Accelerating Improvements with NHS Wales

Accelerating

Improvements with NHS Wales

Annual Report 2022/23

improvement.cymru

Contents

1 A Message from our Director 3 The Year that Was

5 System Level Improvements

Safe Care Partnership

7 Targeted Safety Improvements

Real Time Demand Capacity, Maternity and Neonatal Safety, Wales Cancer Network

11 Mental Health Improvements

Dementia, Outcome Measures

13 Learning Disability Improvements

15 Bespoke Support for Improvement

Intensive Support, Duty of Quality, Quality Management System Support

17 Capacity Building

Improvement Cymru Academy, Education Programme for Patients, Q Lab Cymru

21 Other Highlights

National Conference, Podcast, NHS Wales Awards

23 Looking Ahead

Key Opportunities, Ways of Working

and Reporting, NHS Wales Executive

Welcome to our first ever Improvement Cymru Annual

Report. This past year has been the busiest and most rewarding year of our Improvement Cymru journey to date.

Dr. John Boulton

A Message from our

Director

“

We have had the privilege of working with many passionate and talented NHS Wales colleagues and partners to support a united, integrated, system level approach to accelerate improvements to reduce preventable harm across NHS Wales. I’m very proud of what we are achieving

together, this is why we have decided to publish this report, to share these achievements widely, to ignite further opportunities for joined-up partnership working for improvement.

This coming year offers significant opportunities for us to further scale and enhance our partnerships as Improvement Cymru gradually transitions into the new NHS Wales Executive by April 2024. We will join our colleagues from the NHS Wales Collaborative, Delivery Unit and Finance Delivery Unit to work collaboratively to support the wider NHS Wales system. During this transition we will remain focused on delivering our Achieving Quality and Safety Improvement 2021-2026 strategy to support

the creation of the best quality health and care system for Wales so that everyone has access to safe, effective and efficient care in the right place and at the right time.

I would like to personally thank each and every member of the Improvement Cymru team and the wider NHS Wales Improvement community for your relentless hard work, passion and commitment to improvement.

Thank you.

”

2

The Year that Was

The breadth and depth of Improvement Cymru’s work has increased over the last 12 months to support health boards and trusts to deliver safe, effective and reliable care in the right place and at the right time. There has been a balance between responding to urgent need and laying the foundations for longer term fundamental change.

Nurturing Partnerships

Our focus has been to work in partnership with NHS Wales organisations to provide

cross-system oversight and support to build the conditions, capability and

systems to enable improvement to flourish.

Laying Foundations

We have created a year of learning for the national team and for the local teams involved in improvement work, supported

by external expertise, which will lead to a sustainable approach both

nationally and locally.

Representing Wales

NHS Wales is recognised as a key contributor to the wider UK and

international improvement and patient safety work, and several partnerships formed this year

have contributed to this.

Supporting Leaders

National improvement and patient safety coaching has focused on enabling leaders

to create a culture of continuous learning and improvement through a system-

wide approach to improvement and patient safety.

Strengthening Support

Our support has broadened to encompass the social side of change (social structures, psychological safety, staff wellbeing) as well as the more traditional technical side

of change (infrastructure, training, tools) to enable organisations to foster a sustainable culture of improvement

and patient safety.

4

improvement.cymru

System Level Improvements

Safe Care Partnership

This year Improvement Cymru, the Institute for Healthcare Improvement (IHI) and NHS Wales health boards and trusts have joined together to create the Safe Care Partnership.

Improvement Cymru initiated the partnership to accelerate the pace and scale of improvements in patient safety on a national scale by drawing together international expertise, national support and local knowledge. Health boards and trusts are coached and supported by Improvement Cymru and IHI to improve the quality and safety of care across their systems.

The IHI Publication Framework for Safe, Effective and Reliable Care is the evidence-based roadmap shaping the partnership.

