This annual report sets out NHS Improving Quality's achievements in our first year. Five major improvement programmes have been designed and developed to enable and provoke large scale change across the NHS. Our work to increase improvement capability and capacity across NHS England and the wider health and care system is starting to take shape and over half of all Clinical Commissioning Groups are engaged in our CCG development programme. The impact of NHS Change Day and the School for Health and Care Radicals in mobilising thousands to deliver positive change has been a major achievement and the completion of many programmes of work started by our predecessor organisations is providing real benefits to the frontline. - See more at: http://www.nhsiq.nhs.uk/resource-search/publications/annual-report-201314.aspx#sthash.YGFIAS9G.dpuf

1. ANNUAL REPORT
2013/14
Improving Quality
NHS

2. FOREWORD ››
ABOUT US ››
PROGRAMME ACHIEVEMENTS ››
3
HORIZONS
NHS Improving Quality: ANNUAL REPORT 2013/14
CAPABILITY & CAPACITY
LIVING LONGER LIVES
LONG TERM CONDITIONS
SEVEN DAY SERVICES & ACUTE CARE
EXPERIENCE OF CARE
PATIENT SAFETY
NATIONAL PEER REVIEW PROGRAMME
CORPORATE DEVELOPMENT, COMMUNICATIONS
& CUSTOMER RELATIONS
Improving Quality
NHS
NHS Improving Quality
Integrated Care Pioneer Sites
Seven Day Services - Early Adopter Sites
Long Term Conditions Year of Care
Commissioning Programme
Clinical Commissioning Groups (CCGs) engaged
with the Transforming Care Programme
Stop the Pressure Events
Transforming End of Life Care in Acute Hospitals
Organisations where more than 300 pledges
were made for NHS Change Day
www.nhsiq.nhs.uk
Places where more than 10 people took part
in The School for Health and Care Radicals
Places where NHS IQ ran a significant
masterclass on transformational/large
scale change
Strategic Clinical Networks working with NHS IQ
to implement the intermittent pneumatic
compression (IPC) sleeves programme
CCGs with over 30% of practices
uploading GRASP-Suite data
Spread of transformation

3. FOREWORD
Richard Jeavons, Interim Managing Director
Five major improvement programmes
have been designed and developed to
enable and provoke large scale change
across the NHS. Our work to increase
improvement capability and capacity
across NHS England and the wider
health and care system is starting to
take shape and over half of all Clinical
Commissioning Groups are engaged in
our CCG development programme.
The impact of NHS Change Day and
the School for Health and Care
Radicals in mobilising thousands to
deliver positive change has been a
major achievement and the completion
of many programmes of work started
by our predecessor organisations is
providing real benefits to the frontline.
These achievements have come against
the backdrop of major internal change:
managing the transfer of over 200
staff from predecessor organisations
and subsequent transition into
permanent roles for the vast majority;
a portfolio review of all the work
carried over from our predecessors;
establishing a mechanism for strategic
investment partnerships with delivery
partners and working through with our
hosts NHS England, the procurement,
governance and financial processes
needed to set up and establish a new
national improvement organisation.
54
NHS Improving Quality: ANNUAL REPORT 2013/14 - FOREWORD
In our first year, NHS Improving Quality has made
significant progress against our objectives.
This annual report sets out NHS
Improving Quality’s achievements in
our first year. These achievements
are testimony to a dedicated and
skilled workforce which most
impressively has risen to the
challenges and uncertainties thrown
at them. I know everyone is gearing
up to make 2014/15 a great year for
NHS Improving Quality and invite
you to discover more about our
work to deliver better outcomes for
patients and the public who use the
health and care system by reading
our business plan for 2014/15.

4. OUR PURPOSE AND STRATEGY
76
NHS Improving Quality: ANNUAL REPORT 2013/14 - ABOUT US
The purpose of NHS IQ is to improve
health outcomes for patients across the
NHS in England by:
• Developing and implementing
improvement programmes to
deliver the NHS Outcomes
Framework
• Building improvement capability
and capacity throughout the
NHS commissioning system
• Supporting improvement
across the wider NHS
ABOUT USNHS Improving Quality (NHS
IQ) was founded on 1 April
2013 through a collaboration
agreement between the
Department of Health and
NHS England. This agreement
recognised the need for a
system wide focus for
improvement to be provided
by establishing an
improvement body within
NHS England.

5. 98
NHS Improving Quality: ANNUAL REPORT 2013/14 - ABOUT US
• Source, deploy and manage a
range of delivery partners from
within the NHS and potentially
social care organisations,
voluntary sector, academic
organisations and the
independent sector.
• Work with the emerging Strategic
Clinical Networks (SCNs) and
Academic Health Science
Networks (AHSNs), at a national
level, to build a framework for
local improvement and
innovation.
• Act as a source of expertise,
research, development and ideas
for change and improvement in
healthcare.
• Link with the NHS Leadership
Academy to build leadership
capability for change.
NHS IQ’s way of working is
significantly different to its
predecessors, reflecting both the post
reform NHS structure and the need to
enable and provoke large scale
change across the NHS. NHS IQ is a
relatively small organisation, compared
to its predecessors, that is fully
aligned to the NHS’s commissioning
priorities, as expressed through the
NHS Outcomes Framework, with
in-house capability to:
• Design and commission
programmes of improvement and
improvement capability linked to
the five domain priorities.
• Build knowledge and capacity for
leading change and improvement
across the NHS, particularly in
NHS England teams and CCGs.
THE DEVELOPMENT OF NHS IQ
The 2013/14 business plan for NHS IQ
focussed on ten improvement
programmes across the five outcome
framework domains, capability
building for NHS England and a
capability building programme for
Clinical Commissioning Groups.
From a starting point of over 500 NHS
employees, just over 200 employees of
five predecessor improvement bodies
(NHS Institute for Innovation and
Improvement, NHS Improvement,
National Cancer Action Team, National
End of Life Care Programme, NHS
Diabetes and Kidney Care) transferred
into NHS England as part of NHS IQ. At
the same time, NHS IQ also took
responsibility for hosting aspects of
two Improving Access to
Psychological Therapies (IAPT)
programmes and NHS Interim
Management and Support (NHS
IMAS).

