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Organisational models 2 – reproduced from original image © NHS Photo Library

You can consider your culture and context to be the soil in which the intervention will germinate. The soil needs to be as favourable as possible to allow the intervention to be successful. Context is the local and national environment in which you operate.

Culture covers your practice values, attitudes and ways of working. It includes your practice team, patients and stakeholders: how you involve them and interact together on a daily basis. Your patients and stakeholders are therefore included at the heart of the QI wheel.

Without a culture and context that is keen to experiment, and supportive of trying something new, it will be hard for change to occur, or be sustained, regardless of what tools or methods you use.

This section of the website provides you with tools to analyse your own context and culture, which you can then use to and the best way to create a context that is supportive of the change(s) you wish to make.

  • Resources to support remote consultationThis mindmap published by GP Excellence and Greater Manchester Training Hub provides a simple yet comprehensive collection of useful resources to support GPs, Advanced Clinical Practitioners and Practice Nurses to undertake remote consultations.
  • QOF Quality Improvement (QI) Modules – What’s it all about?The idea behind introducing ‘QI Modules’ rather than targets is that practices can be flexible and, mostly, work on a project that is specific to their patient needs, aiming towards an outcome that is valued by the patients and the practice, and using sound QI methods.
  • Time for Care Quality Improvement for General Practice NursesTime for Care Quality Improvement for General Practice Nurses is a two day programme designed for all nurses working in general practice across North West and North East England.  
  • Greater Manchester General Practice Nursing Resource PackThe GM General Practice Nurse Collaborative (GPN) has developed this resource pack in order that practices have access to information about nurse competencies, job descriptions and career pathways including levels of pay, terms and conditions for Nurses working in general practice.
  • COPD – Greater Manchester COPD ProgrammeHealth Innovation Manchester is bringing together resources from the NHS, social care and pharmaceutical industry to ensure that every person with Chronic Obstructive Pulmonary Disease (COPD) has access to equitable, high quality care. This clinician-led learning tool aims to support local GP practices in the care of patients with COPD.2 comments
  • Chain SMSDoes your practice use Chain SMS? Chain SMS is available from AccuRX ad can be used by practices to send text messages to patients for a range of purposes including recall, care plans, patient information and delivering test results.  Using Chain SMS benefits both practice ...
  • Integrated Community Healthcare and Leadership (MSc/PgDip/PgCert)This new part-time masters degree aims to help people to develop the leadership skills needed to lead neighbourhoods and networks and deliver integrated health and social care services in line with the NHS longterm plan and the new GP contract. Anyone who works in primary care in Greater Manchester may be eligible for a bursary to support their fees.
  • Productive General Practice programmeThe Productive General Practice programme is designed to help general practice continue to deliver high quality care whilst meeting increasing levels of demand and diverse expectations.
  • Resilience – why does it matter?Resilience is a concept that many people struggle to define. However, evidence shows us that many of the elements that make up a ‘resilient’ mindset are key to good clinical practice, making good decisions and minimising error. In this article Dr Rachel Morris, Director of Leadership Courses at Red Whale, offers her take on resilience.
  • Quality Improvement to drive earlier cancer diagnosisCancer Research UK and Dr Bill Taylor (RCGP Clinical Lead for building QI capability) invite you to attend a half day workshop focused on using quality improvement techniques to drive the early diagnosis of cancer in primary care.
  • The General Practice podcastsThe General Practice podcasts published by Ockham Healthcare cover a wide range of issues faced by general practitioners and colleuegs in local primary care teams.
  • Primary care developmentThis briefing outlines training and masterclasses organised by the Royal College of General Practitioners for non clinical practice staff working in primary care. Whether you’re looking to train non-clinical practice staff, further develop your practice managers or seeking to improve or support practices, the RCGP is here as your independent, critical-friend to support and facilitate.
  • Time for Care learning in action programmeThe Time for Care programme is at the heart of the General Practice Forward View's support for practices to redesign their care and manage demand more sustainably. Using a variety of means this initiative provided by the NHS England Sustainable Improvement team will give every practice in England the chance to learn about proven innovations that release time for care.
  • Productive General Practice Quick StartProductive General Practice (PGP) Quick Start is an on-site, hands-on, short term support package for practices that forms part of a local Time for Care programme. Alongside the 10 High Impact Actions the support package provided by NHS England’s Sustainable Improvement team aims to help practices release time for care and build improvement capability.
  • General Practice Improvement Leaders ProgrammeThe General Practice Improvement Leaders Programme is a free training programme designed for GPs, practice managers, nurses, project managers and facilitators working in general practice to support the GP Forward View. The programme provided by NHS England’s Sustainable Improvement team offers step-by-step tools and techniques to help build skills and confidence to lead service redesign in general practice.
  • NHS North West Leadership Academy Mentoring SchemeThe North West Leadership Academy Mentoring Scheme is open to GPs, Practice Managers and wider practice teams across Greater Manchester.
  • Diploma in Advanced Primary Care ManagementThis is a comprehensive diploma for people who are managing primary care and are becoming responsible for creating and running primary care provision at scale including primary care networks, new care models, GP super practices and GP or other primary care federations.
  • e-Learning for Healthcaree-Learning for Healthcare offers an extensive catalogue of e-learning programmes that enhance traditional learning, support existing teaching methods and provide a valuable reference point which can be accessed anytime, anywhere.
  • Life QIThe Life QI online platform is a project and programme management tool for quality improvement, using quality improvement approaches and techniques.
  • Spreading the adoption of innovation into practiceIn this video published by The King's Fund Liz Mear, Chief Executive of the Innovation Agency, shares her experiences of working with within Academic Health Sceence Networks (AHSNs) to spread the adoption of innovation into practice across the NHS.
  • COPD Primary Care Audit 2015-2017 report: Planning for every breathPlanning for every breath is the second of the Welsh COPD primary care audit reports and presents data relating to primary-care-delivered COPD care in Wales. The first Welsh primary care audit report was published in October 2016. A quality improvement (QI)-focused slide set, as well ...
  • Quality Improvement Toolkit For Early Diagnosis Of CancerThis toolkit is to help GPs and their practice teams to improve their early diagnosis of cancer principally by using the findings from the National Cancer Diagnosis Audit (NCDA). The NCDA is an audit of primary and secondary care data of patients diagnosed with cancer. It ...
  • Quality Improvement Project (QIP) Guidance for GP TraineesThe RCGP has produced some guidance for GP Trainees completing a Quality Improvement Project (QIP) as part of their training. Engagement with Quality Improvement activities is a mandatory part of the curriculum for GP trainees (‘Gold Guide’ Reference Guide for Postgraduate Specialty Training in the ...
  • Embedding a culture of quality improvementThis report published by the King’s Fund explores the factors that have helped organisations to launch a quality improvement strategy, and the key enablers for sustaining a focus on continuous quality improvement.
  • Making the case for quality improvement: lessons for NHS boards and leadersThis briefing paper co-authored by The King's Fund and The Health Foundation outlines 10 lessons for NHS leaders that provide a starting point for leaders seeking to embed quality improvement in their work.
  • Atrial fibrillation toolkitThe Health Innovation Network have produced an AF toolkit as part of the Pan-London AF Programme. The three London AHSNs have worked collaboratively with the London Clinical Network to develop a pan-London AF programme, the objectives of which are: To increase the detection of people with ...
  • Quality Improvement toolkits – GP OneThe former Public Health Wales Primary Care Quality Team are now incorporated within the Primary and Community Care Development and Innovation Hub, and have developed a series of quality improvement toolkits to assist practices in collating and reviewing information. From information received, practices still find ...
  • Effective interface – RCGP ScotlandEffective Interface is an e-learning module to assist GPs and consultant colleagues to identify and provide solutions to problems that exist at the primary/secondary care interface.
  • Reporting and Learning from patient safety incidents in general practiceThe purpose of this guide is to: • maximise opportunities to learn from patient safety incidents in your practice, and to share learning via organisational or national reporting systems • outline a process for learning from patient safety incidents in your practice. Where appropriate, this guide will signpost existing well-written resources and does not seek to replicate their content.
  • Sharing practical experiences of Quality ImprovementThis webinar hosted by the RCGP on 6 December 2016 gave clinicians a chance to learn about increasing capability using Quality Improvement, and share experiences of what works for them and the challenges they face.
  • Motivating others to take part in Quality ImprovementThis webinar followed 'Sharing practical experiences of Quality Improvement' and provided more information on the new self accreditation and online website, QI Ready, alongside sharing tips on motivating members of your practice in quality improvement.
  • QI Ready eLearning modulesThe RCGP has produced eLearning modules to compliment the QI Ready network and self-accreditation process. There are a suite of three modules that will assist you in better understanding quality improvement methodologies.
  • Direct GP referral for hernia patientsA case study example of a direct GP referral for hernia patients from a GP practices in Scotland.
  • Quality Improvement HubThe Quality Improvement Hub website provides a range of resources to support organisations to improve the quality of healthcare in Scotland. The tools provided here can support you in your improvement work.
  • Quality improvement tools for different stages of QI projectsThe East London NHS Foundation Trust has developed and collated various tools and resources to be used at the different stages of a QI project.
  • Context checklist for QI ProjectThe context checklist breaks down context into nine elements. Consider each in turn and decide whether they are applicable to your situation, and whether any action is required.
  • Webinar – How Quality Improvement can positively impact on patients with diabetesThis was the second of two QI in Diabetes Care webinars and was held on the 12th of January 2017, and followed ‘The experience of improving diabetes care’. This second webinar further explored issues surrounding improving care for patients with diabetes. The Webinar focused on patient ...
  • RCGP Quick guide: Context and CultureThis RCGP Quick guide helps practitioners to reflect on the context or environment in which a quality improvement intervention is to be introduced.2 comments
  • Benefits of delegated commissioningNHS England have produced a series of case studies to show how CCGs are using delegated commissioning to improve care for local people.
  • Quality improvement and diabetes careThis presentation can be used during a training session to introduce QI tools and methods to the teams who care for patients with diabetes.
  • QI Ready self-accreditationQI Ready is a self approval tool to assist you in better understanding quality improvement methodologies. It offers clear examples of QI in practice and will help you to improve your knowledge and skills in this field.
  • Creating a community-based primary care modelSir Sam Everington, Chair Tower Hamlets Clinical Commissioning Group, GP, Bromley by Bow Health Partnership shares lessons from the internationally renowned Bromley by Bow Centre on how to develop a holistic approach to creating healthy communities.
  • Does quality improvement improve quality?This article considers these challenges and proposes four key ways in which QI might itself be improved.
  • Context checklist for diabetes careConsidering context and culture first will allow quality improvements to flourish. The context checklist allows practice teams to consider what needs to be in place to encourage improvement in diabetes care.
  • An Illustrated Look at Quality Improvement in Health CareIn this video, Dr. Mike Evans, Associate Professor of Family Medicine and Public Health at the University of Toronto, starts with a simple question: Why should you care about quality improvement? He presents a brief history of QI, then touches on system design, the Model for Improvement, and the familiar challenge, "What can you do by next Tuesday?" - all in less than nine minutes!
  • Understanding pressures in general practiceThis report published by the King's Fund looks at patient factors, system factors and supply-side issues to see what lies behind the increasing demands and pressure faced by general practice.
  • Healthcare science transforming patient care: Case studies from the National Healthcare Science Quality Improvement Champions GroupThis brochure contains a selection of case studies submitted by the membership of the QIC group to promote their contribution to transforming healthcare science services out in the community and ultimately improving patient care.
  • Quality improvement – Training for better outcomesThe Academy of Medical Royal Colleges has drawn together a wide range of stakeholders, to align efforts to implement quality improvement training as a core competence in practice.
  • RCGP Quick guide: The QI Wheel for Primary CareThis RCGP Quick guide explains the Quality Improvement wheel for primary care, a simple visual representation that illustrates the the main elements to consider in design, delivery and evaluation of a QI project, acting as a guide to the stages involved.2 comments
  • Context for successful quality improvementBuilding on a series of thought pieces published by the Health Foundation in Perspectives on context, this best evidence review combines the ideas of receptive and non-receptive contexts for change, with a psychological perspective and the proposition that social context is the key facilitator of quality improvement.
  • Improving the quality of end of life experiencesThis submission demonstrates involving the bereaved in quality improvement, the value of relatives and carers sharing experiences, and quality improvement through difficult to reach groups.
  • The habits of an improverIn this paper, Professor Bill Lucas offers a way of viewing the field of improvement from the perspective of the men and women who deliver and co-produce care on the ground – the improvers on whom the NHS depends.
  • Co-produced support for carers of those with dementiaA 2015 case study from NHS Luton Clinical Commissioning Group, who worked with carers of those living with dementia to understand and address the issues they faced, after it was identified many were reaching crisis point.
  • Do OD mobile appThis mobile app commissioned by NHS Employers has been created to enable effective culture change within the NHS and will be of interest to anyone interested in improving organisational culture.
  • Transforming General Practice: what are the levers for change?This briefing and accompanying literature review extrapolates learning from current and past use of incentives to encourage change in General Practice.
  • Tower Hamlets: Managed practice networks to improve rates of cardiovascular diseaseFrom 2009 NHS Tower Hamlets spent an additional £2 million per year to improve the quality of primary care. This included the implementation of a system of managed clinical networks across all primary care teams in 2009.
  • Improving quality in general practice: evidence scanThis is an exhaustive compilation of research evidence around quality improvement in general practice, conveniently packaged into a readable summary.
  • Quality improvement in general practice – A call to action against all oddsDr Mareeni Raymond talks about how GPs can take part in quality improvement work at the same time as doing all the other hundreds of tasks that need to be done each day and gives examples of work which has already been done in practices.
  • Doing OD in the NHSThis toolkit developed by NHS Employers contains a collection of resources, tools and thinking to support effective culture change within the NHS and will be of interest to anyone interested in improving organisational culture.
  • Developing a quality framework for ScotlandThis report is the outcome of a joint project between the Royal College of General Practitioners (Scotland) and Healthcare Improvement Scotland and sets out a framework for improving quality of care in Scottish General Practice.
  • Quality improvement: the role of context and how to manage itIn this webinar Bill Lucas is joined by a panel of experts to explore why context needs to be taken into consideration when attempting improvement, and what skills best help professionals to manage context effectively.
  • The quality improvement guide: The improving quality together editionThis guide brings together learning from around Wales – and further afield - to explain how a simple set of techniques can be applied to improve the services provided by NHS Wales.
  • Quality improvement made simple: What everyone should know about healthcare quality improvementThis guide, from The Health Foundation, focuses in particular at what are known as organisational or industrial approaches to quality improvement.
  • Clinical commissioning groups: Supporting improvement in general practice?The King's Fund and the Nuffield Trust are working together to assess the implementation and impact of CCGs. Between 2012 and 2015, we are following the evolution of clinical commissioning in six case-study sites and will publish the findings annually.
  • How to change practice: understand, identify and overcome barriers to changeThis guide published by the National Institute for Health and Care Excellence provides practical suggestions based on evidence and experience to help managers and clinicians influence changes in practice.
  • The quality improvement guide for educators and studentsThis guide highlights the key role of educators and students in quality improvement and showcases examples of student improvement projects in Wales.
  • Improving the quality of care in general practice: key findings for GPs from an independent inquiryThis report published by the King's Fund provides the findings of an independent inquiry into the quality of general practice in England. It summarises the inquiry’s recommendations for delivering high quality primary care.
  • Quality improvement in general practiceThis report, from The Kings Fund, makes recommendations for action at multiple levels of the health system to nurture and support improvements in quality in general practice.
  • The Facilitator’s Toolkit: Tools, techniques and tips for effective facilitationThis toolkit published by the NHS Institute for Innovation and Improvement provides tools, tips and ideas for facilitating small and large groups.
  • Improving access, responding to patients: A ‘how-to’ guide for GP practicesThis guide is a celebration of some of this good practice, sharing the successes and signposting real examples of things that have proven to work, things that make a real difference for patients and the working lives of our staff.
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