Progress this Year

To date we have:

delivered

2 learning sessions (3 to go)

established 4 workstreams undertaken 8 coaching

calls (24 to go) visited 10 sites with

local teams

congratulated 23

Leading Patient Safety graduates

trained 39 coaches

identified 41 improvement projects welcomed

300 members

(and growing)

Spring 2022

Leading for Patient Safety

Over 40 senior clinical leads from across all health boards and trusts took part in a five- month development programme focusing on their role as leaders of patient safety. The network created from this programme now directly sponsors patient safety improvement projects in the Safe Care Collaborative, building a sustainable infrastructure of patient safety leadership support within organisations and across Wales.

Summer 2022

Foundational Site Visits

Two-day visits provided an opportunity for Improvement Cymru and IHI to spend time with staff, teams and departments across each organisation to learn about the realities, opportunities and challenges of delivering and sustaining safe and reliable health care.

Summary reports highlighted good practice, alongside challenges and opportunities for further improvements. These have informed local quality strategies and improvement focus.

Autumn 2022

Coaching for Patient Safety

Over 45 delegates took part in the four-month development programme, building improvement coaching skills focused on the Framework for Safe, Effective and Reliable Care. The network created from this programme now directly coaches patient safety improvement projects in the Safe Care Collaborative, building a sustainable infrastructure of patient safety coaching support within organisations and across Wales.

Winter 2022/23

Safe Care Collaborative Launch

The collaborative brings together teams, coaches and senior leaders for safety from the health boards and trusts in Wales to focus on common safety priorities spanning four workstream themes: leadership, community care, ambulatory care, and acute care. Members of the collaborative workstreams receive

support from Improvement Cymru and IHI, and access a series of learning sessions, coaching and networking with the other member organisations to learn together to collectively achieve the safe care priorities.

Moving into 2023/24

Safe Care Partnership Next Steps

The Safe Care Partnership will focus on sustainability and leave a legacy of ongoing collaboration and learning between health boards and trusts which will continue after the

partnership with Improvement Cymru and IHI.

Over the next year the collaborative will take partners and teams on a journey to accelerate improvement projects to contribute towards realising a better NHS Wales, for staff and patients.

This will be informed by ongoing independent evaluation work to learn and iterate based on data and insight as the partnership evolves.

6

improvement.cymru

Targeted Safety Improvements

Real Time Demand Capacity

To support hospitals to reduce length of stay in hours to create flow and build situational awareness, Improvement Cymru procured training and coaching from the originators of the Real Time Demand Capacity (RTDC) methodology – RTDC Advisers.

This approach trains and coaches staff about leadership at all levels of an organisation.

It is about creating a behaviour change at ward level, middle management and executive leadership levels about the system response required to reduce length of stay in hours and improve patient flow.

We initiated pilots with hospitals that had the full support of their chief executives and executive directors responsible for patient flow. Initial training took place in 2022, but the implementation of a bed-based improvement methodology during a period of winter pressures, alongside pressures caused by the pandemic and industrial activity has been extremely challenging for organisations.

However, through RTDC, pilot sites are using data to understand issues and have

improved situational awareness with their system. Pareto charts highlighting the reasons patients have not been discharged before 2pm as predicted by the ward staff, have highlighted issues of clinical decision making and senior review. There are

potentially numerous causes behind this and will be considered as pilot hospitals are supported to implement RTDC methodology in the coming months.

Maternity and Neonatal Safety Support Programme

In the summer of 2022, Welsh Government formally requested Improvement Cymru undertake a national Discovery phase for a new NHS Wales Maternity and Neonatal Safety Support Programme (MatNeoSSP).

The purpose of MatNeoSSP is to ensure there are clear and consistent improved approaches to maternity and neonatal safety within all services in Wales. The scope of this work has been to consider patient safety from the point of first booking of a pregnant person, through their antenatal care, giving birth, postnatal care and the provision of neonatal care for their baby (if required).

