We have learnt that while individual, short term support initiatives can be highly valuable to health and social care systems, lasting improvement depends on systems that learn, adapt and grow over time. The following joint partner proposals focus on embedding improvement into daily practice, ensuring that better outcomes are achieved continuously.
These proposals are intended to guide collective efforts towards making improvement support a shared, sustained endeavour.
A collective way forward from Partners
- Consistently adopt the sector-led approach to improvement support – collaborating on bespoke, targeted and universal support with system and sector wide partners to ensure it reflects today’s challenges and meets local needs.
- We know that financial pressures in health and social care can make joint working more difficult and put a strain on leadership relationships. We believe the focus should be on systems being mutually clear, as early as possible, about financial challenges and the financial benefit realisation of improvement work, and building strong leadership and organisational development as part of any improvement support. This will help systems stay connected and effective under pressure.
- People’s voices – whether patients, service users or carers – are not being heard clearly enough in many parts of health and social care system. There is often no strong infrastructure in place to listen to, learn from and act on their experiences. Systems need support to build in this capacity and capability and put people’s lived experience at the heart of improvement.
- We know that systems have valued the diagnostic insights and recommendations from short-term improvement support. However, we have learnt that lasting improvement requires support over a longer timeframe. Our experience indicates that systems would benefit most from longer-term support, helping them to not only understand the recommendations but also to develop, implement and embed actionable plans over time.
- In supporting system leaders with improvement initiatives, it is important to embed a whole-systems approach that focuses on the critical conditions for success – strong relationships, clear and strategic decision-making, effective actions and measurable outcomes. Systems also need support to implement an integrated Management Operating System and to build the capacity and capability necessary to sustain meaningful change over time.
- Systems need support in looking at the data and intelligence they hold in all the different partner organisations through a whole systems lens and recognise it to be a strategic asset, equally important as other intangible assets like intellectual property. To make the most of this asset, systems need support in using data effectively for decision-making. They also need help to embed the universal, sector-wide High Impact Change Model, which provides practical guidance on how data can best be used to support decisions and improve outcomes.
- A more effective approach to sharing best practice with systems is needed, encouraging peer-to-peer learning and supporting systems in adapting proven methods to their local context. This approach should empower systems to become early adopters and innovators, guided by an understanding of insights from behavioural science.
- Wherever possible, national policy and guidance should be supported by practical advice on how to put it into practice, along with tailored support to help local areas apply it in ways that work for them. This will help reduce the risk of different interpretations and avoid unintentional variation in outcomes.
The Better Care Fund Support Programme has implemented a trusted, successful approach to supporting improvement. We look forward to continuing to work with our funding partners to support staff and leaders across health and social care systems in England and continue to share learning and insights with partners from our 2025/26 Support Programme.
