4 May 2021

May 2021                                                                                         

83 QI projects showing improvement across CNWL

Photo: Alpine flowers in Kew Gardens, Peter Smith

QI moves up a gear

CNWL is cautiously moving out of lockdown restrictions and for the QI Programme, that means shifting up a gear to provide a range of training and coaching support to CNWL staff who are undertaking improvement work.

Bitesize QI training has already recommenced and we include the usual list of upcoming dates for you to book your training. Our headline for the CNWL QI Practicum 2021 training, which starts in June, is “Improving Safety and Reducing Harm” and we report on the four quality themes for the course.  Also this month, CNWL’s first cohort of Improvement Leaders start on their apprenticeship training and we look forward to hearing about their QI stories.

Given the focus on rejuvenation of QI training across the Trust, our lead article this month is a timely reminder, about the importance, practice and benefits of service user and carer involvement, right from the start of a QI project.  We report on a QI Coach Forum where Lucy, Sandra, Janet and Grace from the Improvement Team provided a thoughtful presentation and discussion on how we can deliver on meaningful co-production in our improvement work; not forgetting that service user and/or carer involvement is, in the words of Dr Con Kelly, Chief Medical Officer, a “must”, rather than an optional extra to help QI projects to succeed.

This month we also welcome Esha Shah to the QI Team in the role of Improvement Coach at CNWL.

We welcome your feedback and if there is anything you would like to see in future editions of the newsletter, do please get in touch by e-mailing cnw-tr.improvementsupport@nhs.net.

QI Coach Forum: A timely reminder about Service User & Carer Involvement

All QI Coaches across CNWL are invited to join a monthly forum to discuss learning, successes and any aspect of delivering coaching to a QI project team.  Last month we were delighted to host a presentation and discussion led by our Service User and Carer representatives, Sarah Jayacodi and Janet Seale, along with Grace Levy, Patient and Carer Involvement Officer, and Lucy Palmer, Head of Patient and Carer Involvement.

The presentation by Sandra, Janet and Grace took us through some of the best practices and benefits of involving service users and carers in our QI projects and we thought that the key messages that the Involvement Team delivered are well worth sharing with the wider CNWL QI community.

So what does the data say about how we are doing on SU/C Involvement?  Our aim has always been to achieve 80% of QI projects with meaningful involvement, but currently we have a 40% rate.  In the practicum programme that ended last year, we achieved over 90% involvement, so we can do it!

Sandra presented a quote from Dr Con Kelly, Chief Medical Officer that eloquently sums up how we should change our thinking on SU/C involvement to achieve that aim:

“All QI projects must involve service users or carers unless there is a very good reason not to. The project is much more likely to succeed this way. Co-production should be business as usual in the Trust, it should be what we do as a matter of course.”

Dr Con Kelly, Chief Medical Officer

We then went on to consider what service users and carers can actually do to help.  One of the slides sums up very well nine areas in which project teams can work with their service users and carers in a co-production manner.  There are more, but doing several or preferably all of these activities will ensure that your SU/C involvement is meaningful.

Janet then described what genuine (and therefore meaningful) involvement is.  The key words are co-production and co-design, which Janet reminded us constitutes ‘doing with the service users and/or carers’, rather than ‘doing for or doing to’.  This thinking moves our involvement activities away from paternalistic or disempowered involvement to a relationship that is equal and reciprocal with shared power and roles.

Janet identified three major benefits of this shift in behaviours:

  • Strengths and talents of service users are nurtured
  • People become catalysts for change –considered as genuine assets
  • Changes nature of conversation

After reflecting that the ‘doing with..’ can feel at odds with cultural norms, we then looked at how to get the most out of our time working together with service users and carers:

Sandra reflected that when we do involvement in a meaningful way, we open out our understanding of an improvement issue or problem to the views, preferences and experiences of the recipients of our services.  These experiences may be very different to what we, as staff providing a service, might think and this in turn opens up possible changes that are far more likely to succeed.  We love the image of the pathway designed to help people traverse an open space, when clearly those who use the space have worked out their own, more efficient solution.  If ever we have doubt why involvement is vital to our work, this image brings it back into perspective?

