

The core FCA programme team, the Central FCA, developed a one-year action learning course to train NHS staff in team coaching skills and improvement science.

Paired flow coaches are trained and lead ‘Big Rooms’ collaboratively as co-coaches. These pairs comprise a clinical coach, who works in the pathway, and an independent coach, whose day-to-day role in the organisation is external to the pathway.

Big Room meetings

The co-coaches jointly facilitate a ‘Big Room’. These bring together multidisciplinary staff along the care pathway, enabling them to focus on the patient experience and assess, diagnose and iteratively test changes to improve patient flow.

The Big Room makes sure that each person has an equal voice and is able to take ownership of the improvement process, regardless of status or experience.

The views and experiences of patients are central to the FCA model, with coaches using a range of skills and techniques to support meaningful patient involvement.  

Local Flow Coaching Academies

The first FCA cohort trained at Sheffield Teaching Hospitals in 2016 and focused on care pathways such as COPD, stroke and skin cancer.

Since then, 10 local FCAs have been set up, with three more ready to start in early 2021. Nearly 400 coaches, from over 30 NHS trusts and health boards, covering hospital, community and mental health services, have been trained. These coaches work with more than 150 multi-professional teams to improve care pathways such as frailty, sepsis, cancer and diabetes.

Case studies of the local FCAs are available.

In 2019 the FCA won the BMJ award for ‘Innovation in Quality Improvement’. In October 2020, the Gestational Diabetes Big Room from FCA Northern Ireland also won the BMJ award for ‘Innovation in Quality Improvement’ leading to two consecutive FCA wins in this category.

Flow Coaching Academies and COVID-19

The FCA approach has direct implications for patient experience, patient outcomes and pressure on staff, all of which are crucial as services adapt and are redesigned in response to the COVID-19 pandemic.

Local FCA teams have helped to keep pathways running during COVID-19, and many flow coaches have used their skills to support wider organisational efforts to restart and redesign services.

Contact details

For further information about the project, please email sth.fca@nhs.net.

Further reading

Learning report

Improving flow along care pathways

November 2020
Learning report

Based on a report by RAND Europe and interviews with programme leads during the pandemic, this...

Learning report

Improving patient flow

April 2013
Learning report

This learning report describes the work undertaken by two NHS trusts as part of the Health...

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