To deliver the programme, a team of 14

MatNeoSSP Local Champions were embedded within the Welsh Ambulance Services Trust and each health board in Wales, working in partnership with multi-disciplinary colleagues within each service. Four MatNeoSSP leads (national and clinical) undertook wide engagement with professional colleagues and other agencies/

projects active across maternity and neonatal services to understand the range of interests across NHS Wales.

The MatNeoSSP Discovery Phase used a three- step methodology comprising use of the Framework for Safe, Reliable and Effective Care as stage one, data collection and analysis in stage two and a site visit to each health board and WAST as a final step to enable triangulation of other findings and to enhance understanding of local context.

This work was conducted intensively over a three- month period, commencing in November 2022 and concluding with the final site visit in February 2023.

Many hundreds of conversations with colleagues working in maternity and neonatal services throughout NHS Wales, analysis of thousands of individual data entries and 350 hours of combined site visit time combined to create a rich picture of how services are being delivered. Bright spots of excellent existing practice have been identified, along with an understanding of the challenges being faced and what opportunities exist to share learning more widely across Wales. Work is ongoing to draft a report which will summarise the findings of the MatNeoSSP Discovery and will make recommendations for an improvement- focussed Phase two of this important work.

improvement.cymru

8

Wales Cancer

Network

The Wales Cancer Network commissioned

Improvement Cymru for 2022-2023 and 2023-2024 to support three multi-disciplinary teams (MDTs) to test and work through opportunities to improve the coordination and management of the early part of the patient pathway. Three MDTs, in Hywel Dda University Health Board, Cwm Taf Morgannwg University Health Board and Aneurin Bevan University Health Board, were identified to pilot the approach, which includes

a partnership with Toyota and additional clinical lead support.

The aim is that by learning with Toyota, teams will recognise ways in which they can organise their work more efficiently, using a Lean approach. The training was tailored for members of staff from different teams such as medical records, outpatients, radiology, pathology and endoscopy. Site visits by Toyota have taken place and training at the Toyota Management Centre took place in March. Improvement Cymru will be working with the teams and their local QI Hubs to support and coach work on testing changes.

As the work evolves, teams will be supported to recognise the benefits offered by Lean methodology.

However, depending upon the problems in their pathway, teams will be encouraged to think about the most appropriate improvement science approach to tackle issues. Improvement Cymru will coach teams to measure and quantify the impact of any tests of change as they start to apply learning from April 2023.

Improvement Cymru has been working in partnership with the Wales Cancer Network to improve the time in the cancer pathway from the point of suspicion to a date of diagnosis or not by day 28 in the cancer pathway. The aim of the work is to increase the pace and reliability of the early diagnostic phase of the pathway.

improvement.cymru

10

Mental Health Improvements

Dementia

The work of Improvement Cymru offers a framework and collaborative approach with all partners to realise a vision for dementia care nationally and regionally. In particular, this programme supports the Welsh regions in readiness and implementation of the Dementia Pathway of Standards that align to the Dementia Action Plan for Wales.

All regions have engaged in the development of the standards and Improvement Cymru’s delivery framework approach, with extensive collaboration and coaching with each region and via national workstreams. Resources have been scoped and co-produced to support key areas of work such as hospital-specific self- assessment tools, movement and mobility campaign, memory assessment guides for assessment and diagnosis.

Regional infrastructure and plans are in place, with measurement and outcomes defined by the regional and national workstreams to support evidence in achieving the standards, service user satisfaction, workforce enhanced learning and

development, and regional quality improvement projects. The programme will continue through 2023/24, supporting regions to build on their progress.

Outcome Measures

The Together for Mental Health (T4MH) delivery plan 2012 stated that outcomes should be recorded from a ‘service user lens’. Initial work began some years ago but was suspended to enable systems to be put in place to support the use of outcome measures and collect meaningful data.

To move this work forward, funding was provided to pilot mechanisms for embedding agreed PROMS and PREMS. This is supported by a faculty of experts including those with lived experience, health boards, social care, third sector and professional bodies.

