THIS Institute (The Healthcare Improvement Studies Institute)

We've happy to announce that we’ve been awarded funding from the National Institute for Health and Care Research (NIHR) for our new project exploring how NHS organisations can better support staff to speak up, and crucially, how to listen to them, respond, and act effectively. Speaking up is key to improving patient safety and staff wellbeing. The project also aims to explore ‘voice stewardship’ - treating staff voices as a valuable asset for improvement. The project will look at the full ‘voice pathway’, from speaking up to action. Graham Martin, THIS Institute Director of Research, said, “Through this project, we hope to learn from good practice in healthcare and other fields to develop practical ways for organisations to make better use of voice and support staff when they speak up.” Find out more: https://ths.im/4oaLFQz

Everyone in healthcare will have an opinion on the Dash Review, but this is the THIS Institute (The Healthcare Improvement Studies Institute) take from Graham Martin and I, published last Friday in The BMJ: https://lnkd.in/g2tHg3Zi In this opinion piece, we focus specifically on the issues raised by the review, for the intelligence created by patient and staff feedback about services. We highlight: ➡️ The views of patients and staff are more than net promoter scores, pulse surveys, or newly vaunted “patient power payments” to determine whether providers are fully reimbursed following treatment. ➡️ Voice, not just choice, is vital to improvement. ➡️ Making the most of voice needs an infrastructure, including the ability to gather, collate, interpret, and share intelligence system-wide, and guide organisations and the people within them on what to do with it. ➡️ There is a mixed record of NHS Trusts acting on staff and patient feedback. ➡️ So, whilst local ownership of feedback may in theory be a good idea, might it also be a policy reflecting hope over experience?

Penny Dash’s recent review calls for major reforms in how patient safety is organised, a move that few would dispute is necessary. However, the review also raises some important questions. Disbanding Healthwatch England, local Healthwatch and the National Guardian’s Office will remove institutionally independent organisations that were designed to support staff and patients in speaking up. Surveys have shown that even with these bodies in place staff were concerned about the consequences of speaking up, and were not confident that they would be listened to when they did. History has shown that not listening to staff and patients can lead to serious problems in patient care. In this editorial, Graham Martin and Jane O’ Hara issues comment on the Dash review and what the impact might be for patient safety. Read the editorial https://ths.im/44SEsM9

Have you undertaken a quality improvement project in the NHS? Take part in our survey by Thursday 24 July to share your experiences. At THIS Institute, we’re running a national survey to understand how quality improvement is really working for healthcare professionals across the UK. We’re asking you to share your real-world experience, whether your project went brilliantly, fell flat or somewhere in between. Your input will help support the development of new approaches to undertaking quality improvement. It only takes 10 minutes and certificates of participation are available. Find out more and take part: https://ths.im/44zgrLi Please share with colleagues and friends who’ve been involved in quality improvement. The more diverse the responses, the better we can understand what’s needed.

📣 Speaker Announcement for #MatSafety2025! We are pleased to share that Mary Dixon-Woods, Director at THIS Institute, will be joining us as a speaker at this year’s National Maternity Safety Conference 2025. Join us this year on 25th September 2025 at the Hilton Metropole, Birmingham, as we continue to shape the future of maternity care together. 👉 Find out more and register: https://lnkd.in/eqr4G4R7 Location: Hilton Metropole in Birmingham Date: Thursday 25th September 2025 Time: 9:30am to 5pm For block bookings and/or information about exhibitor packages, please contact: support@babylifeline.org.uk #BabyLifeline #MaternityConference #MaternitySafety #Motherandbaby #Charity #Conference #MaternityServices #SaferBirths

🆕 The latest release from our Elements series takes a a deep dive into audit and feedback - one of the most widely used improvement techniques. It is written by Noah Ivers from University of Toronto and Robbie Foy from University of Leeds. It covers: ➡️ What makes audit and feedback effective with practical examples ➡️ The theories and evidence that underpin their use ➡️ Challenges, limitations, and areas for future research Read it here for free: https://ths.im/40NNA3t

Maternity care has not been short of inquiries and reviews, nor is it short of recommendations, so the announcement of another investigation into neonatal and maternity care by Health Secretary Wes Streeting at the recent RCOG World Congress, and repeated in Fit for the Future, might raise questions, eyebrows – and indeed hackles. In this BMJ opinion piece, Jane O'Hara, Graham Martin and Mary Dixon-Woods explore what any new investigation and resulting plan will need to address to drive real and lasting change, rather than becoming another missed opportunity for meaningful improvement. They suggest that it will be important to acknowledge the past and take a responsible, evidence-based, and collaborative approach to the future if any new plan is to succeed. Read the editorial: https://ths.im/44CjYHn

