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Q6. You have made the right decision. It will take time, but can happen with energy and make great and early impact if people believe they are being given the opportunity to make the changes that matter and that they are best placed to design. #QIhour #leadingQI

Q6. You will be changing mindsets. The clarity and purpose people in your position can offer will be invaluable. Make sure you show in what you do that you are reinforcing this new way of working. #QIhour #leadingQI

Q5. As a senior leader you are in the spotlight. Some people will be watching to see if you consistently role model this new way; some will hope you slip, because it lets them off the hook of having to change themselves. Don't let them off the hook. #QIhour #LeadingQI

I think it was Journey who sang "Don't Stop Believing". #QIhour #leadingQI

Our SEND Multi-Sports Camp have had a fantastic day, celebrating their favourite superheroes & sports stars 🦸 ⭐️ Shout out to Game Changer gaming van for providing plenty of fun 🎮😃 West Bromwich Albion | HB Flooring Limited

Rob Edwards and Luton Town FC win Utilita Football Performance of the Week for their victory that secured promotion to the Premier League!! Congratulations Rob! 🏆

Hi Bernard here, part of the WBS team and looking forward to our final TweetChat #QIhour #LeadingQI

Driver diagrams are a great way of making the link between the important issues you need to impact, and the small tests of change you want to try. Investing time in developing them well is a key to the Golden Thread. #QIhour #LeadingQI

A basket of measures. As close to outcomes that service users will recognise as possible. "Balancing measures" designed to spot unintended consequences of our change early. #QIhour #LeadingQI

Things to avoid: Only measuring things we already have to collect for some other purpose; not being granular about the detail (who will measure, what, when , how and how will they report). #QIhour #LeadingQI

This may be old, but it is still really good youtube.com/watch?v=Za1o77… #QIhour

When the outcomes are too far into the future to use to monitor improvement we need "impact measures"; process measures where the evidential link to a good (or bad) outcome is strong enough for them to be a proxy. #QIhour #LeadingQI

A3. Almost all nationally imposed measures risk "HTTBMTP". They are not based on starting positions, natural variation, and most importantly are seldom owned. #QIhour #LeadingQI

The real stretch happens when local people, understanding their real position and passionate to improve, make a promise to the people they serve that they will deliver a better service. Better is never finished. #QIhour #LeadingQI

And don't get me started on RAG ratings. #QIhour #LeadingQI

A4. An improvement culture is a bit like a set of Russian dolls. If people are helped to learn how to lead improvement they will apply the approach to what matters where they work. Not every effort has to be of strategic importance.#QIhour #LeadingQI

A4 (Part 2), but equally, scarce and experienced improvement resources should be available to support the organisation's most pressing challenges. These two approaches are not incompatible.#QIhour #LeadingQI

NHS Impact is a step in the direction of moving away from a failed approach in which we "improve" things regarded as less significant, but when something is really important we "performance manage" it. #QIhour #LeadingQI

Q5. The tweet chat process has been an eyeopener. Must be one of the most effective and cost effective ways to get meaningful conversations about significant academic and policy findings. #QIhour #LeadingQI

Thanks to all the sites that were part of the VMI partnership. Their generosity in helping us learn has been really important #QIhour #LeadingQI