A quality improvement fellowship programme for Health Education East of England

We worked with Health Education East of England on a programme to build skills and knowledge in improvement science among clinicians. We've run four cohorts of the programme since 2012, supporting the development of 70 quality improvement fellows.

Through this fantastic partnership, our fellows have really developed into improvement and innovation leaders for the health and social care system. [The King’s Fund has] ensured that the content of the fellowship has constantly adapted to offer world-class opportunities both in terms of theory and practice... The impact of this has been fellows who are really hungry to spread their expertise and technical skills with other leaders and managers, and through this they have effected changes both in practice and in behaviours.

Chris Birbeck, Head of Quality and Improvement, Health Education England

Health Education East of England is responsible for NHS workforce education and training across the east of England. As a subcommittee of Health Education England, its aim is to enable the health and care workforce to respond effectively to the needs of patients in the east of England's 5.8 million population.

Part of this responsibility involves increasing the skills and capacity for quality improvement among clinicians and managers at every level of the health care system.

Recognising that quality improvement happens best when led by the people actually delivering care, Health Education East of England wanted to establish a development programme that would build skills and knowledge in improvement science while also increasing the impact of clinician leadership in the east of England.

Whereas previous improvement programmes had been driven by the prospect of cost savings, Health Education East of England wanted to engage and inspire clinicians by shifting the focus to improving quality and outcomes for patients.

Our approach

Health Education East of England’s Medical Education and Quality team asked The King’s Fund to help create an experiential programme of quality improvement, leadership and change to support its newly created role of quality improvement fellow. The programme formed part of a year-long fellowship scheme undertaken by clinicians and managers. The participants had been seconded from their formal roles for half their time, so they could undertake the fellowship.

The commissioning team from Health Education East of England was clear that it didn’t want a traditional academic provider to deliver the programme. Instead, it wanted each participant to be provided with bespoke support.

The King’s Fund worked with Health Education East of England to co-design a flexible programme. The programme has run 4 times since 2012 and for each programme the Fund worked with the specific needs identified by each cohort, calling on the skills of a wide range of expert speakers and improvement and leadership specialists to meet these needs.

Each programme comprised a series of learning modules, coaching and action learning sets (facilitated sessions where small groups of fellows work together to solve real-life problems). The modules included sessions on improvement science, leadership, change, self-development, personal impact, innovations and sustaining and spreading learning. We also arranged external visits so that participants could benefit from examples of improvement learning in other sectors.

Fellows were required to implement their own quality improvement projects over the year, developing and applying their learning from the programme. The Fund’s strong links with the University of Middlesex meant we were able to offer academic accreditation for the programme.

Our impact

Since 2012, The King’s Fund has run four cohorts of the fellowship programme, supporting a total of 70 quality improvement fellows. We have continued to develop the programme each year, taking into account learning from Health Education East of England’s independent evaluation, which has been overwhelmingly positive.

A wide range of clinicians have taken part in the fellowship, including doctors, scientists, allied health care professionals, nurses and midwives. Bringing clinicians from different disciplines together in this way and providing a mix of leadership and quality improvement support has been celebrated as an innovative way of building the capacity to improve patient care. The Health Education East of England quality improvement fellowships were shortlisted in the 2014 national HSJ award for Education and Training in Patient Safety, and the model is now being adopted by Health Education England as the template for the national Health Education England fellowships.

The fellowship is succeeding in its aim to create a community of practice in quality improvement across the east of England. All the fellows supported by the programme have gone on to do something meaningful in the field of quality improvement, often growing and spreading their test quality improvement projects to have a wide reach and impact. Many have been invited to present their work at international conferences. Several fellows have already been promoted to more senior roles, some with a specific remit for promoting quality improvement and for training other staff in this area.