6. 1110
NHS Improving Quality: ANNUAL REPORT 2013/14 - ABOUT US
team working on thought leadership
and mobilisation for change.
During the latter part of 2013/14 the
National Peer Review Team (formerly
part of the National Cancer Action
Team) and Improving Access to
Psychological Therapies teams were
transferred to the medical directorate
of NHS England. NHS IMAS remains
hosted within NHS IQ and a separate
annual report sets out its
achievements.
The delivery team were subject to a
formal change management and
consultation process which was
completed on 31 March 2014 with the
vast majority of delivery team staff
securing roles elsewhere in the
organisation. As part of this process a
separate Connections team was also
created, to come into existence on
1 April 2014.
Using the allocated administration
funds, three core functions –
improvement programmes,
improvement capability and corporate
were established with a separate
delivery team funded from programme
funds. Recognising that this
arrangement was a pragmatic staging
post to the final intended form of NHS
IQ, the life of the delivery team was
guaranteed until 31 March 2014.
During 2013 both the structure of NHS
IQ and our work programmes were
reviewed to ensure NHS IQ focused on
leading and enabling large scale
change to improve health outcomes.
The ten improvement programmes
were consolidated and a portfolio
review identified how the continuing
work from our predecessor bodies
aligned to these programmes. The
creation of a new Horizons programme
within NHS IQ provided a dedicated
So for the future, NHS IQ is organised
around five interdependent functions:
HORIZONS
• Looking to the future and across
the world to challenge current
NHS thinking about large scale
healthcare improvement and
how it is achieved.
CAPABILITY & CAPACITY
• Building the knowledge and
capacity to lead change and
evidence based improvement
across the NHS.
IMPROVEMENT PROGRAMMES
• Designing and commissioning
programmes of improvement and
capability linked to the five
domain priorities.
CONNECTIONS
• Responding to unexpected
developments and urgent
requirements by connecting with
the NHS and its resources.
CORPORATE & DEVELOPMENT
• Enabling NHS IQ to achieve its
objectives effectively.

7. 12
PROGRAMME
NHS Improving Quality: ANNUAL REPORT 2013/14 - PROGRAMME ACHIEVEMENTS
ACHIEVEMENTSPROGRAMME ACHIEVEMENTS
2013/14
NHS IQ has made significant
progress in the delivery of
its programmes of work
throughout 2013/14 and the
following pages represent
some of the key achievements
and highlights during this
period.
2013/14
13

8. 14
The Horizons programme was
established in summer 2013. Our
messages about ways in which to
deliver and lead large scale change and
transformation have reached every part
of the country and every corner of the
globe. Over the past year, we have
focused our work on three key areas.
HORIZONS
ACHIEVEMENTS
• During 2013/2014 more than
20,000 health and care
leaders heard our messages
in a face-to-face setting,
about large scale change and
transformation, nationally
and internationally
• Over 40 blogs and
publications were completed
during the year. These were
shared extensively, receiving
positive feedback. Our
presentations and slide packs
were downloaded nearly
30,000 times and shared
nationally and internationally
• Our twitter reach from
members of our team and
from the campaigns our
team supported was over
250 million
15
NHS Improving Quality: ANNUAL REPORT 2013/14 - PROGRAMME ACHIEVEMENTS
NHS Change Day took place on the
3 March 2014. Change Day is a
frontline led grassroots social
movement; the largest of its kind, with
a shared purpose of improving health
and care. The mission is to inspire and
mobilise people everywhere, staff,
patients and the public to do
something better together to improve
the quality of care.
This year, NHS Change Day had an
unprecedented impact, using a Pledge,
Share, Do, Inspire approach. The
purpose of Change Day aims to
connect with people to think about
new ways of making change and
innovation and accelerating the spread
and adoption of ideas to improve care
locally through a call to action.
By the end of the campaign we
celebrated over 730,000 pledges from
staff, patients and leaders everywhere.
One quote from a frontline member of
staff stated: ‘I read about Change Day
last year, and was impressed with the
numbers of people who stepped up
their commitment to patient care, to
the NHS and to their colleagues.’
Change Day was the catalyst for a pretty extraordinary experience for me
and the team as our pledge to spread compassion circles put this powerful
practice well and truly on the map.”
“We fully support the NHS Change Day idea because it enables people
to make a very personal promise to improve the way they work.”
“
MOBILISING FOR IMPROVEMENT -
NHS CHANGE DAY
THOUGHT LEADERSHIP, ACTING AS
AN AMBASSADOR FOR NHS IQ
EXTERNALLY AND SUPPORTING
OTHERTEAMSWITHIN NHS IQ
Horizons has provided ideas and
advice to people who are leading large
scale change to stimulate new and
‘disruptive’ approaches in support of
healthcare transformation and enable
them to achieve their improvement
goals.

