Models for Improvement

Developed by Associates in Process Improvement

The ‘Model for Improvement’ framework, developed by Associates in Process Improvement, is a simple, yet powerful tool for accelerating improvement. You can read more about it and find other practical improvement techniques here:

Other useful insights about improvement work

Insights about co-design and patient experience

Catherine Dale, Programme Director at the Health Innovation Network and an internationally recognised expert in co-design, spoke at the Collaboratives and shared a number of free resources and tools:

Quality improvement tools

During the collaboratives, we introduced a number of different tools and platforms linked to quality improvement methodology principles. This included worksheets for teams to fill in at the workshops and take away with them for future work, as well guidance on how to use Life QI, an online platform for monitoring and evaluating quality improvement projects that everyone working in the NHS has access to. More about these tools here:


Figure 1 Life QI online platform

Real-life examples of innovation

We invited several subject-matter experts to speak at our Digital Outpatients Collaboratives workshops, including clinicians with experience of implementing projects to improve the outpatient experiences. Here are some examples:

Figure 2Connecting Care for Children (CC4C) model

Connecting Care for Children (CC4C) is a paediatric integrated care model which has been used to implement whole system change and to improve the way children’s care is commissioned, delivered and experienced across north west London. In March 2018, paediatrician Dr. Bob Klaber spoke to the collaboratives about how this outpatients transformation model was developed and what the key ingredients to success in service improvements are, including the concepts of Practice Champions and co-design with service users, as well as the importance of focussing on connections and relationships and using education and development for the whole multi-professional team to find new ways of working together. More on this work can be found here:

We also heard from Dr. Shanti Vijayaraghavan who led an ongoing project to introduce video consultations within the Diabetes team at Newham University Hospital, Bart’s Health. The scheme, which started off with young people but has now rolled out to all age groups, offers a regular clinic appointment on Skype for those patients who do not require physical examination. This has reduced ‘did not attends’ (DNAs) from 30-50% to 16% and has significantly increased productivity and patient throughput, saving approximately £27 per consultant appointment in clinician time, as well as providing a far more flexible service for patients which has garnered positive patient feedback.

To read more about the project, use these links:

Royal Brompton Adult Cystic Fibrosis Centre ran an 18 month project to reduce clinic waiting times using data interrogation, which transformed staff and patient experience in the process. Helen Parrott, a physiotherapist at the Royal Brompton, spoke to the collaboratives about how they used quality improvement principles and tools to understand their baseline, learn more about the patient experience, and redesign the patient pathway using digital solutions. They introduced remote consultations which reduced the patients’ need to travel to regular check-ups at their own cost and at risk of worsening symptoms, and used a new digital platform and device that enabled patients to check their own lung health by blowing into a mouthpiece connected to a smartphone which reports data back to their clinicians. Read more here:

Companies and products that relate to digitising outpatients

Some examples of innovative companies that presented to the collaboratives include:

  • DrDoctor transforms patient care by using mobile technology – an online platform that allows patients to view, change and schedule outpatients appointments themselves, online, on smartphone or by conversational SMS
  • Perfect Wardis a smartphone/tablet app which eliminates the administration in conducting and reporting ward inspections, freeing up staff time to care for patients and improving accuracy
  • Healthcare Communications provides an online appointment management platform that helps NHS Trusts reduce paper usage and improve patient experience
  • AliveCor is a small device that takes a medical-grade EKG in just 30 seconds, uploads results to an app, allowing users to share data with doctors and avoid trips to the ER

Innovation programmes in the NHS

If you want to learn more about NHS-led programmes that sponsor, encourage and promote innovative practice, as well as information on innovations/solutions that have already been evaluated and are in use across the country, look at the links below:

  • NHS Innovation Accelerator (NIA) – supports uptake and spread of proven, impactful innovations across England’s NHS; NIA fellows include:
    • My Diabetes My Way (MDMW) – offers online test results and education to diabetes patients
    • io – remote urine testing using a smartphone and home testing kit, keeping care in the community
    • MyCOPD – allows COPD patients to access test results, inhaler technique videos, educational content and pollution/weather information in one unique app
  • See Laura Boyd’s NIA slides here
  • London Accelerator – works with high potential start-ups and supports them to develop and deploy solutions to NHS challenges;
  • Innovation and Technology Payment (2018/19) – an NHS England initiative to remove financial and procurement barriers to uptake of certain innovations;
  • Report: Against the Odds – the Innovation Unit and the Health Foundationjoined forces to understand and share insights about how to scale innovation in the NHS.

Figure 3 NHS Innovation Accelerator evalution graphic: developed by the NHS Innovation Accelerator

Project posters from Trusts who took part

If you have any questions or wish to learn more about any of the resources or projects, please contact