Improvement in action: get to know five member-led projects

Across the Q community, members are turning insight into action: testing new approaches, strengthening collaboration, and improving care for patients, populations and staff.

Below, we highlight five member‑led projects showing improvement in action. Each one explores the problems they’re addressing, the approaches they’re testing, and their emerging learning. 

There is a rising Type 2 Diabetes prevalence alongside variation in processes of care across Lothian. In response, this project is building an intelligence‑driven approach that strengthens both patient‑level care and population‑level decision‑making. By using linked primary and secondary care data through the Type 2 Diabetes Intelligence Framework, the team created a robust descriptive baseline of prevalence, cohort sizes, and variation between practices in the region, which can also be mapped over time.

Co‑designed with analysts, clinicians, and managers, the framework provides GP practices with interactive dashboards supporting cohort identification, benchmarking, and patient‑level insights, alongside a mechanism to track population cohorts and evaluate the impact of interventions.

The project demonstrates how joined‑up intelligence, co‑design, and strong data foundations can support prevention, early intervention, and more consistent evidence‑based care, and forms a scalable model for intelligence‑led improvement across long‑term conditions.

REACH aims to increase the reporting of racist incidents, improve psychological safety for open conversations about racism and its impact on staff, and ultimately reduce racist incidents through education, accountability, and restorative justice approaches. 

Alison and her colleague Carl shared their experiences and the importance of reading between the lines when it comes to the data: ​“We know that racism is under-reported nationally and it was no different in our trust”. 

A key area of focus for the project is strengthening support for team members who experience racism; ensuring they feel believed, protected and supported. REACH has introduced staff support packages, regular wellbeing sessions, a mutual expectations framework, an incident‑response flowchart, a sanctions‑letter process and restorative conversations. The staff-led nature of the approach has helped with its adoption and staff ​“feel like they own it”.

The project has received recognition for its achievements, and the team are looking to share their transferable learning to support wider adoption. 

This project aimed to establish a clear and evidence-based Occupational Therapy (OT) pathway for lower limb amputee patients at King’s College Hospital in London. Internal audits and clinician confidence ratings highlighted inconsistencies in assessment, reduced adherence to national best practice guidelines, and variable multi-disciplinary team (MDT) awareness of optimal rehabilitation for people who have undergone lower-limb amputation. 

Using QI methodology, the team explored the root causes, identifying gaps in processes, confidence and shared understanding across the MDT. They then developed a specialised OT amputee pathway, grounded in NHS England guidance, supported by targeted staff training to build expertise and standardise practice. The work challenged traditional ways of working between occupational therapy and physiotherapy, but this shift was essential to make meaningful progress.

The project was small scale, developed without additional resources, and had a positive impact. Their post‑implementation audit data showed a significant increase in holistic OT assessment and intervention across physical, cognitive and psychological domains. The team found that clinician confidence also improved, with early signs of reduced discharge‑planning pressures and shorter lengths of stay.

Next steps for the project involve embedding the pathway further and sustaining staff education. 

Transforming urgent frailty care by ​‘redesigning the front door’ around partnership, data, and early decision-making was key for this project. The Frailty SDEC model brings together geriatricians, advanced practitioners, nurses, therapists, pharmacy, social care, virtual ward teams, community intra venous services, primary care and ambulance partners to deliver integrated, senior‑led care from arrival without default admission. Working closely with Call Before You Convey and the GP Federation, the team has focused on avoiding unnecessary—particularly social—admissions.

Using QI methods and real-time data, the team embedded a shared Comprehensive Geriatric Assessment, therapy‑led pathways and daily MDT huddles to reduce delays and support safe discharge. 

The impact has been significant: 

• 23 beds released in one quarter
• Readmissions halved
• Length of stay reduced by over 50%
• Emergency department time cut by up to 10 hours
•  94% of patients reporting a positive experience. 

The work shows that many frailty admissions stem from system design rather than clinical need, and that with the right partnerships and data, frailty care can safely shift upstream, aligned with the ambitions of the NHS 10-Year Plan.

Across health and care, innovation, research and improvement activity is often siloed despite shared aims and overlapping teams. Such activity across Humber and North Yorkshire (HNY) has historically been delivered in parallel but often in isolation. Although these domains share similar aims, differing terminology, structures and entry points have created fragmented routes for teams seeking support with improving care delivery.

Delivered through Q’s Supporting Q Connections programme and led by IRIS (HNY’s Innovation, Research and Improvement System, based in the ICB), this project brought together these areas in Humber and North Yorkshire to create a more unified culture that supports faster, more collaborative change. 

Through using Communities of Practice, the project has been able to able to address the challenges of similar disciplines feeling like ​“separate worlds”. 

If you’d like to learn more about the project, you can email the team or get in touch with the Q member leads below.

These projects reflect a small amount of the diverse improvement work happening across the community. But they demonstrate the commitment from members to collaborate and improve together. 

The teams involved are keen to share their learning and connect with others working on related challenges.  If you see an opportunity for crossover, adaptation or partnership, please get in touch and help take this work further.