Why we did this project
In recent years, the NHS has placed an increasing emphasis on delivering greater value for patients and citizens – ie, maximising the outcomes the service delivers from the resources it is given. Our recent work on Better value in the NHS highlighted a number of areas in which the NHS has opportunities to improve value in the future, focusing in particular on changes in how clinical services are delivered.
The task of maintaining and improving the standard of clinical care is especially difficult at a time when budgets are constrained. Significant attention has been given to the development of metrics and diagnostic tools to identify the scale of improvement opportunities in the NHS and to developing skills in delivering quality improvement in frontline services. However, there has been relatively little focus on the challenges that face frontline leaders who want to deliver better-value services.
What we did
Building on recent work around productivity, better value, quality improvement and tackling variations in clinical care, we worked to understand the challenges that frontline clinical, operational and managerial leaders encounter in pursuing better-value health care.
Our work had three key aims, to:
- collect and describe a range of different approaches to delivering better value in clinical services
- review common features of successful initiatives
- identify the common problems that arise in implementation and how these can be resolved.
- an analysis of national policy initiatives on improving productivity and promoting quality improvement
- case studies and interviews with providers of health services from across England to understand the range of approaches they are taking to the delivery of better-value services
- analysis of published literature on international good practice on delivering better-value care
- roundtable discussions with providers of health services to better understand their approach to improving value.