Information call transcript

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Information call transcript

Evaluation of the NHS Partnership with Virginia Mason Institute

4 July 2017

NOTE: All tenders should be completed using the tender response form. An electronic copy should be sent to [email protected] by 12:00 (midday) on Tuesday 8 August 2017

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Our aim is a healthier population, supported by high quality health care that can be equitably accessed. We learn what works to make people’s lives healthier and improve the health care system. From giving grants to those working at the front line to carrying out research and policy analysis, we shine a light on how to make successful change happen.

We make links between the knowledge we gain from working with those delivering health and health care and our research and analysis. Our aspiration is to create a virtuous circle, using what we know works on the ground to inform effective policymaking and vice versa.

We believe good health and health care are key to a flourishing society. Through sharing what we learn, collaborating with others and building people’s skills and knowledge, we aim to make a difference and contribute to a healthier population.

Further details about the organisation can be found at www.health.org.uk.

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Speaker Key:

Op Operator

SL Shaun Leamon

GM Greg Madden

Q/A Q&A participants

Introduction

Op Good afternoon, ladies and gentlemen, and welcome to the Evaluation of the NHS Partnership with Virginia Mason Institute. My name is Matt and I'll be your coordinator for today's event. At this time all the lines are in listen-only mode.

Later we will conduct a question and answer session. At that time, if you have a question, you will be asked to press star, one, on your touchtone phone. If you need assistance at any time please press star, zero, on the telephone keypad and you will be connected to an operator. As a reminder this conference is being recorded.

I would like to turn the conference now over, to your host, Shaun Leamon.

Shaun please go ahead.

SL Thank you Matt. Good afternoon, everyone, and welcome again to the information call for the evaluation of the NHS Partnership with Virginia Mason Institute. Thanks everyone for joining us. As mentioned, my name's Shaun Leamon and I'm a Research Manager here at the Health Foundation. And I'm responsible for the management and delivery of the invitation to tender and the evaluation contract. And in the room with me today is Greg Madden, NHS Partnership Programme Lead from NHS Improvement and Diane Redfern-Tofts, Assistant Research Manager, at the Health Foundation.

The purpose of this call is to provide you with an overview of the NHS partnership with the Virginia Mason Institute and the evaluation of the programme. And to go through what we're looking for in your tender responses.

We'll try to answer any general questions as we go through this information before opening up to questions at the end. Afterwards, we'll follow up with a transcript of this call, which will be posted on the same page as the information invitation to tender on the Health Foundation website. And that'll be posted by the end of next week.

The call is designed to clarify the parameters of the programme and the evaluation and to address some of the common questions that you may have.

So, please note, that we can't answer any specific questions about your tender response. If you'd like to discuss your specific tender response please contact us on [email protected] and we can arrange a suitable time to discuss your question or reply to you direct. Similarly, when you complete your tender response, please email that to us at [email protected].

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As mentioned, if you experience any issues with the sound during this call, please raise this immediately with the moderator who'll let us know. I'll now hand you over to Greg who'll give you some brief information on the programme.

Overview of the programme

GM Hello, everyone, and welcome to the call. Just to take you through what the programme consists of, so, what is the partnership with the Virginia Mason Institute? It was announced in July 2015 by the Secretary of State for Health.

The partnership is between the NHS Trust Development Authority, which is now part of NHS Improvement, five NHS trusts and the Virginia Mason Institute over five years. The reason the partnership is over five years is in recognition of the time it takes to build and embed a sustainable culture of continuous improvement.

Virginia Mason was founded in 1920. It's a non-profit organisation offering a system of integrated health and related services in Seattle. It is spread across nine locations in the city and it includes a 336-bed acute care hospital with over 5,500 employees and a $1 billion turnover. The Virginia Mason health system now also includes Virginia Mason Memorial, a 226-bed hospital serving the Yakima Valley in central Washington. Gary Kaplan MD serves as Chairman and CEO.

At the turn of the millennium, in response to financial and quality challenges, Virginia Mason, inspired by the Toyota production system in Japan, created the Virginia Mason Production System or VMPS. This is a management method, based on systematic use of Lean techniques to continuously improve quality and safety, eliminating waste and reducing cost. The impact of this on the organisation was transformative and Virginia Mason remained amongst the top ten hospitals in the US by the Leapfrog Group, including Hospital of the Decade in 2010.