9. 16
NHS CHANGE DAY ACHIEVEMENTS
• More than 730,000 pledges have been made by individuals and
organisations to improve health and care with the top themes being;
improving patient experience and patient safety
• 82 campaigns launched with the reach of 399,987 pledges of support
for their cause in reaching out to others to join them in making a
difference
• On Change Day itself – 3rd March 2014, there were over 12,000 visits to
the Change Day website www.changeday.nhs.uk
• Over 86 million Twitter impressions. On the day itself Change Day was
trending above high profile media stories
• Over 300 pieces of regional media about Change Day covered a
population of over 16 million people in England.
• Over 22,000 video views on the Change Day YouTube account.
• 300 organisations and charities were contacted across health and social
care to support campaigns, build relationships and make connections
for future work.
• Our radio, online and TV coverage had a combined reach of over 37
million people.
• An engaging and creative stand at NHS Expo, with a theme of ‘Change
Day Street’ which attracted a high number of clinicians, students and
emerging leaders culminating in a Change Day celebration, and over
800 individual pledges. Over 200 frontline staff attended and engaged
with Change Day at the NHS Expo.
17
NHS Improving Quality: ANNUAL REPORT 2013/14 - PROGRAMME ACHIEVEMENTS
The school brings together the exciting
work of NHS Change Day, Horizon’s
and Capability and Capacity
programmes. The overarching aim of
the school is to equip people across
the health and care system with the
core skills to become change agents.
The school worked to ignite people’s
passion in improving services and be
an arm of the grassroots change
movement through Change Day by
providing people with new ways of
thinking about improvement. The
School demonstrated a new way to
provide learning to a huge number of
people in a low cost, high leverage
way.
Thank you for the opportunity to
benefit from such an inspirational
programme and to engage with so
many peers who are clearly
motivated to make change and
improve care.”
“
Clinical Director, The Mary Stevens Hospice
I feel energised and enthused for taking my new knowledge
forward.Thank you for establishing the School.”
“
Head of Medicines Management, Leeds Community Healthcare NHS Trust
THE SCHOOL FOR HEALTH
AND CARE RADICALS

10. SCHOOL FOR HEALTH & CARE RADICALS ACHIEVEMENTS
• Almost 1,500 people enrolled from 40
countries from Europe to Australasia
• Five weekly learning modules were held
live between January and March and
available 24/7 from ‘change starting with
me’ to ‘making change happen’
• A weekly tweet chat using #SHCRchat to
discuss and collaborate upon the
learning’s from each module and share
personal stories and impact
• An average weekly twitter reach of 2.6
million on a national and international
scale
• The opportunity to become a mentor or
mentee, with over 90 volunteer mentors
signing up, connecting people and
building relationships
• Over 25,000 shares of the slides and materials on Slide Share, with
great feedback about the content
• More than 5,000 tweets using #SCHRchat
• A weekly Storify capturing the week’s content was created; with more
than 1,000 viewings
• The use of Pinterest has helped to establish the school’s brand, increase
our audience and drive traffic to our website. The board now has 76
followers
• At the time of going to press, more than 70 people have followed the
learning process through to become “certificated change agents” with
a virtual badge. This number will grow significantly
18 19
NHS Improving Quality: ANNUAL REPORT 2013/14 - PROGRAMME ACHIEVEMENTS
The capability and capacity programme
exists to develop the science,
knowledge and skills infrastructure
that the NHS needs to deliver
improvement and transformational
change.
During this start-up year, work has
focused on building infrastructure,
relationships and support for new parts
of the system such as Commissioning
Support Units (CSUs), Academic Health
Science Networks (AHSNs) and NHS
England. Our role also involves
commissioning research and impact
evaluation to underpin the
improvement programmes.
CAPABILITY & CAPACITY
• Developing a measurement master
class to a brief from Professor Sir
Bruce Keogh that was piloted with
NHS England National Clinical
Directors and their nursing
equivalents. A combination of two
face-to-face events and three
webinars on using measurement for
improvement were delivered by
UK and international experts and
attended by more than 150
delegates.
• Linked to this, in collaboration with
NHS England and the Healthcare
Quality Improvement Partnership,
NHS IQ led the design and delivery
of an event to prepare the NHS for
the publication of consultant-level
outcomes data, and share the
vision for making this an
opportunity to improve patient
outcomes. The event was attended
by more than 150 members of the
clinical leadership community.
GROWING SCIENCE ACHIEVEMENTS
GROWING SCIENCE
THE SCHOOL FOR
HEALTH&CARE
RADICALS
1,470
enrollees
MORE THAN
40ACROSS
COUNTRIES
PROMOTEDTHROUGH AVERAGEWEEKLY
SOCIAL MEDIA TWITTER
REACH
2.6MILLION
10,000+views of the slides on
SlideShare
90VOLUNTEER
MENTORS
1,800+views of the study guides on
SlideShare
5,000+
1,000
TWEETS USING
#SHCRchat
TIMES
STORIFYhas been viewed nearly
60
OVER
PEOPLE HAVE BECOME CERTIFIED CHANGE AGENTS AS PART OF
THE SCHOOL ANDTHIS NUMBER IS EXPECTEDTO INCREASE
Improving Quality
NHSTo find out more about NHS Improving Quality:
www.nhsiq.nhs.uk
@NHSIQ
enquiries@nhsiq.nhs.uk
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The use of research, measurement and
evaluation are fundamental to the way
NHS IQ works, underpinning its ability
to understand and demonstrate the
benefit of its work.

