• Run by NHS North West from December 2009 to March 2011.
  • ‘Owned’ and driven by provider organisations across the north west of England.
  • Aimed to develop the safety improvement infrastructure within the region, creating a working community to support innovation, knowledge management and transfer.
  • A nodal structure was set up, with each node working in partnership with other organisations to deliver improvements around selected themes.

This project involved developing safety networks across England’s north west, using a nodal structure for distributed leadership of safety improvement.

The nodal structure is a working community of teams that support innovation, knowledge management and transfer, with the aim of delivering breakthrough improvements around selected improvement themes. Each node worked in partnership with other organisations to deliver improvements around these themes, particularly the safety and reliability of specific care processes.

Who's involved?

The setting up of the nodes was coordinated centrally by the Advancing Quality Alliance. The Institute for Healthcare Improvement (IHI) gave additional support for building capability.

The participating organisations and their projects were:

North Lancashire PCT

The main aim was to reduce hospital deaths attributed to venous thromboembolism (VTE) by improving risk assessment and thromboprophylaxis rates to 90%. The project also aimed to implement robust measurement systems and raise public and staff awareness of VTE. The trust worked to reduce deaths caused by VTE in collaboration with:

  • Pennine Acute Hospitals
  • East Lancashire PCT
  • Countess of Chester Hospital
  • Salford Royal NHS Foundation Trust
  • University Hospitals of Morecambe Bay
  • Blackpool, Fylde and Wyre Hospitals NHS Foundation Trust.

Salford Royal NHS Foundation Trust

The key aim has been to reduce prevalence of pressure ulcers to 50% across all pilot sites. The trust worked in collaboration with:

  • Manchester PCT
  • Salford PCT
  • Pennine Acute Hospitals
  • Stockport NHS Foundation Trust
  • Swinton Hall Nursing Home
  • Blackpool, Fylde and Wyre Hospitals NHS Foundation Trust.

The Walton Centre for Neurology

The key aim was to prevent avoidable deaths from head injury and apply the lessons learnt to other hospitals and trusts. A further aim was to make sure that head injury patients get the best outcome possible. The centre worked to improve the pathway of the deteriorating neurological patient in collaboration with:

  • Aintree University Hospitals NHS Foundation Trust
  • Royal Liverpool and Broadgreen University Hospitals NHS Trust
  • Southport and Ormskirk Hospital NHS Trust.


These partnerships all showed improvement in their patient safety topic area, by changing the way individual organisations and teams work. All three nodes achieved between modest and significant improvement.

About this programme


Working with strategic health authorities

This programme created partnerships with four strategic health authorities to improve patient safety between 2009 and 2012. 

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