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Who are we?

Our community is open and inclusive. We believe everyone is an improver and there are lots of ways to get involved. We welcome anyone committed to improving health and care in Gloucestershire to join us as we learn and create change together.

We have a small core of QI specialists across Gloucestershire leading programmes within our partner organisations. We join together regularly as a Steering Group to coordinate our system improvement work. We are also backed by an Improvement Community Board of executive directors giving leadership commitment to embedding an improvement approach across our health and care partnership.

For more information, look at our: Improvement Community Strategic Approach

What is our PURPOSE?

Our shared purpose as the One Gloucestershire Improvement Community is to extend our collective improvement capability and capacity, and to develop fresh approaches to our shared practice for system improvement.

As Health and Care partners we are committed to improving the health and wellbeing of our population as we work together to provide joined up, high quality, and best value care.

Quality Improvement enables our teams to succeed in addressing health and care priorities by applying evidenced, systematic tools and methodologies. Indeed, we already have a great track record of QI enabling numerous projects that have delivered real benefits to people in Gloucestershire: patients, service users, families, carers, communities and our staff.

However, as partners we are now facing many significant challenges, with the continued pressure of service recovery, increasing demand, stretched workforce and financial constraints. Also, in a faster paced and more connected world our services are becoming increasingly interdependent. This gives us complex problems to solve, but more benefits to gain from collaboration. As we build a future of greater integration, new models of care and a place-base focus a QI approach will equip our teams to lead change together with service users and communities.

What is our VISION?

To nurture a thriving Improvement Culture across the One Gloucestershire Health and Care Partnership

What are our aims and principles?

As part of One Gloucestershire’s Five Year Forward Plan, through to 2028 our aims are to:

ENERGISE
  • Bring people together with a common language of improvement, integrating QI into our working practice.
  • Connect colleagues through strong and inclusive networks of working relationships.
  • Encourage the spread of new ideas and celebrate success
LEAD
  • Work with service users and communities as improvement partners.
  • Build our teams’ agency to lead improvement projects, and share lessons learnt.
  • Support with sustained leadership commitment to improvement across our organisations and system.
FOCUS
  • Make a radical shift to place-based and population health led improvement.
  • Fasten dedicated support to the biggest challenges in our system
  • Strike a balance as we manage to both direct our improvement efforts towards measurable system priorities, and creating an environment where staff closest to our service users can initiate change.

Quality Improvement is about giving the people closest to issues affecting care quality the time, permission, skills and resources they need to solve them. It involves a systematic and coordinated approach to solving a problem using specific methods and tools with the aim of bringing about a measurable improvement. (adapted from https://www.health.org.uk/publications/quality-improvement-made-simple)

Quality Improvement draws on a wide variety of evidenced-based methods, although many share underlying principles that enable us to:

  • Explore issues to be address from different perspectives.
  • Clearly set aims to cohere our improvement teams’ effort.
  • Define measurable benefits so we know when a change is an improvement.
  • Work together to design solutions.
  • Progress through cycles of change to develop our new models of working.
  • Ensure benefits and further improvement are sustained over time.

QI encourages an open, curious, and co-operative mindset in practitioners. It required both technical and relational skills in how we work with others and build effective teams.

QI has been well adopted in recent decades both within the UK and internationally.

QI is flexible in tackling local or wide-ranging improvement:

“… the English NHS cannot hope to meet the health care needs of the population without a coherent, comprehensive, unifying and sustained commitment to quality improvement as its principal strategy.

By quality improvement we mean designing and redesigning work processes and systems … [which can range] … from redesigning how teams deliver care in the clinical microsystems that make up health care organisations to large-scale reconfigurations of specialist services…”

Improving quality in the English NHS: A strategy for action
Sir Chris Ham, Don Berwick, Jennifer Dixon, 2016.

Providing training, coaching and support is the foundation of how we enable colleagues to adopt and apply QI in their work. We are lucky enough to have three thriving Quality Improvement faculties working in One Gloucestershire.

If you work for Gloucestershire Hospitals, Gloucestershire Safety and Quality Improvement Academy (GSQIA) can provide for your training needs and support your improvement projects.

At Gloucestershire Health and Care NHS Foundation Trust, the QI Hub provides teaching and support for improvement projects across the Trust and in the community. Email QI@ghc.nhs.uk for more information.

In primary care Quality Improvement many colleagues have participated in training provided through the national improvement programme, Productive General Practice Quick Start.

The Quality, Service Improvement and Redesign (QSIR) faculty provides training to anyone who works across the One Gloucestershire Integrated Care system and support projects of all sizes but can also be a good place to bring together colleagues from across the system for system transformation work.

However, we also work in active partnership with colleagues leading complex system improvement programmes. Our offer includes a range of system facilitation approaches, with expert input from one or a small team of our QI partners. Some of our recent and current assignments include:

  • Virtual Ward Programme: co-designing and facilitating in-person and virtual stakeholder engagement and design workshops for nearly 200 participants.
  • Palliative and End of Life Programme: in-depth collective system improvement support to enable refresh of programme strategy.
  • Anticipatory Care Programme: facilitation of a large-scale stakeholder launch event and planning for place-based improvement collaboratives.
  • Gloucestershire Local Maternity & Neonatal Care: partnering in building system-wide QI capability.

Our capacity is finite, and we are actively seeking to align with key system challenges but if you have an area that you would like help in, please contact glicb.improvement-community@nhs.net.

A full library of QI tools is available from the national NHS team:
https://www.england.nhs.uk/sustainableimprovement/qsir-programme/qsir-tools/

The West of England Academic Health Science Network offer a good QI resource here:
https://www.weahsn.net/toolkits-and-resources/quality-improvement-tools-2/

Most people benefit from attending one of our in-person QI programmes and building connections with local colleagues, but there are some on-line programmes too support your learning, such as this from NHS England.
https://www.england.nhs.uk/sustainableimprovement/improvement-fundamentals

‘Q’, a community driving sustainable change in health and care is a valuable channel to connect with others carrying out improvement work and membership is free. This leaflet provides more information about becoming a ‘Q’ by joining the Q Community: Becoming a ‘Q’

We have had a great deal of fantastic improvement work happening in Gloucestershire. In May 2024 we had the opportunity to present posters describing some examples at the South West launch of NHS Impact.

View the posters to read more about this work:
Acute Respiratory Infection (ARI) hubs
Co-diagnosing dementia
The discharge to assess pathway
Supporting patients with Huntington’s disease
Smoking cessation in Inner City Gloucestershire
We Wait Well (The Health Foundation, Q Exchange, Funded Project 2023)

For more information about improvement work in Gloucestershire, take a look at our QSIR posters.

If you are interested in joining the Improvement Community and would like more information, contact glicb.improvement-community@nhs.net.

Also otherwise do contact Kathryn Hall, Associate Director, One Gloucestershire Improvement Community (kathryn.hall7@nhs.net) if you would like to discuss our programme.