Using the Improvement Cymru delivery framework, work began with pilot sites across Wales in Local Primary Mental Health Support Services, Adult and Older Adult Community Mental Health Teams, Child and Adolescent Mental Health Services, Adult and Older Adult Acute Inpatient Wards, and Low and Medium Secure Units. Iterative tests of change were undertaken with pilot sites with the learning gathered providing information on how to spread and scale the work and further develop a theory of change. From this outcome measures training was developed and launched.

So far outcome measures training has been undertaken by at least one staff member of:

78%

teams in Wales

88%

services

100%

of children’s mental health

and learning disability

services The feedback for the training has been

overwhelmingly positive. Going forward, an update on the project will be provided to health board senior management teams together with an invitation for those teams with staff trained to attend a workshop to support implementation. Workshops will be co- designed where possible with service users and will include exemplars from teams who have used the training and successfully embedded outcome measures into day-to-day practice.

“Mental health services were not routinely capturing outcome measures – without outcome measures, it is difficult to understand the impact of our activities on the health of people supported. Outcome measures also help practitioners to track the progress of people they are working with and support the therapeutic relationship.

In 2018/19 Welsh Government asked Improvement Cymru to lead a piece of work to improve the use of outcome measures across mental health services.

Improvement Cymru has worked in partnership with health boards, service users, Welsh Government, the NHS Collaborative, Social Care Wales and Health Education Improvement Wales to develop training and support embedding outcome measures into practice.

Over 1,000 employees have had training and Improvement Cymru is working with HEIW to embed the use of outcome measures into practice as well as producing e-learning resources. This work has had a huge impact on the quality of experience for people with lived experience as well as introducing skills for practitioners on teams.”

Ainsley Bladon Implementation Lead, Strategic Mental Health Workforce Plan Health Education and Improvement Wales (HEIW)

improvement.cymru

12

Learning Disability Improvements

It is recognised that improvements need to be made to how health and care services identify and respond to the physical health needs of people with a learning disability (LD).

The physical health work programme is part of the learning disability improvement programme, commissioned by Welsh Government as part of the learning disability strategy, launched in 2022. The physical health work programme identified priority areas utilising the existing evidence base in respect to avoidable health problems, delayed treatment, and premature and/or avoidable deaths. These were agreed with nursing office colleagues and the LD ministerial advisory Group.

Aspects of the improvement work will continue until March 2025, current headlines include:

Health Check Packs

A modular health checks education pack on delivering health care to people with learning disabilities. This includes an accessible resources pack for health care staff in Wales who deliver health care to people with a learning disability.

To support delivery of the resources, specialist learning disability services identified a link person for each primary care cluster in their area.

Awareness Training

The launch of the learning disability awareness training on both Learning@Wales and the electronic staff records systems was progressed and is

expected in June 2023.

Addressing Constipation Risks

An evidence base was developed for a programme of work around constipation in people with a learning disability across the lifespan, as well as engaging with stakeholders in the validation of a suitable bowel profile tool for people with a learning disability.

Accessible Vaccines Campaign

The team worked with the Public Health Wales vaccines and preventable disease Programme (VPDP) in development of surveys, allocation of supplier, and focus group work for co-production of an accessible vaccines campaign for the 2023/2024 vaccines season. They also supported the

distribution of the VPDP survey across networks.

Health Profile Campaign

A programme of health profile awareness raising was completed with identified stakeholder groups.

Acute liaison nurse data is being monitored to identify increases in the percentage use of the health profile.

An evidence-based communication campaign was conducted highlighting the health profile as a patient safety tool and an evaluation commissioned of the usability of the health profile for delivery in May 2023.

Health Profile Flags

The team continued to engage with Digital Health and Care Wales to map the health profile and subsequent need to ‘flag’ across systems such as Welsh nursing care record (WNCR) and the NHS Wales app. The team also worked with specialist LD health services who should be flagging those who access their services within local health board digital systems.

Care Bundle Options Appraisal

An options appraisal of care bundle practice across Wales was commissioned and a summary of the findings including recommendations for the future of the care bundle is due for completion in June 2023.