11. 20 21
NHS Improving Quality: ANNUAL REPORT 2013/14 - PROGRAMME ACHIEVEMENTS
Equipping clinicians, educators,
researchers and commissioners with the
tools, knowledge and skills they need to
identify and deliver improvement is our
third major priority.
• Launch of NHS England PDF learning tool on the NHS Change Model.
• Established a partnership between Jönköping County Council, Qulturum,
University of Jönköping, Jönköping Academy for Health and Welfare
Improvement (Sweden), and NHS IQ to share and build global improvement
capability.
• To support transformational change in leaders across the NHS we co-designed
and led a study tour to Jönköping for AHSN and CCG leaders and NHS England
commissioning development team. Funding was made available for five
attendees from CCGs and AHSNs, with organisations funding additional places.
Six organisations joined the tour. As a result NHS England are looking to engage
in a strategic partnership with Jönköping, the AHSNs are sharing their learning
across all AHSNs and the CCGs are embedding their new knowledge in their
work and plan to return next year.
• Established strategic partnerships with the Health Foundation, to develop
sustainable networks that will deliver improvement and transformational
change.
• Designing and delivering a comprehensive range of programmes for
commissioners, CSUs and providers including Leading Transformational Change,
Quality and Service Improvement
• Contributed to the design of the framework for Commissioning
Support Services
• Supporting nine of the 14 Keogh trusts with a diagnostic, and in three,
bespoke support
ACHIEVEMENTSGROWING SKILLS
Leading several projects to help
improve the way the NHS uses,
manages and shares improvement
knowledge and expertise.
• Developing a Knowledge Hub
(Khub) – a modern, informative
website is essential for sharing
knowledge efficiently. Initial
scoping work for Khub is
complete with the specification,
procurement and implementation
phases to follow in 2014/15.
• In partnership with NHS England,
developing a series of NHS IQ
improvement digests to support
Clinical Commissioning Groups
in commissioning high quality
care in line with national
priorities.
• Better Care, Better Values
monthly publication for
commissioners.
ACHIEVEMENTS
GROWING KNOWLEDGE
Matthew Bazeley, deputy
managing director at NHS Central
London CCG described the impact
of support as facilitating an
“acceleration of our change
effort”. He added “the offer and
support were invaluable” and “it
has felt like you’re part of our
project team”.

12. 22 23
NHS Improving Quality: ANNUAL REPORT 2013/14 - PROGRAMME ACHIEVEMENTS
Drawing on the experience and
credibility of NHS IQ’s delivery team in
supporting CCGs, a new practical
support offer was launched in April
2013 to provide CCG leaders and their
local system partners with the tools
and approaches for addressing large
scale challenges. The support offer
features a core programme of up to
seven one-day tailored and practical
workshops, with facilitated action
learning and coaching, to CCG-led
local alliances of system partners. The
programme focusses on locally
determined change priorities and has
been made available to all CCGs
across England.
• By the end of March 2014 over
half of CCGs were underway
or have made a firm
commitment to take-up this
support.
• A purpose built web-based
learning management system
has been launched to support
participants, featuring
programme resources and
e-learning materials.
Through evaluation, CCGs have
told us that they value:
• Our clinically-led approach
• Our use of evidence-based
models and approaches
relevant to the NHS
• The quality of facilitators
drawn from our core team
and faculty of clinicians,
commissioners and
improvement experts
• The focus on supporting the
whole system in realisation of
benefits for patients.
ACHIEVEMENTSCCG TRANSFORMING CARE
PROGRAMME: BUILDING CCG
CAPABILITYTO LEAD
TRANSFORMATIONAL CHANGE OF
THE CARE DELIVERY SYSTEM
This programme exists to reduce the
number of people who die too soon
from illnesses that could have been
prevented or treated.
ACHIEVEMENTS
The team has worked in
collaboration with NHS England
and other partners to identify a
focus on people with serious
mental illness. Estimates
suggest that there would be up
to 12,000 fewer deaths from
CVD each year if people with
serious mental illness had the
same outcomes as the general
population.
At the beginning of 2014, NHS
England, with support from NHS
IQ, has developed a national
CQUIN to support the
identification of physical illness
in people with serious mental
illness.
LIVING LONGER LIVES
CARDIOVASCULAR DISEASE
(CVD) OUTCOMES STRATEGY
NHS HEALTH CHECK PROGRAMME
ACHIEVEMENTS
NHS IQ’s work has focused on
the following areas supported
by the following outcomes:
• NHS IQ has produced material
to support the spread of
innovative better practice
around the promotion and
uptake of NHS Health Checks
and the transfer to intervention
for those having passed
through the NHS Health Check
programme. The work was
specifically focused on the
seldom seen and seldom heard
groups.
Outcome: Six case studies
have been produced to date
and placed on the national
NHS Health Checks website.

