Service and quality improvement

The core focus of clinicians, practitioners, managers and organisations is how best to improve the support that they provide to patents and their communities.

Over recent years it has been recognised that in addition to delivering better outcomes, health and care services must also address the other ‘triple aims’ of increasing health equality and ensuring that resources are used efficiently.

There is now considerable evidence and theory regarding service improvement and the translating knowledge about what works from research into practice. Despite this accumulated wisdom, health and case services can struggle to successfully introduce and sustain improvements in the longer term.  Working across professional, service and organisational boundaries is a particular challenge.

The difficulties are many – competing priorities, unreceptive cultures, lack of resources, insufficient improvement skills and fragmented thinking. So too though are the solutions, and with careful planning, design and delivery it is possible to achieve benefits for the long-term.

What work do we do in this area?


HSMC completes evaluation and research projects which seek to support, investigate and learn from improvement initiatives and the factors that support them in practice.

Recent & current projects include:

Critical Friend Role

HSMC acts as a ‘critical friend’ to organisations reviewing, planning or undertaking change in response to current and future challenges. This can include facilitation of stakeholder workshops, providing informed advice and challenge on proposed visions and action plans, and being a sounding board for individuals and leadership teams. Read more about our work:

Age UK - Integrated Care Programme

HSMC are providing research, policy and OD advice to Age UK as they seek to explore the role of third sector in promoting integrated care at local level and seek to evaluate outcomes. This involves helping to define the inclusion criteria for case study sites, advising on approaches to evaluation and signposting to relevant evidence.

Supporting service transformation: over time, HSMC has been invited to take part in a number of transformation projects, sitting on the relevant project Board as an advisor, drawing on good practice from other areas, summarising the evidence base and acting as a critical friend to the process. Examples include sitting on the Surrey County Council Transformation Board, advising on the selection of the government's integrated care pioneers and providing input to the work of the NHS Future Forum.

ACE Pioneers Programme

Cross-city CCG have introduced a radical new approach to working with general practice to improve patient experience, clinical outcomes and local cost-efficiency. They have recognised that to achieve improved management of long term medical conditions in General Practice it is likely that practices will have to work together in a different fashion to enable them to provide the full range of services for these complex patients. Community services will need to be arranged more closely around individual practices or practice groupings, allowing GPs to have much greater influence in the composition of the community team and how closely they become integrated with their practice. A number of groupings of practices are testing out this new approach, and HSMC have been asked to support the CCG and these ‘pioneers’ as they attempt to break new ground. This support includes facilitation of a fortnightly learning set, undertaking a rapid review of evidence of improvement in primary care and development of a performance and quality framework.



The Health Care Quality - Measuring and Assuring and Health Care Quality: Improvement and Innovation modules are specifically focussed on the improvement process and can combined as part of a ‘quality and service improvement’ specialism. There are other modules which also provide related learning, including the Introduction to Organisational Development and Integrated Care (Policy & Theory).

Improvement is also embedded throughout the Programmes we deliver on behalf of external agencies. These include the NHS Leadership Academy Anderson and Bevan Programmes, and the Medical leadership in Service Improvement programme was designed and delivered with Alliance Manchester Business School for Doctors in the North West. The workshops were designed to enable them to develop the tools and techniques required to deliver their chosen service improvement, which formed the basis of their assignment.

Who is involved in this work stream?

Dr Ross Millar, Professor Russel Mannion, Hilary Brown, Yvonne Sawbridge, Dr Jo Ellins, Deborah Davidson, Professor Judith Smith, Dr Kerry Allen, Iain Snelling 

The key contacts for this work stream are Dr Robin Miller and Yvonne Sawbridge