NHS Quest

1. 1
NHS Quest
Peer Site Visit Report 2016-17
Summary
NHS Quest Peer Site Visits (PSV) are seen as an extremely high value part of the NHS Quest subscription
with a lot of potential to contribute to improvement. There have however been decreasing numbers in
sign-up to participate and it was therefore agreed to pause the visits, to investigate what has worked
well and what could be improved for this aspect of the NHS Quest offering.
The review, carried out by Sarah Garrett, an Associate with NHS Quest, has involved several elements,
including: one-to-one telephone interviews with site leads and a number of chief executives from NHS
Quest member organisations; discussion at site leads meeting; a review of evidence from network
theory and good practice outside NHS Quest.
It is important for the network to recognise the core purpose of the PSV programme as being to
facilitate and deepen learning across the NHS Quest network in pursuit of excellence. The programme
aims to:
• Highlight and learn from innovations, stand out improvements and new ways of working within
member organisations
• Bring together peers to share learning, exchange ideas, debate different approaches and
observe results on the ground
• Get ‘beneath the surface’ of improvements to understand what works and why
• Bring collective know-how to bear on common problems and thorny issues
• Inspire new ways of thinking and doing within member organisations
Key outcomes from a successful peer site visit programme will include:
• A deepening and widening of peer relationships across the network at executive, site lead and
clinical level
• An increase in the pool of ideas, approaches and tools that member organisations have access
to
• Building collective intelligence around improving the quality, safety and experience of care and
around wider organisational development
The most beneficial PSVs have been where presentations have been well thought out and delivered;
where there has been space to talk about challenges, key learning, and the ‘nuts and bolts’ of
improvement work e.g. approaches tried, tools used, pitfalls as well as successes; and where
participants have been able to take clear ideas and learning back to their organisations.
Although no-one within the review wants to lose the face-to-face element offered by the site visit
programme, there are a number of ways in which a virtual approach could also be explored to both
enhance the offering and to reduce some of the challenges. As an example, introductory elements of
immersive site visits (e.g. background to the work, overview of re-design etc.) or of learning exchanges
(e.g. brief overview of each site’s work around a theme) could be carried out online using video,
documents etc. to free up more time for the critical elements better suited face-to-face interaction,
such as in-depth discussions and peer networking and for observation of work in practice.

2. 2
It is clear that, especially for a single day event, a ‘one size fits all’ format is neither possible nor
desirable. There are several different approaches, and therefore potential formats, which, if brought
together as a programme of events over a year, would fulfil the needs of the network.
With all of the options outlined, there are some consistent requirements that emerged from the review,
namely:
• Explicit topic, objectives and focus for each PSV in order to identify and engage the right team
to participate from each organisation
• Notice of at least two months with the date, topic, objectives and briefing (N.B. for executives,
this may need to be four to six months)
• Detailed planning and pre-work to ensure high quality and value
• Timings of the PSV taking into account travel time for each organisation
• Commitment to participation of all member organisations, including at an executive level, to
maximise value and learning for the whole network
OPTION 1: Learning Exchange
Purpose: To share practical learning on a particular theme / topic from across the network member
organisations.
Objective: Getting ‘beneath the surface’ of learning around a core area of improvement: clinical or non-
clinical. Exploring challenges and pitfalls as well as achievements and successes; discussing and debating
the range of approaches tried and used by different members.
Format: A mixture of sharing activities (e.g. storytelling, presenting, posters, video) and discussion (e.g.
Q&A, work in organisational teams or mixed groups, buzz sessions). Some elements could be run as
parallel strands (e.g. QI and workforce focus; executives, site leads and frontline staff) as well as shared
learning across all participants.
Location: Anywhere.
OPTION 2: Immersive Site Visit
Purpose: To deepen understanding of how a member organisation has achieved innovations or ‘stand
out’ improvements in a particular area or area.
Objective: See and ‘feel’ how a key area works (e.g. redesigned A&E or theatres, simulation suite,
Kaizen space); learn more about the ‘nuts and bolts’ of the re¬design; how improvements are working
in practice; and what / how ideas might be transferred to another member site.
Format: Structured ‘tour’ or observation of area(s), talking with operational staff, facilitated group
discussion of insights and learning.
Location: At host hospital site.
OPTION 3(a): Immersive Site Visit and Showcase
Purpose: To present and celebrate innovative work by a member organisation and to deepen
understanding of how improvements have been achieved in a particular area or areas.

3. 3
Objective: Celebrate local success and share what has worked well; learn more about the ‘nuts and
bolts’ of the re-design or innovation; observe how improvements are working in practice.
Format: Overview presentations (and/or market stalls) on key projects combined with a structured
‘tour’ or observation of the relevant area(s), conversations with operational staff, and facilitated group
discussion of insights and learning.
Location: At host site.
OPTION 3(b): Immersive Site Visit and Learning Exchange
Purpose: To deepen understanding of how the host site has achieved innovations or significant
improvements in a particular area and to explore and share how other network members are
approaching the same topic or challenge.
Objective: Learn more about the ‘nuts and bolts’ of the host’s re-design or innovation and observe how
improvements are working in practice. Share the range of approaches being tried by different network
members, getting ‘beneath the surface’ of learning.
Format: A structured ‘tour’ or observation of the relevant area(s), conversations with operational staff,
and facilitated group discussion of insights, combined with a learning exchange session (presentations
and discussion groups) to share and debate the different ideas and approaches used across the network
on the same topic.
OPTION 4: Challenge Workshop
Purpose: To work collectively on a ‘thorny problem’ / compelling issue common to network members.
Objective: Use the combined knowhow of the NHS Quest network to explore ideas and develop
potential approaches to challenges that members have in common.
Format: Facilitated workshop.
Location: Anywhere.
K Goldthorpe
Associate Director of Networks
March 2017
A copy of the full report is available from the PMO: nhs.quest@nhs.net