Understanding and increasing Q’s impact

Learning and evaluation have always been core to Q. We’ve invested in it since our inception in 2015. We’ve had multiple independent evaluations into different aspects of Q, complementing routine internal monitoring and impact assessment. This has given us plenty of useful feedback on our events and programmes, with lots of positive encouragement and evidence of immediate benefits of Q.

Picker and their partners have just published the results from their two-year evaluation of Q. We asked the team to go further than we’ve gone before and beyond what’s possible and typical for other public and charitably funded initiatives like Q. By looking across member experience and using a range of methods, the evaluation considers how far we’re realising the deliberately stretching ambitions we set in our theory of change.

We are tackling some of the most complex and stubborn challenges facing health care. We are seeking to create a culture and infrastructure where insights and good practice are shared freely and quickly. We are continually trying different ways to support effective problem solving and collaboration across professions and sectors. This is critical to achieving the transformation goals of the sector, but – as we know from our work together – is really hard in practice. 

I’m pleased the evaluation report describes many examples of benefits that Q members see from their participation in the community. This includes benefiting from unique learning and connection opportunities which increase members’ motivation, skills, knowledge, and confidence.

The report also helps us understand with greater precision how and where our impact reaches beyond individuals: to their organisations and systems. For example, the evaluators found evidence of Q supporting organisational upskilling and culture change as well as enhancing the spread of improvement ideas across systems. The independent evaluation also captures examples of Q’s ultimate impact on patient care.

I’d like to thank the evaluation team and our advisory group for their diligent and thorough approach. Most of all, thank you to the hundreds of people who gave their time to share their perspectives and tell us how we can improve.

Modelling the learning and improvement culture that makes Q special and which will enable us to change for the better, the Q team has responded with openness and energy to the findings. We benefited from access to interim results as the research was conducted and have already started adapting in response. 

We’ve distilled a clearer, briefer purpose and vision for Q – to collaboratively accelerate the improvement of health and care. We are using this to guide what we do and how we communicate it; helping us to focus on the realistic and unique contribution we can make for our members and how we work alongside others to enable health sector change.

The context in many organisations and systems creates barriers to engaging with Q, with improvement and learning inconsistently supported. In response:

• We’ve focused our activities and resources on pressing health system challenges, with a topic-focused approach that seeks to position Q and improvement as critical to the must do challenges facing the sector.
• We’re developing programmes that seek to support senior leaders, building their skills and understanding of improvement at organisation and system levels. We’re doing more to raise the voice and experiences of our members to ensure the realities on the ground influence national policies.

Co-designing with members, we’ve made it much easier to navigate our content and redesigned our group spaces. Launching our new website was just the first step. We’ll keep listening to our members to make further improvements.

Our recent move to the NHS Confederation, while retaining close links with the Health Foundation and partners across all five nations, builds on great foundations. It will allow us to be further embedded in the NHS, with stronger and more influential connections between Q and the work of organisations and systems.

We are expanding the focus of Q to include change and transformation, explicitly recognising terminology and approaches used in different sectors. This will help make Q more inclusive and also increase our reach and influence.

In parallel to welcoming those with a wider range of experiences, we are redesigning Q’s application process. We are making sure our programmes, events and content speak to the needs of different parts of the community, and the biggest priorities for the sector.

Financial pressures come through strongly in the evaluation as a challenging part of the context for Q members. This is also impacting Q.

We have the benefit of a further five years of funding from the Health Foundation and others. However, the amount is reducing. This is driving a need to both focus our activities on what will have the greatest impact and consider new ways to resource and deliver Q’s work.

The evaluation findings are helping inform our choices about the best use of available resources. 

• Reviewing our funding programmes: Unfortunately, as we shared in autumn, our funding changes mean a few familiar programmes are not being renewed, such as Q Exchange. I know this is a source of regret for many in the community and our team, especially given the examples of impact in the report. This evaluation reinforces our commitment to enabling opportunities for collaborative action, even if we need to change the way we do this.

• Building on the success of Q Lab: The impact from Q Lab shines through in this evaluation. We will be seeking ways to continue and grow our work in this area. The Q Lab we’re currently developing with Macmillan, is a great example. And so that more of the community will benefit, we are also creating more spaces and events to support people with practical tools, methods and resources to work through different elements of the Lab process. Our next Skills for Collaborative Change and Leading Successful Partnerships events are currently open to book.

• Developing new partnerships and delivering commissioned work: We are committed to keeping membership of the community free for the long term. So to complement funds from our partners, we are delivering commissioned work that aligns with our mission. For example, we are supporting the development of Quality Management Systems in Wales. And with the NHS Confederation, we’re offering organisations cost effective tailored support to transform services and achieve sustainable cross-system improvement.

This is just a flavour of the changes we’re making as we move forward in our second decade, using the many riches of this evaluation. You can read more detail on how we’re responding to the lessons and recommendations from the report. I hope you – our members, partners and friends – will continue to help us learn and adapt as we take our next steps in our journey together.