ABSTRACT
The chapter reports the findings from interviews with senior clinical and managerial staff who were involved in implementing two of the Agency’s first major national service improvement initiatives, the Cancer Services Collaborative, and the National Booking Programme. Interviews concentrated on their experience of those programmes, and in particular on the factors they considered to be influential in sustaining and spreading those initiatives. The Agency aimed to produce measurable improvements in patient care. However, the size and complexity of the service made this challenging. Both initiatives were ambitious, and were designed to introduce rapid service-wide improvements. Less than 18 months after the launch of the booking initiative, while much progress had been made, concerns had also been raised. There were wide variations in achievements between pilot sites, and there had been problems in sustaining improvements beyond the pilot stage (Ham et al., 2003). Why were some pilot projects more successful than others? Why had some initiatives flourished and been sustained, while others struggled to survive or failed to maintain their early achievements? What were the critical success factors? How should future improvement programmes be nurtured? The Agency commissioned a study of staff experience and opinion to identify the factors that facilitated spread and sustainability in national improvement programmes.
