Picker publish their independent evaluation of Q

Today Picker and their partners have published the findings of their independent evaluation of Q. 

The evaluation team concluded that Q’s perceived impact was greatest for individual members. They also found that projects that Q has funded have resulted in direct benefit to patients, despite the indirect nature of Q’s work. In addition, they identified ways Q benefits organisations and systems. However, this was lower than the impact for individuals, with a range of factors limiting our work at organisation and system levels.

Despite the barriers to engagement created by the challenging sector context, the evaluation found there is an innate value in the Q community. It has an important role for many who often work in small teams or in isolation to deliver improvement work. Some people depend on Q for the opportunity to connect and learn from others. Connecting, peer learning and collaborating emerged as key mechanisms for achieving impact. 

The evaluation found that there was a clear link between the level of engagement and level of impact members perceived. Generally, the more someone engages with Q, the more they get out of it, and the greater the benefit and impact they perceive Q to have.

The insights shared through the evaluation indicate many opportunities for us to increase the benefit and impact of Q for individual members, organisations and systems.

Between July 2023 and August 2025, the Independent Evaluation Team (made up of experts from Picker, Researching People (ResPeo) and Healthcare Priority Solutions (HPS)) sought and analysed the perspectives of around 700 people. They did this through multiple surveys as well as one-to-one interviews, group workshops and case studies. 

Contributors included a range of Q members and senior leaders within the health and care system. A small number of individuals who are not members of Q also participated in the evaluation. 

The data collection work was followed by detailed analysis to understand what’s working, for whom, in what context, and why. 

Q’s perceived impact was strongest at the individual level. Q members who reported this impact described increased motivation, skills, knowledge, and confidence. They also indicated a growth in their personal networks and career development. 

At the organisational and system levels, the perception of impact was more limited and difficult to attribute compared to at individual level. However, where identified, this impact included: organisational upskilling (with Q members sharing learning and resources with other colleagues), supporting changes in organisational culture, as well as changes in approaches and practices when delivering improvement work. 

At system level, Q’s impact included enhanced spread and scale of improvement ideas and innovation across systems, breaking down silos and increasing the visibility of quality improvement.

The evaluation identified a number of barriers to engagement, which consequently limit Q’s impact. These barriers often overlap and interact.

Some barriers were due to context, for example an individual’s lack of time and capacity, or organisational culture and lack of support for Q or improvement more generally.

Additional barriers included a perceived focus of Q’s activities and content towards acute care, perceived exclusivity of membership and activities, and technical and communication issues. 

When looking at specific activities that Q delivers, those which had the most impact often focused on a theme, provided practical steps and advice for addressing real-world challenges and helped members to collaborate effectively and grow in capability. 

Activities which had the highest impact at multiple levels (i.e. individual, organisational and system levels) were identified as: 

• Q Lab (our innovation lab)
• Q Exchange (our collaborative funding programme)
• Some of our events (such as our online workshops and webinars, as well as our local and regional events)

Member-produced content also had impact at all levels. 

The findings are already influencing decisions around how Q will operate and the activities and opportunities it will offer going forward, in the context of our changing environment. Some projects and changes are already underway. 

Learning from the insights and recommendations in this report will enable us to work towards our vision of an embedded culture and practice of improvement, which supports high quality care for all.