New report: Supporting system improvement through peer learning

With the health system at a crossroads, facing huge demand for services and constrained finances, there is an urgent need for transformation. At Q and the NHS Confederation, we believe that large-scale change in health and care will happen through leaders across multiple organisations, sectors and localities coming together to intentionally plan, collaborate and deliver work holistically. Improvement approaches are the heart of this and are a key way to ensure change is sustainable and long-lasting. 

A new report, Supporting system improvement: lessons from a peer learning programme, shares insights into some of the key challenges facing those leading and delivering improvement across systems. These include fragmentation and siloed working, financial constraints, and lack of senior leadership support. The report also identifies how peer learning can facilitate progress in this space. Benefits include reducing feelings of isolation and facilitating sharing of knowledge and experience. 

The report also highlights how the importance of taking an adaptive and inclusive approach to the tools and methods in system improvement. Our Cross-System Improvement Framework was one example of this. Participants thought this framework was particularly valuable because it was not NHS or health-centric and thus more amenable to sharing with partners outside health care. 

System-level improvement is key to delivering the government’s ten-year health plan and transforming health and care systems for the future. To achieve sustainable improvements across multiple organisations and hierarchies, leaders from across systems need to come together to plan and deliver work holistically. 

The report recommends that to support system improvement, system leaders should consider: 

• Strengthening and embedding peer learning mechanisms and processes. 
• Enhancing leadership and governance for system improvement. 

Central bodies have a key role to play in facilitating and supporting this work. They should consider: 

• Developing and promoting a shared approach to system improvement. 
• Supporting peer learning programmes and networks at a national scale. 

As part of this report, you can also read the five key principles for supporting peer learning. 

The report draws on insights from Learning and Improving Across Systems peer learning programme, which we delivered in partnership with the NHS Confederation and the Health Foundation. More than 150 health and care leaders have shared their views on the importance of peer learning opportunities to help enhance leadership and develop system-wide improvement programmes for health and care services. 

Learning and Improving Across Systems brings together the improvement expertise of our community, the Health Foundation, and the networks and relationships of the NHS Confederation. 

The programme was structured around the Cross-System Improvement Framework that supports leaders in creating the conditions and delivering large-scale health and care improvements across systems.