📢 Six key things to consider when spreading, scaling, and sustaining healthcare improvement. ➡️ Starting from scratch isn't always the answer ➡️ Think about the potential for spread, scale-up, and sustainability early on ➡️ They tend to be overlapping and interdependent, not a step-by-step process ➡️ Pay attention to the context and the resources that can support the process ➡️ Bring in the right people, with the right skills, at the right time ➡️ Be open to adapting interventions to work in different settings Find out more in the first resource from Explain THIS: our series of quick, practical guides to major improvement approaches. https://ths.im/3IlSGgW

Change programmes have often been used to drive improvement and service change at national level across the NHS. They can be complex, multi-layered and resource heavy. While there is a move away from top-down approaches to generate change and increasing emphasis on delivering outcomes and results at local level within the NHS, some large-scale or national programmes to create change across the system are always likely to be needed. If designed and planned well, these programmes could help deliver some of the transformational changes needed to improve patient care that are central to the government's Fit for the future: 10-Year Health Plan for England. But large-scale programmes in health, as in many other sectors, are prone to underperformance in delivery, cost, schedule, outcomes, and impact. It is also known that many of the challenges arise during the early planning stages of a programme. It’s at this “front end” where things often start to go wrong – but bespoke guidance for policymakers and programme leaders to support early planning of large-scale change programmes specifically in the health field is lacking. To address this gap, a collaboration involving THIS Institute, Ipsos and The Health Foundation is developing a framework to support senior leaders and teams leading the initial stages of change programmes. It’s based on analysis of research literature and guidance on large-scale programmes (sometimes known as “mega-projects”) across multiple sectors, the research literature on change programmes in healthcare, and interviews with leaders of previous NHS programmes. A beta version of the framework is now available. Offering series of guiding questions spanning three themes, it supports structured thinking about design and early planning of large-scale or national NHS change programmes. It is intended to facilitate discussions and dialogue rather than serve as a checklist or tick-box exercise and is likely to be most useful when used as part of a team-based discussion. We’re keen to engage policymakers and programme leaders in refining the framework. We’re currently carrying out an online consultation on Thiscovery to gather insights, and plan to test the refined version using a scenario-based table-top exercise. We’ll make the final version freely available. National programmes can be a powerful way to create a change in healthcare. We hope this framework will ultimately help to make design and early planning better, ultimately benefitting patients. Access the beta version of the framework and take part in the online consultation here: https://ths.im/4nDVUg3 Ipsos has published a new report on what good looks like when designing national programmes in health care which is aimed at supporting leaders in the health and care sector. Read it here: https://ths.im/4nFHA6D

In its recent spending review, the UK government announced a £10 billion investment aimed at “bringing the current analogue-based NHS into the digital age”, and a 50% increase in the NHS technology budget. Building on this, the 10 Year Health Plan for England contains a strong focus on how Artificial Intelligence (AI) and digital technology can be used to improve healthcare – with initiatives such as a single patient record to enable more coordinated care and a ‘doctor in their pocket’ which builds on the existing NHS App by introducing a broader range of features and services. How can these innovations be used in a way that best supports health systems, improves patient outcomes, and enhances experience? Niels Peek, THIS Institute’s Professor of Data Science and Healthcare Improvement, believes that AI may have the potential to help to free up valuable time that would have been spent on admin and routine tasks, leaving doctors and healthcare professionals more time to do what they are best at, talking to patients and making clinical decisions. He says: “Some AI tools can help with small but important processes like documenting consultations or collecting information about patients who approach their GP. If tasks like these can be carried out, even partially by AI, that could potentially free up valuable time from NHS staff.” At the same time, there are concerns that will need to be navigated, ranging from questions about control and ownership of data through to worries about whether AI could be intended to replace human interaction. At face value, AI tools like digital scribes seem promising, but we currently have no evidence of their impact on clinician time, productivity, or patient safety. If AI and digital technology is to be successfully implemented in healthcare, our top priority must be gathering high-quality evidence to support its effective use. We spoke to Niels, along with Marcus Lewis, a GP from North London, about the potential – and pitfalls - of AI in healthcare. Find out more: https://ths.im/3Go5F1a