Health Liaison Nurse Support

The team developed an understanding of the needs of health liaison nurses across Wales. In collaboration with health liaison nurses, areas of need and support were identified through an improvement methodology lens to enhance skills and improve practice.

improvement.cymru

14

Bespoke Support for Improvement

Intensive Support

In 2022, Welsh Government commissioned Improvement Cymru to provide a bespoke offer of intensive support on specific challenges and issues – most notably patient safety concerns. This offer is for organisations who require help and assistance at a level of pace, scale and intensity that is focussed on system challenges.

Each offer of support is bespoke to the needs of each organisation. Intensive support aims to complement and enhance existing local improvement efforts and is a positive offer to help organisations work through system challenges. Intensive support has required close liaison with Welsh Government. Equally it has also required sensitive and considered engagement with chairs, chief executives, executive directors and local leaders.

Improvement Cymru has worked with two organisations to provide very different offers of support. Organisation one has been supported with site visits and meetings with executives, independent members, and local leads. Together with these colleagues, and with Welsh Government, Improvement Cymru agreed an offer of national support including board support, an opportunity to build system level leadership and improvement skills, and the offer of support to help with patient flow. This work has been progressed with the chair, chief executive and Welsh Government and external expert support.

Organisation two sought support to help build situational awareness and

improve flow for two hospital sites. This was an issue of targeted intervention and Improvement Cymru has provided targeted support from existing capacity and utilised external expertise via its contract with experts in patient flow.

Duty of Quality Support

The Duty of Quality is one element of the Health and Social Care (Quality and Engagement) (Wales) Act 2020 and to support its implementation, Improvement Cymru chaired and provided subject knowledge expertise and programme support to two national duty of quality workstreams.

Workstream one led the development of the overarching principles and the statutory guidance for the duty, working with a core group of service representatives. Through extensive workshops and stakeholder engagement, the definition of quality was agreed, and new quality standards developed comprising six domains of quality and five enablers. These standards replace the Health and Care Standards 2015.

The draft statutory guidance was issued for public consultation in December 2022 and feedback is being incorporated by Welsh Government into the final statutory guidance which will be issued in April. The workstream also identified tools and approaches to support Welsh ministers and NHS bodies to actively consider improving quality and outcomes when making decisions about health services.

Workstream five is leading the development of educational resources to support the duty, working in partnership with service representatives to develop the content.

The resources include organisational awareness training (e-learning) and enhanced leadership training for Welsh ministers, senior civil servants and board members of NHS bodies. The enhanced leadership training has taken place with work ongoing to develop an e-learning package which will be issued in the summer.

Quality Management System Support

In response to the Duty of Quality and the Quality and Safety Framework, Improvement Cymru has focused on implementing a quality management system through a pilot in Public Health Wales. An internationally

recognised methodology that has achieved system- wide improvements, quality as an organisational strategy, was selected and phase one is currently underway. This will enable Public Health Wales to operate as a system designed for managing quality, focused on continuous improvement and innovation, and driven by the needs of the population it serves.

improvement.cymru

16

Capability Building

Improvement Cymru Academy

The Academy provides quality-assured improvement skills, resources and a supporting capability framework for staff across NHS Wales. This is achieved by building the infrastructure, creating a standardised approach to support the delivery of improvement skills locally and providing results-based improvement training and coaching which changes behaviour and outcomes.

The Academy works with individuals and

organisations including NHS Wales improvement leads, managers and frontline staff, national networks, partners, other sectors and international improvement experts. The Academy’s strategy is enabled by a spiral core curriculum of improvement science and improvement extra modules, with integrated, wraparound support;

developing improvement capability breadth with accessible, quality-assured content; through a combination of internal and external expertise, with a broader range of improvement skills development available to the system.