To round off the presentation, Grace provided some thoughts on how to make service users and carers feel genuinely involved in our improvement work and some considerations around getting help from the central involvement team and keeping everyone well during the work. 

And not forgetting the excellent co-produced guide that is recommended reading for all QI project teams: Involving Patients and Carers in Quality Improvement Projects: A Practical Guide. 

The guide is available from the QI web pages here.

Help and Advice

If you would like help or advice from the Involvement Team, including help in either finding or training a service user or carer to help support your improvement work, please contact them at involvement.cnwl@nhs.net

A big thank you to Lucy, Sandra, Janet and Grace for providing a thought evoking and action orientated presentation and talk.

CNWL Quality Improvement Practicum 2021


Last month we introduced readers to the CNWL QI Practicum, which will commence in June 2021.  Discussions with Divisions are nearing conclusion and the QI Team are busy identifying staff to attend the Practicum and learn about the model for improvement whilst undertaking a QI project.

Our strapline for our year-long 2021 Practicum is “Improving safety and Reducing Harm”, and there are four themes of work that will provide the focus for improvement work:

  • Improving safety
  • Violence Reduction
  • Reducing Pressure Ulcers
  • Improving Flow

We are excited by the range of themes that the Practicum will cover, with 24 project teams, each consisting of 3-4 staff on the practicum course and further project team members in each service.  Not forgetting service user and carer involvement in every project!  Supported by a dedicated QI Coach, senior sponsor and monthly training and themed learning workshops, we are hoping for some really solid improvement in each of the services.

We look forward to reporting progress and hearing QI stories from the practicum over the coming year.

Meet the team – Esha Shah

This month we welcome Esha Shah as one of our new Improvement Coaches.

Esha has over 13 years’ experience within the charity sector, managing and developing a range of projects within Mental Health, Elderly and End of Life Care and has a background in Neuroscience & Psychology alongside an APM Project Management qualification.

Most recently Esha has worked as a Senior Employment Specialist, coaching and mentoring clients back into the workplace and also has experience of leading organisational change; embedding process improvements and new initiatives across various teams whilst collaborating with stakeholders at all levels.

Commenting on her new role, Esha said “I am passionate about creating meaningful and sustainable change in the workplace using a systematic, measured and collaborative approach, and believe the staff and service users need to be at the forefront of these processes”.

We wish Esha every success in her new role at CNWL.

Improvement Leader Apprenticeships

As part of CNWL’s QI training portfolio, eight CNWL staff embark on an 18-month level 6 apprenticeship (degree level) course this month.

Covering advanced improvement methodologies this (virtual) training has been developed in collaboration with five other NHS providers across London and so the CNWL staff who have applied and been accepted will join a total cohort of 30 learners from a variety of NHS backgrounds.

Each apprentice will undertake a strategic improvement project as part of the course, learning about various aspects of leadership to bring about improvement, but also putting that into practice throughout the course.

We are sure to be hearing about their QI journeys as the apprenticeship course progresses!

Upcoming Training Dates

Bitesize QI 

Dates for the ever-popular monthly 3-hour virtual QI training on the model for improvement and how to set out on a QI project are bookable on LDZ at: https://cnwllearning.org/login/index.php

Search for ‘Bitesize QI’ to find the course, which is available on these dates all starting at 9.30am:

  • Tuesday 11 May 2021       
  • Tuesday 15 June 2021      
  • Tuesday 13 July 2021        
  • Tuesday 17 August 2021  
  • Tuesday 14 September 2021       
  • Tuesday 12 October 2021 
  • Tuesday 16 November 2021
  • Tuesday 14 December 2021

Useful links

Contact information for Improvement Advisors:

Diggory Division: Michele Dowling - michele.dowling@nhs.net

Goodall Division: Peter Smith - petersmith3@nhs.net

Jameson Division: Geetika Singh - geetika.singh@nhs.net

CNWL QI Microsite: www.cnwl.nhs.uk/qi

Life QI: www.lifeqisystem.com/

IHI Open School: https://www.cnwl.nhs.uk/qi-new/book-training

If you want to get in touch please contact us here: cnw-tr.improvementsupport@nhs.net