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Improvement Science London launch

150 patients, academics, front line staff and senior system leaders joined the launch of Improvement Science London on Tuesday 26 June. Martin Marshall opened the evening with an overview of the positioning of the science of improvement.

Two presentations followed, demonstrating high quality improvement science work taking place across the capital; the first presentation by Tony Rudd and Naomi Fulop on the London Stroke work, the second presentation by Derek Bell and Julie Reed on the NIHR CLAHRC for Northwest London’s COPD work. Martin Marshall chaired a panel with Al Mulley, Chris Ham and Vivienne Parry to explore the presentations and challenges arising from the work. Improvement Science London Panel

Key points arising from the panel discussion include:

  • Context matters: healthcare is delivered in complex and adaptive systems. Context is important in identifying what interventions will work well, where.
  • Patient pull is important: patients often don’t know what ‘good’ is and often confuse ‘good care’ with ‘nice care’. We need to empower patients further and understand improvements from a patient’s perspective.
  • The power of patient stories: don’t underestimate the power of patient stories, while they may not be hard evidence, they are incredibly useful to winning hearts and minds.
  • Ways of knowing: there are many ways of knowing and ways to make day to day decisions. Many managers and non-clinical leaders will make decisions based on hunches, experience, politics and the art of the possible. An evidence base must complement and strengthen existing ways of knowing.
  • A collection of sciences: improvement science is a collection of sciences and disciplines. It uses and supports multiple methods. Its focus is on adding value through pragmatic and immediate ways.
  • Dissemination of evidence: we need to create bite sized information for managers who are managing numerous large and complex projects. We need to generate a pull for evidence, rather than a push from evidence generating communities.
  • Pragmatic evaluation: evaluations of interventions need to focus on both processes and outcomes in order to gain new insights.
  • There isn’t one answer: we need to watch, learn and respond to what is happening. We need to support the building of collaborative networks across clinicians, academics and patients to support our core focus of improving patient care.
  • Other sectors: what can healthcare learn from other sectors, particularly around incentives and disincentives? How can we foster a greater evidence base in wider decision making, eg. politics?
  • Energy and bravery: we need to create space for clinicians and patients to improve services. We need brave leaders, who are developed and supported to make culture changing decisions.


  • Tony Rudd (Consultant Stroke Physician, Guy’s and St Thomas’ Hospital)
  • Naomi Fulop (Professor of Health Care Organisation & Management, University College London)
  • Derek Bell (Professor of Acute Medicine, Imperial College London)
  • Julie Reed (Research Strategy Manager, NIHR CLAHRC for Northwest London).

Panel members

  • Al Mulley (Director, Dartmouth Centre for Delivery Science)
  • Chris Ham (Chief Executive, King’s Fund)
  • Vivienne Parry (broadcaster and science journalist)
  • Chaired by Martin Marshall (Lead, Improvement Science London).
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