13. ACHIEVEMENTS
GRASP-AF - (Guidance on Risk Assessment and Stroke Prevention for Atrial
Fibrillation) is a simple but effective audit tool to help GPs improve the
management of stroke risk in Atrial Fibrillation (AF). The GRASP-AF tool is
now being actively used by 2,591 practices in 157 CCGs across the country -
an 8% increase from April 2013 to 2014.
In the last three years the number of GP practices using the toolkit has risen
from around 300 to over 2,600. Nearly 330,000 patients with AF are now
managed by practices using the GRASP-AF toolkit. In the practices using
GRASP, the use of oral anticoagulation in those at high risk of stroke has
risen by an average of 4.6%, which is estimated to have prevented around
360 strokes per year and saved over £4.2 million per year in acute stroke
care.
An economic analysis of cost-effectiveness of the management of AF in
primary prevention of stroke commissioned by NHS IQ in 2013-14 suggests
that the annual net saving to the NHS in England from averted strokes in
AF associated with current prescribing patterns is estimated at £148 million.
If anticoagulants were prescribed for people with AF in accordance with
European Society of Cardiology guidelines we estimate that there would be a
further net saving to the NHS of £71 million a year. The economic analysis is
due to be published in 2014.
IMPROVE CLINICAL ENGAGEMENT
IN THE BIG KILLERS
24 25
NHS Improving Quality: ANNUAL REPORT 2013/14 - PROGRAMME ACHIEVEMENTS
ACHIEVEMENTS
• NHS IQ have produced material
addressing issues around the
delivery of NHS Health Checks
to people in prison.
Outcome: NHS IQ have produced
four case studies on prisons and
a final prison report which are
available on the NHS Health
Checks website.
• NHS IQ have worked with the
national NHS Health Check
programme to support the
Share, Listen, Act conference in
February 2014.
Outcome: The conference had
431 delegated attend including
stakeholders from Local
Authorities, private sector, third
sector and other public sector
bodies. 96% of attendees rated
the conference as excellent. NHS
IQ ran two workshops which were
rated good/excellent by 86% and
91% of attendees respectively
Thank you for producing this
hugely informative report
and case studies.This is
incredibly useful and NHS IQ
and contributors are offered
our thanks and
congratulations for your
support on a highly
important subject.”
“
Jamie Waterall, NHS Health
Check National Lead, Public
Health England

14. ACHIEVEMENTS
Improve public awareness
and early diagnosis -
Through 2013/14 the NHS IQ
Living Longer Lives team has
been supporting the award
winning ‘Be Clear on Cancer’
programme working closely
with partners in the
Department of Health, Public
Health England, Cancer
Research UK and NHS
England. We have seen
increased public awareness
of cough/hoarseness as a
symptom of lung cancer
from 41% to 50%, plus an
increase of 30% in the
number of urgent referrals
for suspected lung cancer.
I am delighted that results suggest that
hundreds of patients received
potentially life-saving surgery following
the first national campaign for lung
cancer. Be Clear on Cancer, alongside
continued work to improve access to
diagnostics and treatments, is helping
to move things in the right direction for
lung cancer.”
“
Sean Duffy, National Clinical Director
for Cancer at NHS England
26 27
NHS Improving Quality: ANNUAL REPORT 2013/14 - PROGRAMME ACHIEVEMENTS
ACHIEVEMENTS
IPC sleeves - The Living Longer Lives
team at NHS IQ has secured £1million
to ‘pump-prime’ the widespread
adoption of intermittent pneumatic
compression (IPC) sleeves by all stroke
units in England as part of a major
national programme to improve
outcomes for stroke patients. Stroke
patients have a high risk of
developing Deep Vein Thrombosis
(DVT), but the recent ‘CLOTS 3’ study
showed that the use of IPC sleeves led
to around a 30% relative reduction in
DVT and an improvement in overall
survival to six months.
NHS IQ’s programme, which is being
championed by the National Clinical
Director for Stroke at NHS England,
will contribute towards meeting the
Government's ambition to prevent
avoidable mortality by saving an
estimated 800-1000 lives per annum.

15. NHS Improving Quality: ANNUAL REPORT 2013/14 - PROGRAMME ACHIEVEMENTS
28
NHS Improving Quality’s ‘Long Term
Conditions and Integrated Care’
improvement programme has
developed learning and resources for
improvement and change, to ensure
consistent high quality care
throughout the individual’s journey,
regardless of condition.
ACHIEVEMENTS
• Sites across the country were
invited to bid to become 'pioneers'
of integrated care and support,
working to transform the way
health and care is being delivered
to patients. Norman Lamb,
Minister of State for Health and
Care, announced the 14 successful
pioneer areas on 1 November
2013, and attended the
programme’s formal launch,
organised by NHS Improving
Quality, on 3 December.
• Since then, the pioneers have been
working to transform the way
health and care is being delivered
to patients. They are showcasing
innovative ways of creating and
spreading change across health
and social care, drawing on
expertise from a range of national
partners and other organisations,
including NHS Improving Quality’s
Integrated Care and Support
programme team.
29
INTEGRATED CARE AND
SUPPORT PIONEERS
LONG TERM CONDITIONS
& INTEGRATED CARE
ACHIEVEMENTS
• NHS Improving Quality has
joined forces with a number
of national partners from
across health and local
government to launch the
National Collaboration for
Integrated Care and Support.
The Collaboration aims to
make health and social care
services work together to
provide better, more person-
centred support at home and
earlier treatment in the
community to prevent people
losing their independence or
needing unplanned hospital
care.
ELECTRONIC PALLIATIVE CARE
COORDINATION SYSTEMS (EPaCCS)
ACHIEVEMENTS
• Providing a shared locality
record for health and care
staff, EPaCCS allow rapid
access across care
boundaries to key
information about a
person approaching their
end of life, including their
expressed preferences for
future care. From a
starting point of 15% in
2012, now over 30% of
CCGs have a ‘live’ EPaCCS.
If current predictions are
realised we will deliver the
ambition of 70% rollout
across England for EPaCCS
by 2015.

16. NHS Improving Quality: ANNUAL REPORT 2013/14 - PROGRAMME ACHIEVEMENTS
30
ACHIEVEMENTS
The Long Term Conditions Year of Care (LTC YoC) commissioning model
programme has the potential to change the payment system for up to
20-25% of the total health and social care budget in England and better
incentivise providers to improve the efficiency and effectiveness of
services for patients.
• Improved relationships in local areas to support this way of working
• Supporting Early Implementer teams to plan the link between current
integrated care services and new funding systems, to enable shadow
testing in 2014/15
• Recovery, rehabilitation and reablement (RRR) clinical audit and step-
by-step guide to provide the evidence to support changes in early
discharge from acute care
• Whole population analysis and mapping of activity and financial
information flows to support development of a draft national LTC
YoC commissioning framework
• Initial estimates completed for the local tariff that a health economy
might assign to a Year of Care currency
31
LONG TERM CONDITIONSYEAR OF CARE
COMMISSIONING PROGRAMME
TRANSFORMING END OF LIFE
CARE IN ACUTE HOSPITALS
ACHIEVEMENTS
• We have provided a number
of networking events across
the country, as well as a
supported partnership end of
life care education and
training programme ‘Train
the Trainers’. Over 40 new
sites having come on board
since 2013.
MENTAL HEALTH AND
DEMENTIA
ACHIEVEMENTS
• We have provided support to
investigate dementia
diagnosis and post diagnostic
support services, and to
identify if there are any
common factors influencing
diagnosis rates.

17. 32 33
NHS Improving Quality: ANNUAL REPORT 2013/14 - PROGRAMME ACHIEVEMENTS
NHS IQ received 70 expressions of
interest from across England and
selected 13 sites.
Following site visits by an NHS IQ
multidisciplinary team with members
of the Forum of NHS England, local
programmes have now been launched.
Average GI bleeding mortality rate
is reduced by 10% by having access
to 24/7 endoscopy, interventional
radiology and surgery working
together as a multidisciplinary
team.”
“
SEVEN DAY EARLY ADOPTER
COMMUNITIES
SEVEN DAY SERVICES
TRANSFORMATIONAL
IMPROVEMENT PROGRAMME
(SDSIP)
Sir Bruce Keogh officially launched the
SDSIP on Saturday 16 November 2013
in Birmingham. The event which was
supported by NHS IQ, was well
received with over 350 delegates
attending from across the health and
care economy.
SEVEN DAY SERVICES
& ACUTE CARE
SEVEN DAY DIAGNOSTIC SERVICES
Endoscopy services
NHS IQ in conjunction with the British
Society for Gastroenterology (BSG)
have developed ‘The Productive
Endoscopy Unit Toolkit’, a resource
that will support all endoscopy services
to work towards a seven day service,
increase productivity, improve safety
and support earlier diagnosis.
Healthcare science services
NHS IQ conducted an online survey of
365 healthcare scientists across
England in 2013.
Key findings included:
• Majority of staff believe they should
offer services seven days a week
• Less than 50% of departments consult
with service users regarding the need
for services seven day a week
• 50% of services had expanded
services across seven days, using
predominantly on-call systems for
specific diagnostic tests rather than
whole department service provision
Erika Denton, National Clinical Director
for Diagnostics
DISSEMINATION OF LEARNING AND
SHARING GOOD PRACTICE
ACHIEVEMENTS
• Following the launch of the
programme (December – March) the
NHS IQ dedicated seven day services
website has had over 6,198 views
and the Acute Care pages where
models such as ‘Enhanced Recovery
Seven Days a Week’ are sited
received 4,237 views during this
time period. The enhanced recovery
work has been endorsed by Royal
Colleges and can be found at:
www.nhsiq.uk/enhancedrecovery.
• An active Twitter feed
(#7Dayservices) has had a reach of
over 70,000. Social media ‘Storify’s’
have also been produced.
Healthcare science services
NHS IQ conducted an online survey of
365 healthcare scientists across
England in 2013.

