In August 2016, Care City was awarded a grant by Health Education England (HEE) to deliver an educational programme designed to empower the local health and social care workforce to make necessary efficiency savings, integrate and innovate.

Care City had identified demographic pressures, the changing burden of disease, rising patient and public expectations and reduced public funding as drivers behind these needs. Making these improvements is dependent upon a workforce that is skilled in Quality Improvement (QI), a systematic approach that uses specific techniques to make care safe, effective, person-centred, timely, efficient and equitable.

Over the last year, the Care City QI Programme developed and delivered:

• The ‘Foundations of QI’ course, a one-day basic course in QI, with the aim of spreading QI knowledge and awareness to a high number of people across the system.
  A coaching programme to upskill a smaller group of QI champions to cascade learning to other frontline workers within and outside of their organisation, initiate and sustain quality improvement within their own organisations.
• Access to IHI Open School licenses to allow those who could not partake in classroom learning the opportunity to train in QI through online distance learning.
• four quality improvement collaboratives including falls reduction and improving AF detection and management, spurring on QI activity across the system and demonstrating what could be achieved.

Earlier this year Skills for Care were appointed to conduct an independent evaluation of the QI programme, with the aim of answering the following key question: How does the Care City Quality Improvement programme impact on staff: perceptions of their role in improving quality, the extent to which they feel empowered to engage in improvement activity, behaviour in their day-to-day roles and any improvement activity they engage in?

Evaluation Findings

• The delivery of the QI programme has been a success and has added value to the local system. 
• The programme is unique in its design, context and links to other initiatives, leading to locally specific learning and connections that are unlikely to have taken place without the experience of the programme.
• The ‘Foundations of QI’ course has been delivered to over three hundred and fifty participants, and the coaching programme to fifteen.
• The ‘Foundations of QI’ course was rated ‘excellent’ or ‘good’ by 97% of respondents.
• Its facilitators were rated ‘excellent’ or ‘good’ by 100% of respondents
• All the respondents from the coaching programme also rated every aspect of the course as ‘excellent’ or ‘good’.
• Beneficiaries interviewed said that they found the learning for the course easy to fit around their job, enjoyed the course and found the pace good.
• Beneficiaries interviewed also told of how completing the course had helped increase their confidence, refresh their skills and remind them of the importance of embedding QI in everyday activity.
• Most coaching respondents said that they had both improved quality at their workplace and rolled out learning to other colleagues – on average four further people had been trained per coach.
• Stakeholders agreed that Care City was the right organisation to deliver the QI programme. They recognised it has a local, unique and neutral position, cutting across research, education and innovation, approaching the system as a whole and having important relationships with other players.

Skills for Care commented “The Care City QI Programme appears to have been a resounding success. At reasonable value for money, an excellent team of staff have been recruited and made a positive impression with local stakeholders; and a curriculum has been developed which is widely considered high quality and has been adapted by two other major providers for their own use.”

Dean Rigg, Programme Manager, Care City commented “Evidence suggests that organisations that adopt QI practices are more likely to improve outcomes and experiences for people who use their services and achieve ‘Outstanding’ CQC ratings. We are delighted that Skills for Care has given our QI Programme the seal of approval and that we have been able to support local organisations to develop a culture of improvement where all staff feel supported to speed up and influence change.

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“Simple to use and complete, interesting and thought provoking learning.” “Easy to understand and modules can be done anywhere, even on your phone while on the bus or train.” –E-learning participant.

“It reinforced good practice that I knew about, it has corrected some bad habits, it’s provided an aide-memoire in terms of some of the discipline around QI… I think it has been helpful in reminding me around the disciplines required.” – Participant on the ‘Foundations of QI’ course (NHS employee)