The Improving Quality Together series of bronze, silver and gold IQT awards have been updated with a new Improvement Series and the Academy team has worked to strengthen the portfolio of improvement training, giving consideration to accessibility, evidence-based practice, and making learning interesting and interactive. Five new courses were developed and delivered in 2022/23 and two health boards were supported in delivering courses. The Academy team has been instrumental in developing and delivering training within the Real Time Demand Capacity work and Safe Care Collaborative.

“The staff are friendly and knowledgeable and the games on the course days serve as fabulous ways to create active learning opportunities for the attendees. Having a dual hat on within the course both seeking inspiration and materials to help teach improvement and doing my own improvement project has meant that I have relished the depth of information provided.

I have enjoyed the learning, and I am excited to start and complete my project to see if there is any improvement because of my project. I cannot recommend more highly the course as an excellent way to learn about improvement as well as to give you practical tools with which to seek further improvements in all aspects of your professional role.”

Gareth Kennard-Holden

Bsc (Hons) Biochemistry, Bsc (Hons) Nursing

The next steps for building on the spiral core curriculum are to develop an NHS Wales Improvement Advisor course, Leader level improvement series training and offer Master classes at Improvement Adviser level. Learners will have access to a new learning management system that supports their learning.

Additionally, a quality framework is being developed for the improvement training that facilitates a standardised approach to delivery, development of a ‘Passport to Practice’

for trainers, which will provide annual update training, support and mentoring.

Accreditation of courses through Agored Cymru will be undertaken, strengthening the quality of content and facilitating access to qualifications for learners.

A portfolio of learning resources is being developed and access will be improved by making them publicly available on the Academy webpage. A compendium of case studies showcasing improvement projects is planned that will facilitate sharing.

Education Programme for Patients (EPP)

The Education Programme for Patients (EPP) Cymru supports health boards in the development and delivery of self-management programmes for individuals with chronic conditions.

There is now widespread recognition of the potential for partnerships between patients and health care professionals to transform the way in which people living with chronic conditions make use of health care resources.

To make such shared decision-making an everyday reality there is a need for

approaches that support patients to have the confidence, information and support to participate in their healthcare. EPP Cymru provides this, by supporting people living with chronic conditions to develop the knowledge, confidence and skills needed.

The training is directly provided by Improvement Cymru, in partnership with EPP trainers/coordinators in health boards. Current EPP Cymru delivery includes courses on chronic disease management, diabetes, chronic pain and cancer. New self-management courses are planned or in development for

chronic conditions including fibromyalgia, dementia, multiple sclerosis and HIV.

improvement.cymru

18

Q Lab Cymru

Q Lab Cymru is a partnership between Improvement

Cymru and the Health Foundation to help people

take action on complex health and care challenges

in Wales, and through collaboration, create their own

sustainable improvements for systems wide change.

Over the past year the team have collaborated across several areas of interest including supporting colleagues from Public Health Wales’s wider determinants of health team as they tested their Communities4Change Wales initiative.

During September 2022, the Wales Cancer Network requested support to develop the team’s capability for collaborative change. This was achieved through a highly participative, evidence-based, introduction to skills for collaborative change.

The team also began working with the national learning disability team hosted by Improvement Cymru. The focus of this multi- year collaboration is to increase the national learning disability team’s capacity to work with others across the system to improve learning disability services for children and

young people in Wales, using learning as their approach. They are participating in a mini-lab, designed by the team, with the aim of introducing the concept and practical application of the human learning systems approach, which is largely grounded in the field of systems thinking.

The Q Lab Cymru team has developed

connections across Wales, the UK, and beyond, who are also using learning at the heart of their improvement approaches. Several other collaboration and partnership opportunities are being explored or in development.

“Q Lab Cymru are on a mission to tackle complex challenges in the health care system in Wales. I am inspired by their ambition and how they work in a way that is participatory, thoughtful, and human centred. The spaces they create help health care leaders to develop the ideas, the skills and the relationships needed to create the enabling conditions for bringing about healthier lives for the people of Wales.”