18. 34 35
NHS Improving Quality: ANNUAL REPORT 2013/14 - PROGRAMME ACHIEVEMENTS
ACHIEVEMENTS
• Since November 2013 over 800
copies of NHS IQ NHS services – open
seven days a week: every day counts
publication has been disseminated
across the country. It is one of
NHS IQ’s most in demand
publications and is on its third
re-print. It is available on the seven
day services website pages where
the publication has received over
6,447 views. www.nhsiq.nhs.uk
ACUTE CARE
The CYP transition to adult services
work stream is one of the six national
priorities for the National Clinical
Director (NCD) CYP and Transition and
is, therefore, endorsed and part of the
overall strategy for NHS England.
CHILDREN &YOUNG PEOPLE (CYP)
&TRANSITIONTO ADULT SERVICES
NHS Improving Quality has been
supporting NHS England in
developing this work programme
through bespoke task and finish
scoping work.
REHABILITATION
ACHIEVEMENTS
• Critical elements of an
effective transition model
have been defined
• An expert clinical group
has been established.
A review of a service
specification has been
undertaken and 90%
completed to ensure the
needs of this group are
identified.
The work of the Experience of Care
(EoC) team during 2013-14 has been
behind the scenes, supportive of other
programmes, operational in nature
and about design and development.
During 2014-15 the dedicated and
transformational work programmes
of the team will be brought to life.
Bespoke pieces of work that were
led by the team include:
• Loss in pregnancy report - The EoC
team led a project to extensively
research and review the known good
practice and shortcomings in service
provision.
• Commitment for Carers - As part
of the refresh of the National Carers
strategy, the EoC team co-ordinated,
organised and managed a four-week
long national participation exercise
that attracted in excess of 300
responses to inform a suite of
commitments and a national report.
EXPERIENCE OF CARE
• Supporting strategic clinical
networks (SCN) - The EoC team
provided leadership and
co-ordination for a number of
engagement activities with the SCN
staff, National Clinical Directors,
charitable and voluntary
organisations and patient and carer
leaders to support a coordinated
approach to addressing national
priorities during the transition year
2013-14
• Enhanced recovery - The EoC team
conducted a number of interviews to
gather patient stories to strengthen
the patient voice and promote the
Enhanced Recovery programme and
to bring to life the Enhanced
Recovery publication.

19. Driven by NHS reforms, the NHS
Outcomes Framework and grounded
in recommendations from Professor
Don Berwick (Berwick Report, August
2013), the NHS Improving Quality
Patient Safety Team have been
engaged in extensive ‘listening and
learning’ activities with people across
the health and care system on what
matters to them on improving patient
safety in England. The aim is to deliver
a large scale improvement programme
to create one of the safest healthcare
systems in the world.
DELIVERINGTHE PATIENT SAFETY
IMPROVEMENT PROGRAMME
PATIENT SAFETY
ACHIEVEMENTS
• NHS IQ has been working
with NHS England and other
partners to create a national
network of patient safety
collaboratives, where the
creation of local learning
systems focuses on the
continual improvement and
delivery of safer care, based
on local priorities. Following
approval at the NHS IQ
Programme Board in October
the Patient Safety
Collaborative proposal has
been approved by the NHS
England Board on 24 January.
A design event has taken
place with key stakeholders to
inform the programme
design.
ACHIEVEMENTS
• The NHS IQ patient safety team
have continued to work with
the Virtual College to offer a
suite of five e-learning
modules, to support healthcare
professionals in ensuring
diabetes is treated safely.
During 2013/14, NHS IQ has
continued to support the
development of new modules
and to work with Virtual
College and NHS England to
promote the modules across
the NHS. Over 200,000 health
professionals have registered to
complete one or more modules.
• NHS IQ, in partnership with the
University of Lincoln and NHS
England (Midlands and East)
have delivered a student nurse
conference on preventing
pressure ulcers with an
associated social media reach of
320,000.
36 37
NHS Improving Quality: ANNUAL REPORT 2013/14 - PROGRAMME ACHIEVEMENTS

20. CASE STUDY
38 39
NHS Improving Quality: ANNUAL REPORT 2013/14 - PROGRAMME ACHIEVEMENTS
The partnership ran an innovative whole university student nurse conference on
preventing pressure ulcers. Aimed at eliminating unnecessary suffering and
reducing significant costs to the healthcare system, this idea started with a
single tweet between a first year student nurse and a Chief Nurse (Midlands &
East). Held in October 2013, the conference aimed to educate, motivate and
inspire the new generation of nurses in acting to prevent avoidable pressure
ulcers.
Adopting social and other media, active publicity and a planned communication
strategy we succeeded in spreading the learning widely.
• #stopthepressurelincoln reached approximately 320,000 individuals on Twitter,
secured around 2 million timeline deliveries
• A grass roots movement developed as a result encouraging other similar
events across England. These were linked to Stop the Pressure
www.stopthepressure.com national campaign (originating in Midlands &
East), and NHS Change Day 2014 www.changeday.nhs.uk
A PARTNERSHIP BETWEEN THE NHS IQ PATIENT SAFETY TEAM, UNIVERSITY
OF LINCOLN AND NHS ENGLAND (MIDLANDS AND EAST)
Awards
• Stop the pressure-Lincoln - shortlisted for the Student Nursing Times
‘Partnership of the Year award’ – award on 1st May 2014
• Abstract accepted and poster being presented at the Quality & Safety Forum
in Paris in May 2014

21. 40 41
NHS Improving Quality: ANNUAL REPORT 2013/14 - PROGRAMME ACHIEVEMENTS
During 2013/14 the Peer Review
Programme was hosted by NHS IQ
prior to a transfer to the NHS England
Medical Directorate on 1 March 2014
under the leadership of the Clinical
Director for Specialised Services, James
Palmer.
While the programme has continued
to focus on the quality assurance of
cancer, the programme also took on
reviewing paediatric diabetes services
and major trauma centres.
During 2013/14 the programme has
continued to deliver this important
work, which was cited in both the
Frances and Keogh overview reports.
NATIONAL PEER REVIEW
PROGRAMME
This is due in no small part to the
commitment and support of front line
clinicians (1,305 reviewers) and
Patients and Carers (373 Reviewers)
giving their time to the programme.
It has been agreed that the
programme will be an accredited
accreditor for the Care Quality
Commission (CQC). Information from
the Peer Review programme is already
shared with CQC and used as part of
CQC intelligence and on their
inspection visits.
Programme
Cancer
Paediatric
Diabetes
Major Trauma
Review cycle
dates
April 2013 -
March 2014
October 2013 -
September 2014
November 2013
- April 2014
Cycle type
Targeted visit
programme
Comprehensive
visits to all
services
Comprehensive
visits to all
services
No. planned
visits to clinical
services
293
131
26
Visits completed
to clinical
services
291
60
22

