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Q is a respected and appreciated home for improvers.

Activities, connect with each other and share learning. Q has established a positive profile among improvers in the UK health and care system and its members share a strong sense of identity and feel mutually supported. More widely, Q has helped raise the profile of improvement in health and care and strengthened the understanding of what it might contribute.

Q has helped build a community of improvers with confidence in their own knowledge and in their ability to deliver improvement.

The initiative has successfully supported this by connecting members to each other and bridging to a wider community, making it easier for lessons and good practice to spread. The connections made through Q have also been used to support ongoing improvement work and help create improvement projects.

Q supports practical knowledge mobilisation on the ground.

For example in changing patient experiences, resulting in fairer or more efficient care, or improving outcomes. Q members say that the collaborative nature of the Q Exchange funding programme and the financial support offered have led to a number of tangible impacts.

Q aims to connect people working in quality improvement across the UK healthcare system, to make it easier for them to share ideas, enhance their skills and thus bring about a change that benefits patients. It is led by the Health Foundation and supported and co-funded by NHS England and NHS Improvement. As an embedded but independent evaluator commissioned by the Health Foundation, RAND Europe has been a 'critical friend' of Q from 2016 to 2020. The first two years of this evaluation were primarily formative in approach, focusing on how Q was designed and established, and feeding the data back to the Q team to support and inform the ongoing design and management of Q. The later stages of the evaluation took a more summative approach, focusing on the impact of Q on its members as well as on its wider contributions to healthcare improvement. The study has involved nearly 200 interviews and focus groups, 13 surveys, several case studies and deep dives of Q in different areas of the UK, citizen ethnography, review of key strategic and improvement literature, observations at Q events and Q team meetings and a social network analysis of connections between Q members. RAND Europe conducted a separate evaluation of the first design year of Q in 2015 and an interim evaluation report for this study was published in 2018.

• Chapter One

  Q in context

• Chapter Two

  Members' experience of Q

• Chapter Three

  Impact on how members approach improvement

• Chapter Four

  Impact on the health and care system

• Chapter Five

  The design, governance and management of Q

• Chapter Six

  Conclusions and recommendations