Leading change across a healthcare system : how to build improvement capability and foster a culture of continuous improvement : lessons from an evaluation of the NHS-VMI partnership

The NHS-VMI partnership was a five-year collaboration between the English NHS and Virginia Mason Institute (VMI), a not-for-profit consultancy specialising in development of Lean-based improvement capability among healthcare providers. In 2015 five NHS hospital trusts were selected via competitive application to work with improvement experts from VMI in a tripartite partnership with NHS England and NHS Improvement (hereafter: NHS E & I). The goal of the partnership was twofold: first to foster a sustainable culture of continuous improvement capability within each of the five NHS trust partners, and second to derive lessons about how NHS leaders can foster continuous improvement capability across the wider healthcare system. The NHS-VMI partnership came to a formal conclusion in March 2021 (a year later than planned due to the global pandemic COVID-19). At this time, much of the infrastructure designed to support development of a continuous improvement culture remained in place in each of the five partner NHS trusts, while mechanisms for sharing learning between partner organisations have also continued. Notably, the CEOs of the five partner NHS hospital trusts continue to meet monthly as a ‘Transformation Guiding Board’ (‘TGB’) with NHS E & I. As such, the TGB has emerged as an effective mechanism for collaboration, where healthcare service providers are working in partnership with regulatory organisations to share learning in ways that shape policy and practice, and support development of continuous improvement capability at a national level