22. 42 43
NHS Improving Quality: ANNUAL REPORT 2013/14 - PROGRAMME ACHIEVEMENTS
CORPORATE DEVELOPMENT,
COMMUNICATIONS & CUSTOMER
RELATIONS
CORPORATE
ACHIEVEMENTS
• Implementation of an estates strategy has realised savings of over
£1million. Cost of the overall estate (including sites inherited from
predecessor organisations) have been reduced from £1.67 million
(2013/14 costs) to approximately £600k (2014/15 costs).
• Managed the HR transition process into the new NHS IQ structures.
The programme was managed in accordance with NHS England
Organisational Change Policy, to deadline and minimising redundancies.
• Produced a detailed proposal to accelerate progress towards setting up
strategic investment partnerships with AHSNs and we are continuing to
work with NHS England and the NHS Business Services Authority to
identify the fastest and most effective solution to meet the needs of the
NHS improvement agenda.
• Worked with NHS England governance leads for finance and
procurement, legal and governance issues, intellectual property and HR
in order to develop further the NHS IQ governance arrangements as the
commissioner of improvement activity within the NHS England hosting
context.
• Work has been completed on the review of the commercial activity
portfolio that was inherited from the NHS IQ predecessors.
ACHIEVEMENTS
• A comprehensive return on
investment system
(Commissioning and Delivery
System) has been
implemented which
incorporates PMO and
reporting functionality in
order to automate
programme highlight
reporting.
• A review of inherited legacy
body intellectual property has
been completed and action
taken to register previously
unregistered IP.
CUSTOMER RELATIONS
ACHIEVEMENTS
• Since April 2013, NHS IQ has
presented at and/or had a
stand presence at around 100
health or social care events.
• The customer relations team
have received and dealt with
nearly 3,000 enquiries via our
website, enquiries email
address and phone line.
• To help NHS IQ identify future
programmes and models of
work we have carried out a
stakeholder survey in
September (sent to 900
recipients) to help identify
what had worked previously
with the former national
improvement organisations,
what should continue and what
can be improved upon. Of
those who responded over
79.6% had heard of NHS IQ.

23. 44 45
NHS Improving Quality: ANNUAL REPORT 2013/14 - PROGRAMME ACHIEVEMENTS
Statement
Access to best national and international
practice in leading improvement
Access to practical tools and resources to help
you deliver improvement in your organisation
Building change and improvement expertise for
the NHS workforce
Leading large scale change
Working as an implementation site with an
expert service improvement team e.g. seven
day services pilot site or integrated care
pioneer site
Question: To what extent would you be interested in NHS IQ supporting
and/or developing the following areas of work with you?
% interested or
very interested
93.1%
88.3%
78.6%
67%
56.3%
COMMUNICATIONS
ACHIEVEMENTS
• A digital programme was
implemented to consolidate 62
legacy websites and tools and
streamline NHS IQ’s digital
approach. The programme is
expected to realise savings of
over £1 million.
• Web statistics for 2013/14 have
increased significantly over the
year (from 13,000 in July 2013 to
72,000 in March 2014). In
addition, presence on social
media has continued to increase
month on month. As at 31 March
2014, NHS Improving Quality had
nearly 9,000 followers on Twitter,
with a Twitter Klout Score1
consistently above 50, and more
than 1,000 followers on LinkedIn.
• An internal communications plan
has been developed and is now
being implemented.
1
A Klout Score is a number between 1-100 that
represents our online social influence
100,000
90,000
80,000
70,000
60,000
50,000
40,000
30,000
20,000
10,000
0
JUL 13 AUG13 SEP13 OCT13 NOV13 DEC13 JAN14 FEB14MAR 14
Unique website page views
Unique website visitors
Views of SlideShare content
NHS IQ MONTHLY WEB STATISTICS 2013/14

24. 46
ACHIEVEMENTS
• The communications team has responded to 30 Freedom of Information
requests.
• An external monthly e-newsletter has been developed and is distributed
to our partner organisations and stakeholder groups. The newsletter was
forwarded over 800 times.
• New publications and information leaflets continue to be developed to
support key programmes of work. For example, so far we have
supported: seven day services, end of life care, diagnostics, enhanced
recovery, experience of care and productive endoscopy.
• There is continued communications support provided to programmes,
most recently focusing on NHS Change Day, seven day services,
integrated care, safety and improving capability.
• Growing the profile of service improvement and transformation through
a series of national events, national key note speaker and conference
chairing opportunities, publications and reports.

25. @NHSIQ
www.nhsiq.nhs.uk
To find out more about NHS Improving Quality:
enquiries@nhsiq.nhs.uk
Improving Quality
NHS
Published by: NHS Improving Quality
Publication date: April 2014 - Review date: April 2015
© NHS Improving Quality (2014). All rights reserved. Please note that this
product or material must not be used for the purposes of financial or
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materials to any person.