Improving NHS culture: learning and innovation

The fourth cultural characteristic fundamental to the delivery of continually improving, high-quality care is encouraging learning and innovation.

Sustaining cultures of high-quality care involves all staff focusing on continual learning and improvement of patient care. Learning and quality improvement are dependent on continual patient input – innovation is most likely where patients’ views and feedback play a strong role.

A focus on improvement should ensure that:

  • teams at all levels collectively take time to review and improve their performance
  • quality and patient safety practices are an ongoing priority for all
  • there are high levels of dialogue, debate and discussion across the organisation to achieve shared understanding about quality problems and solutions.

All staff should encourage, welcome and explore feedback and treat complaints and errors as opportunities for learning across the system rather than as a prompt for blame. This encourages collective openness to and learning from errors, near misses and incidents.

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The Mayo Clinic model of care

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Stephen J Swenson
The Mayo Clinic's Stephen J Swensen talks about delivering high-quality, compassionate medical care in a multispecialty, integrated academic institution. 

Perspectives on medical engagement

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Gill Gaskin
Our interviews showcase the work of a number of organisations in England that have created cultures in which doctors are engaged in the management, leadership and improvement of services.

How can organisations support patients to lead quality improvement?

Jocelyn Cornwell

Jocelyn Cornwell speaks about the benefits of involving patients in leadership.

Essential reading

Staff engagement


Staff engagement publication
Give staff the tools to lead service transformation: one of the six building blocks for harnessing the creativity and enthusiasm of NHS staff.

Virginia Mason Medical Center
The experience of the Virginia Mason Medical Center, in Seattle, United States, shows how improvement can be achieved from within.

From the blog

Improving care: what can leaders do?


In organisations like hospitals, many of the answers are found among staff rather than in the executive offices and boardrooms, says Chris Ham.


Experience-based co-design toolkit
This toolkit outlines a powerful and proven way of improving patients' experience. As well as step-by-step guidance, the toolkit showcases the experiences of people who have taken part in EBCD projects