Q’s direction and the path ahead

We recently announced a set of changes for Q – the outcome of a scheduled strategic review with the Health Foundation. The key headline is that we’re moving to a new home with the NHS Confederation, with ongoing but reduced funding from the Health Foundation for the next 5 years. There will also be some important changes to our activities. 

I would like to share with you how improvement principles, a focus on Q’s core purpose and what we’ve heard from the Q community have guided me and the team as we developed our future plans. 

These changes are taking place a decade after the start of Q, yet, if I close my eyes, I can take myself right back to the beginning. I’m with the 231 founding members who co-designed Q through three 48-hour workshops over 6 months – with lots of Post-it notes and coffee! We tested the emerging ideas with 50 organisations, and together created the Q community. 

Many insights from that time have guided my work since, including the recurring message that you wanted Q to be different from the short-term initiatives you’d seen before. You wanted a community that would be around for what one person described as the ​‘generational challenge’ of embedding a culture and practice of improvement in the health and care sector. 

In developing Q’s future plans, we’ve drawn on principles for effective, multi-faceted, long-term improvement. In preparation for the Health Foundation’s strategic review, we clarified our core vision, purpose and strategic contribution. Based on the feedback from an independent evaluation of Q and our new financial context following the Health Foundation’s review, we understood the shifts we need to make. This understanding has guided the development of our plans and helped us make sometimes difficult choices in service of ensuring sustainability.

We have distilled an overarching guiding purpose: to collaboratively accelerate the improvement of health and care. We have also established four core areas of work and the four values underpinning them all: purposeful, inclusive, collaborative and learning.   

Driven by what’s important to our members and the sector, these principles guided the Q team and myself to make purposeful choices in responding to a new context and opportunities. Our four strategic areas moving forward are:

1. Building and sustaining a large, vibrant and diverse community that connects across sectors and countries. 

Reaching across the UK and Ireland, Q’s members are at the heart of what we do and remain central in our future strategy. We’ll make sure the new developments we’re exploring create learning and opportunities for members and enable us to keep Q membership free. 

You’ll see many of the same activities from us, as well as some new and adapted services. Although there are some resource constraints, we’ll ensure activities and services are easy to access – and designed with you. We’ve also heard we need to do more to reduce barriers to participating in the community. Upcoming changes will address these. 

Over the past 10 years, the ambition and range of work happening to improve health and care have broadened. Collaborating with our partners and members, we’ve been leading the way in shaping and supporting this evolution. While the work to change health care happens under a range of labels, we’ve been celebrating and connecting people using different methods to support creative links and systematic learning. We will in future explicitly recognise and welcome the breadth of improvement, change and transformation work needed to deliver radically better care. 

2. Enabling people to share, learn and collaborate to address pressing health system challenges. 

Q’s Lab methodology has proven a highly valued and impactful approach to understanding and addressing complex challenges. We are exploring ways to expand this work, for example with new partners. And we’ll be doing more to make insights and tools widely available to the community, creating opportunities for more people to learn together. 

Unfortunately, given funding constraints, we won’t be able to continue with our flagship funding programme, Q Exchange. I know this will be as disappointing to many of you as it is to me. But I’m committed to finding other ways to support collaborative change in practice. And we will make the most of the amazing examples, resources and learning that have emerged from all the projects we’ve funded over the years. 

3. Influencing the health sector to create the culture and conditions in which improvement efforts succeed. 

We are making this a more explicit goal for our work. Since the beginning of Q, we’ve focused on what enables improvement. Together with members, we want to shape the environment in organisations and systems to both show what’s needed and proactively create these conditions.

Over the past few years, our existing partnerships with NHS Providers and the NHS Confed have boosted the profile and reach of improvement and Q among board members and across organisations and systems. I’m excited about the potential to take this further as we move to the NHS Confed. 

4. Strengthening and maintaining our organisational resilience and agility to achieve our vision. 

As well as providing great strategic opportunities, our move to the NHS Confed will also support Q to diversify our funding in a way that stays true our values and aligns with our mission. 

We are working with NHS Providers, the NHS Confed and our many partners to explore ways we can support improvement that make the best use of public resources and provide learning for the benefit of all. 

The past 10 years wouldn’t have been possible without the Health Foundation as an amazing home. We look forward to a continued partnership and funding for the next 5 years. This will support a gradual transition to a model where we’re fully and sustainably embedded in the health and care system across England, Scotland, Wales, Northern Ireland and Ireland. 

I’m confident and optimistic about where we’ve landed with Q’s strategic review. The way we’re adapting puts us in a strong position to continue supporting our members, building on our learning and focusing on our impact.

Right now, there are major ambitions for transformation across all countries. It’s never been more important to ensure Q is fit to meet our community’s needs for the long term and support the improvement of health care for all. 

Thank you for all the insights and feedback you’ve given us over the months and years that have led us to here. In the spirit of purposeful collaborative improvement, myself and the team look forward to your help as we shape this next phase for the Q community together. If you’d like to get involved down the line, please do register your interest.