Q – building improvement capability

Q is an initiative connecting people across the UK who have experience in improving health and care. It is led by the Health Foundation and supported and co-funded by NHS Improvement. This year, we are inviting more people to apply to join the Q community. Dominque Bird is Head of Capacity and Capability for 1000 Lives Improvement – the national improvement service for NHS Wales delivered by Public Health Wales – and is one of the Q members who joined recently. We spoke to her about how Q is supporting quality improvement plans in Wales.

What impact is Q having for members in Wales?

Improvement work in the health service can be quite isolating. With Q, people feel part of something. They have a safe space, where they can share ideas and explore challenges and opportunities. At 1000 Lives Improvement we bring people together in smaller groups through our networks in Wales, but Q offers a great opportunity for networking and support across the geographical borders. For me, the real power of Q is its diversity.

It has been useful for people to be able to benchmark what’s happening in Wales against what’s happening elsewhere and to feel that we are on the right track. I think it was really powerful for Q members from Wales to see that their opinions and expertise are valued across the UK.

Members of Q from Wales who have really committed to the Q community have made excellent contacts. They regularly have calls with people in other parts of the UK to talk through what their teams are doing. Some of our Q members say they’ve changed the way their teams work in response to learning that’s come from Q. We’ve also changed the way some of our events are run, and how we facilitate and network, so being part of the Q community is refreshing our approaches. 

I think the potential is there for Q to lead to more action to improve care on the ground within health and care. Many working in health have worked in a certain way for so many years and it has become hard to imagine how things could be done differently. But we’re all facing similar challenges, and there are pockets of brilliance in the approaches being developed, with fresh ideas like building community assets, and looking at social prescribing models. Because we are facing similar challenges, Q can provide the community of support and learning around that. It may be based on your individual personal development, but the benefits to the system are immense.

How is improvement expertise being developed in Wales?

I work within 1000 Lives Improvement – we are the national improvement service supporting NHS Wales to improve outcomes for people using our services by supporting local and national quality and patient safety improvement programmes. I lead the national Improving Quality Together (IQT) programme. IQT provides all NHS Wales staff, trainees and educators with a common and consistent approach to improving the quality of services. IQT has three levels of skills and competencies. Completing the bronze level demonstrates an understanding of the quality improvement principles. The silver level is for people doing their first improvement project and the gold level is for people who coach and teach others in quality improvement. We see Q as aligning with our gold-level network.

Quality improvement capacity is being spread throughout Wales, with over 30% of our staff now trained to bronze level. What we find more difficult is building improvement capability and building quality improvement into the everyday experience of staff. I think others have a similar gap. We need more coaches and mentors in the system to nurture improvement within organisations and to build sustainable capability through teams, organisations and the whole system. If we don’t have the support mechanism then we have a block.

How do you see Q helping to build a confident community of people who improve quality?

Q offers a personal development opportunity for people in Wales working to improve the quality of care for patients but it also has another role for Public Health Wales. First and foremost, I think Q will help us to identify people who are already working in improvement but are not involved with the existing networks in Wales. Working with Q offers us another route to identify those people.

We are getting to a stage where there are many people in Wales who want to do improvement projects but we don’t have enough coaches and mentors. We need to build that expertise and increase our network of people with gold-level experience.

Having Public Health Wales as a system-level partner in Q is a clear indication of our wholehearted support. The next opportunity for people in Wales to join opens in May. To anyone thinking about applying, I’d say this is a unique opportunity to join a community of like-minded but also diverse people who are making improvements to benefit those who use our health and care system. It will benefit not just your personal development but services you are part of delivering and care that is given to patients.

Find out more about Q and how to join on the Q website. Applications to Q are being phased across different parts of the UK and we are partnering with a number of organisations including Public Health Wales who are helping us to grow the community. We are now welcoming applications (until 10 April 2017) from Scotland, Yorkshire and Humber, UCLPartners – North East and North Central London, South & West Herts, South Beds & South West and mid-Essex, North West Coast – Cheshire, Merseyside, Lancashire and South Cumbria, and West Midlands. In May, applications will be open in Wales, Wessex, Greater Manchester, Kent, Surrey and Sussex, and Eastern England.