Jen Morgan Head of Design and Collaboration/ Q Labs Network (Interim), the Health Foundation

20

improvement.cymru

Other

Highlights

Improvement Cymru National Conference

The Improvement Cymru National Conference in May 2022, was a celebration of improvement across health and social care in Wales and beyond, including guest speakers joining the conference from the USA, Scotland, Northern Ireland, Ireland, England and Scotland.

Delegates joined online with the opportunity to network and learn about a wide range of subjects on the latest knowledge and experiences in improvement.

You can read more about the Improvement Cymru National Conference on our website.

Podcast: Talking Improvement

In Autumn 2022, we launched a brand new podcast series, Talking Improvement, a safe space to talk all things improvement.

In our first series, we showcased some great improvement stories from across the health and care system in Wales, talked about the importance of raising awareness of sepsis and discussed tools and technologies within the improvement and innovation space.

We’re excited to be planning future episodes for a second series. You can listen and subscribe to Talking Improvement on Apple Podcasts, Spotify and wherever you get your podcasts.

Talking Improvement Trafod Gwelliant A brand new podcast

from Improvement Cymru

In each episode we will bring you new guests and topics within the world of improvement.

improvementcymru.net

Return of the NHS Wales Awards

In October 2022, we hosted the NHS Wales Awards

following a two-year gap due to the COVID-19 pandemic.

This annual celebration began in 2008 to celebrate the sixtieth anniversary of the NHS and to recognise and promote good practice across Wales. This year, the NHS will mark 75 years of service. We’re excited to celebrate this milestone at the 2023 awards.

Entries were received from a range of organisations, showing the high standard of innovative and diverse work that has transformed the experience and outcomes for people in Wales.

The judges found shortlisting especially difficult as the calibre of entries was so high. One judge commented,

“There are some phenomenal projects out there, it was a

challenging and emotional task to complete the shortlisting amidst the tears, but it was really lovely to read about the great work that is underway across Wales.”

22

improvement.cymru

Looking Ahead

Key Opportunities

Improvement Cymru looks to 2023/24 to build upon the strong foundations and relationships we have built with each health board and trust across Wales, through our national support, regionally delivered.

The Safe Care Collaborative moves from readiness into testing phase, with organisations sharing their early successes through the first action period of 2023/24 with showcasing at the June learning session.

The Academy launches its second expert level training for improvement capability, to reach over 100 improvement advisors trained across NHS Wales.

In partnership with other NHS Wales Executive functions, Improvement Cymru will support the design and delivery of a patient safety improvement programme focused on maternity and neonatal services, responding to the discovery phase and co-designed with stakeholders from across the service.

The mental health and learning disability teams will continue to work closely with Welsh Government on key areas identified to improve service, access and outcomes for these communities.

In addition, through close working relationships with each health board and trust, specific areas of improvement support will be co-designed and aligned to the local context and need.

To achieve this, we need continued engagement and senior leadership support as we continue to work alongside organisations to create the conditions, build the capability and make the connections for improvement to flourish.

NHS Wales Executive

During 2023/2024 Improvement Cymru will transition to become the quality, safety and improvement function within the NHS Wales Executive.

Improvement Cymru will work closely with NHS Wales Executive function partners to align and integrate our support to organisations focused on key priorities in the mandate.

The establishment of the NHS Wales Executive provides opportunities to align national support for quality planning, quality assurance and quality improvement, enabling a coordinated approach to supporting NHS Wales achieve its quality and safety priorities.

Ways of Working and Reporting

Over the last year Improvement Cymru has established regional ways of working to support organisations to continuously develop its capacity and capability to improve the quality and safety of health and care services in Wales.

These regional teams work closely with improvement teams in organisations to identify areas for local support and inform national approaches to support from across Improvement Cymru.

Improvement Cymru leadership team representatives meet regularly with nominated senior leaders in organisations to review existing support offers and scope new requirements. Organisations will receive quarterly reports on our partnership agreements.

and signing up for our

monthly e-newsletter: