NHS England Revives Compulsory Improvement Collaboratives for Key Services
NHS England is bringing back a significant improvement strategy: compulsory structured improvement collaboratives focusing on outpatients, urgent and emergency care (UEC), and frailty services. This move mirrors the large-scale improvement methods of the Modernisation Agency in the early 2000s, aiming to quickly spread best practices and improve patient outcomes in areas struggling with performance and inconsistency. This decision, confirmed by Health Service Journal, shows a renewed national focus on embedding systematic quality improvement (QI) through cross-organisational learning, shared methods, and peer support.
These collaboratives involve groups of health organisations working together with agreed-upon tools, shared measurement frameworks, and collective learning to meet defined QI objectives. NHS England will concentrate these efforts on three priority areas: Outpatient services, to tackle long waits and fragmented care; Urgent and emergency care (UEC), to address persistent four-hour wait and ambulance handover issues; and Frailty services, to better coordinate care and prevent avoidable hospital admissions for older people.
The Revival of Quality Improvement: Opportunities and Challenges
Under the new framework, participating trusts and Integrated Care Boards (ICBs) must adopt a structured QI methodology, share data, and implement evidence-based changes. Crucially, the programme is expected to be compulsory for systems facing significant performance challenges, highlighting NHS England's commitment to drive rapid progress where it is most necessary. For outpatients, this aligns with goals for more coordinated pathways, promoting virtual and same-day appointments. In UEC, the collaboratives will reinforce current planning guidance and support the adoption of best practice across the entire pathway, from ambulance services to same-day emergency care, using QI tools and near real-time data to reduce delays.
While learning from the Modernisation Agency’s success in building QI capability, today's initiative benefits from new assets like digital tools and data platforms. NHS England's approach acknowledges that top-down mandates are insufficient without mechanisms to build local capability and foster a continuous improvement culture. However, the revival faces challenges, including the limited improvement capacity, workforce shortages, and competing priorities within high-pressure systems. Success will depend on adequate resourcing and alignment with broader system goals.
Ultimately, this revival presents a significant opportunity to embed a culture of continuous improvement across the NHS, using data and shared learning to enhance patient outcomes. For the health and technology sector, the collaboratives offer a structure to directly link digital insights to operational change, improving decision-making and performance tracking. The coming months will be critical in shaping the initiative and determining its effectiveness in delivering integrated, efficient, and patient-centred care amidst current pressures.
