Quality, Innovation, Productivity
and Prevention (QIPP)

NHS Improvement has now established a dedicated QIPP website. To visit the website CLICK HERE.

NHS Improvement works with NHS organisations and clinical networks to help transform, deliver and build sustainable improvements across the entire pathway of care in cancer, diagnostics, heart, lung and stroke services as well as focussed improvement work in audiology.

With over ten years practical improvement experience, NHS Improvement aims to:

• develop sustainable effective pathways and systems
• share improvement resources and learning
• increase impact and ensure value for money to improve the efficiency and quality of NHS services.

Currently working with over 240 sites through piloting, implementing and spreading improvements, NHS Improvement has the practical knowledge and ‘how to’ approach to improve the quality and productivity of services through using innovative approaches as well as tried and tested improvement methodology.

With a focus on quality, productivity and innovation, NHS Improvement works closely with the NHS Medical board and Department of Health with all work aligned to national priorities and supporting the delivery of key national strategies. Our practical improvements have made a difference to services along the patient pathway and are clinically led and patient focused to achieve the best outcomes.

NHS Improvement also represents clinical networks as members of key groups such as the NHS Evidence Project Group and QIPP Clinical Advisory Group. Our work ensures that learning and good practice is successfully transferred across the country, and has been nationally recognised to assist the NHS in meeting the Quality, Innovation, Productivity and Prevention national agenda. The following projects highlight some of these practical initiatives that if scaled up to a national level could potentially make significant impact within the NHS:

Atrial Fibrillation - one of the top six QIPP examples featured on the NHS Evidence
Atrial fibrillation (AF) is common and affects over 600,000 patients in England (1.2%). It is a major predisposing factor for stroke, and those strokes caused by AF can be particularly severe and disabling. The annual risk of stroke is five to six times greater in AF patients, but if treated with Warfarin it can reduce the risk of stroke by 50-70%.

NHS Improvement has worked with eighteen priority project sites and has identified ways that can potentially save up to 4,000 lives per year and help prevent lifetime disability. These findings have helped to increase efficiency and reduced the financial and resource demands placed upon secondary care and other services. Up-scaling such innovative work has the potential of generating savings of £134.5m for the first year of stroke in patients with AF.

Quality - Reduction in the risk of stroke in AF patients between 50% - 70%.
Innovation - Co-working to find new ways that could save many lives.
Productivity - Potential financial and time savings and better utilisation of resources.

Delivering the Cytology Screening Target ahead of schedule
The Cancer Reform Strategy made a promise that all women receive their screening tests results within two weeks by 2010. NHS Improvement has supported 10 pilot sites over the last 12 months and is now supporting a further eight, to test how this vital sign can be achieved using Lean methodology. NHS Improvement has identified practical ways in reducing turnaround times, improving quality, safety and productivity which teams can adopt and adapt to meet their local setting. This work clearly demonstrates how QPC can be achieved:

Quality - 100% delivery of the 14 day standard by all 10 pilot sites and 80% sites are now achieving the standard within seven days
Innovation - Through applying lean methodology sites have re-designed and/or created new processes.
Productivity - £100K savings per site with 14% re-work eliminated. If the improvements identified were applied by all cytology labs the potential national impact is £18m per annum.

New models of care – delivery can reduce bed days
Working closely with over 40 sites, the NHS Improvement Transforming Inpatient Cancer Care programme has identified through testing four winning principles, that if spread could make significant improvements in quality, efficiency, patient experience as well as promote value for money and importantly value the patients’ time.

If every trust applied these winning principles which include reducing length of stay, enhanced recovery and averted admissions, this one initiative has the potential to reduce bed utilisation by 20%, saving around £250m. This winning principle has been recognised as one of the top six QIPP examples featured on the NHS Evidence website.

Heart Failure has a significant impact on patients and NHS resources
Heart failure readmission rates are among the highest for common conditions and accounts for 5% of all emergency admissions. Early findings from NHS Improvement Heart Failure pilot sites have identified that the use of BNP testing and improvements along the pathway have potentially shown a 15% reduction in inpatient stay and 35% reduction in readmissions within 28 days of discharge.