Putting Quality at the Centre of our Training Offer

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My name is Tom, and I work within the Academy; the training team within NHS Wales Performance and Improvement’s (P&I) Quality, Safety and Improvement directorate. The Academy has traditionally focused on improvement training. We have a strong track record of supporting teams across the system, through structured learning, to use improvement tools and methods to drive change and solve problems. But against the backdrop of P&I’s work with Q, led by the Health Foundation, and Quality Improvement Clinic (QIC) to deliver the national Quality Management System (QMS) workstream, there has been a growing awareness that our training offer needs to evolve.

The Academy has always relied on a ‘push’ model; offering a fixed portfolio of improvement courses that individuals and teams can opt in to if they wish. However, as the needs of the system have changed, we’ve started to shift to more of a ’pull’ model, designing training based on what teams are telling us they need in real-time.

The insights we’ve gained from this approach have been eye-opening. Teams are asking for support that goes beyond improvement and into the other aspects of managing quality: Quality Planning (QP), Quality Control (QC) and Quality Assurance (QA). They’re looking for help with modelling capacity and demand, using tools from implementation science to embed policy, research and evidence-based practice, and standardising processes to meet regulatory requirements. These needs often fall largely outside the scope of traditional Quality Improvement (QI) tools.

These insights were accelerated by an AI-assisted review of our existing portfolio of courses. Academy course descriptions, learning outcomes, instructional content and other factors were cross-referenced against definitions and examples of the tools and processes associated with each of the four aspects of QMS. The findings were clear:

  • There’s a strong bias towards QI in our current portfolio.
  • We do offer some courses that are strongly aligned to the other aspects of quality, but they are being delivered by trainers through a QI lens. . For example, control tools are designed to reduce variation and ensure consistency, not to drive iterative change, but it’s crucial to pay attention to them to hold your gains from improvement work. Teaching them as if they’re QI tools risks diminishing their impact, so we challenged ourselves to think differently and make the alignment with QMS elements more obvious.

Over the last few months, we’ve been integrating informal QMS discussions into our training, but on September 11 2025 we delivered our first course that has been designed and delivered specifically from a Quality Control perspective. Standardisation for Quality Control in Healthcare Settings, was developed for the microbiology team at Public Health Wales. In laboratory settings standardised processes are essential to maintaining accreditation with bodies like UKAS. Variation isn’t just inefficient, it’s a risk. By framing the course as a Quality Control intervention, we were able to focus on the right tools, mindset, and outcomes.

Our collaboration with Q, QIC and teams from across P&I has given us the push we needed to move from being an improvement training team to a quality training team. This isn’t just a change in language, but a change in mindset. Managing quality in healthcare involves planning, controlling, assuring, and improving, all in balance. Our training offer must reflect that complexity and support teams across all aspects of QMS.

We’re still on the journey. We’re continuing to review, redesign, and respond to the system’s needs. But we’re clearer than ever about our direction: building a training offer that supports the full architecture of quality across NHS Wales.

If that’s something you’re interested in exploring, please don’t hesitate to get in touch with us at the Academy.