100 Voices: The human wisdom behind improvement

We are good at sharing the ​‘hard’ knowledge of improvement: evidence, methods, measures, frameworks, tools and case studies of what worked. We need all of those things.

But there is another kind of knowledge too: the human wisdom we gain through experience. What we learn about change, courage, failure, persistence, relationships and ourselves. The things that become clearer with hindsight, including what didn’t go to plan and what surprised us.

Improvement needs both. Yet while hard knowledge can be documented and shared, that human wisdom lives in people. Unless we make time to listen, much of it can simply disappear. That is the idea at the heart of 100 Voices.

100 Voices brings together patients, carers and people with lived experience alongside clinicians, leaders, those with improvement formally in their role and people who might never describe themselves as ​‘working in improvement’. The aim is to capture something we don’t always hear about: the human experience of trying to make health and care better.

Across the conversations there is extraordinary passion, resilience, talent, curiosity, determination and creativity. There is honesty too. People talk about mistakes and disappointments alongside successes, moments of doubt, things they would do differently and experiences that changed how they think.

Some of that wisdom is practical, some deeply personal. Much of it would never find its way into a framework, project report or toolkit. Yet the people I’ve had the privilege of interviewing for this series have chosen to share it, passing on what experience has taught them in the hope that someone they may never meet might find something useful.

The conversations have reinforced something I feel strongly about: improvement mustn’t become a clique. Those of us who work formally in improvement bring valuable knowledge and skills, but we can’t, and shouldn’t, do it all.

You don’t need ​‘improvement’ in your job title to make things better. Patients, carers, staff and leaders each know and see things that others don’t. Everyone has something to bring.

This is where a beach ball has become a simple metaphor within 100 Voices (thanks to Q member Gill Phillips). If we all stand in different places around the same ball, we might each see different colours. Healthcare is no different. We experience the same system from different places, and those different perspectives matter.

Perhaps we need to spend less time persuading others to see what we see, and more time being curious about what they see that we can’t.

Because improvement isn’t about inviting people in. It’s recognising that improvement belongs to everyone.

While reports and project plans remain, the judgement, mistakes, relationships and moments that actually shaped us rarely make it into print.

Part of the ethos of 100 Voices is a simple idea: you are not alone. Making things better can be difficult, frustrating and sometimes lonely. Sharing what we have learnt won’t give someone else a formula to follow, but it might make their path a little easier.

Someone else’s experience can reassure us, challenge us, spark an idea or give us the courage to try again. Sometimes it simply makes us stop and think, ​“I’d never looked at it like that before”. That is why this wisdom is worth sharing.

100 Voices may have started with an idea, but it has been built by many people. It has been genuinely collaborative and co-produced, shaped by those who were willing to share their story, as well as by people who have challenged, encouraged, connected and shared their expertise.

The project has also received invaluable support from the Q community, with many Q members among those sharing their own experiences, including Penny Pereira.

There is something fitting about that. A project built on the belief that everyone has something valuable to bring has only been possible because so many people have.

None of us has the whole picture. We need each other.

100 Voices: How Better Feels launches today, Wednesday 4 November 2026, with three conversations released together and new episodes following fortnightly. 

On 25 November, we’ll take the conversation further in a special Q community webinar where I’ll be joined by Jono Broad, Gill Phillips, Adeshola Akanji, Amanda Roberts, four Voices from the series. 

When you listen, I hope you do so with curiosity. No single Voice has the answer. That’s the point. Each person sees something different and brings something different. Their experience might resonate, provoke a new thought, or simply help us see something familiar differently.

We already know how to share the methods, measures and evidence of improvement. We are much less deliberate about capturing the human wisdom gained from actually doing it.

100 Voices aims to help that wisdom travel, from one person’s experience into somebody else’s thinking. And that is only possible because people are generous enough to pass on what they have learnt.