In 2008, in response to interest in their journey, the Virginia Mason Institute was created to train healthcare professionals and others from around the world in the Virginia Mason Production System. There was overwhelming interest in taking part in this programme and the trusts were carefully selected in an application process that involved them having to demonstrate their suitability across a range of key characteristics, such as board-level commitment, and leadership stability.

The trusts selected cover a broad range of scale, geography, and service challenges; Barking, Havering and Redbridge University Hospitals NHS Trust, Leeds Teaching Hospitals NHS Trust, Surrey and Sussex Healthcare NHS Trust, the Shrewsbury and Telford Hospital NHS Trust and University Hospitals Coventry and Warwickshire NHS Trust. Key elements of the support the Virginia Mason Institute are providing to the trusts over the five years include creating the infrastructure, intensive training in the method from advanced Lean training to certify a small number of staff in the Kaizen Promotion Office, to daily Lean-

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management training for a broader set of leaders in the Lean for Leaders course as well as access to licensed materials.

Applying the method; the trusts are receiving hands-on coaching in the application of the method, for example, in running Rapid Process Improvement Workshops or RPIWs. Sustaining the results; ongoing mentoring and, over time, the five trusts will be able to deliver the training themselves to their own staff so they are able to build a sustainable culture of continuous improvement. The broader intention is for these organisations to share their learning and experience with others in the system as five trusts committed to embedding an improvement methodology.

The partnership is not about turnaround or quick fixes. It is about building improvement capacity and capability for the long term with continual incremental changes. This work is very much in line with the wider direction of policy at the moment, in the context of the publication Developing People - Improving Care, which is an evidence-based national framework to guide action on improvement- skill building, leadership development and talent management, for people in NHS-funded roles.

Current progress; the first phase of the partnership began in autumn 2015 as each trust established their trust guiding team to oversee the work in their organisation. These meet monthly with representation from VMI in a coaching and supporting role. The first cohorts to receive advanced Lean training began that in autumn 2015, approximately three people per trust, who then form a Kaizen Promotion Office, or KPO, in each organisation. The KPO is the department responsible for the deployment and application of the Virginia Mason Production System tools, methods, and concepts.

Each trust has chosen between three and five value streams, areas of work, to imply the improvement methodology to, eg, a patient pathway, within which they have selected areas to hold Rapid Process Improvement Workshops or RPIWs.

These bring together multi-disciplinary teams for five days to examine a process in depth and introduce improvements which are then measured regularly.

The Lean for Leaders course, being run in each of the trusts, is the real catalyst for beginning to spread this method within the organisation. This begins with two cohorts of 20 in each trust co-taught with VMI. The trusts are then able to deliver this training themselves to future cohorts. The course takes approximately six months with six classroom days and homework in between. It focuses on teaching daily Lean-management techniques, for example, visual management, daily accountability and leaders' standard work.

Although this partnership was created nationally, each trust is working at a pace, which is locally determined in terms of roll-out and in terms of the areas they focus their improvement methods on. Each trust is also creating their own local version of this method. In other words, they are not all implementing the Virginia Mason Production System, but their own locally owned take on that. So, for example, in Leeds they are developing the Leeds Improvement Method.

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I will now hand you back to Shaun who will explain the evaluation of the programme.

Application and assessment process

SL Thanks, Greg, for the overview of the VMI partnership programme. The ITT that we launched last Tuesday is aimed specifically at recruiting a provider to undertake an independent evaluation of the NHS partnership with VMI. The tender is an open, competitive process, and it's available to suitably qualified and experienced evaluation teams based in the UK. All submissions must be received by us by 12 noon on the Tuesday, 8^th August, 2017 using the tender response form that accompanies the ITT. Submissions received after that time will not be accepted.

The evaluation partner will be appointed in late October, 2017, to commence the evaluation in early 2018. The evaluation is expected to last approximately 36 months and a final evaluation report will be due in March 2021.

The overarching role for which the evaluation partner is tasked is twofold. Firstly, to examine the impact of the locally adapted improvement approach on the quality and efficiency of healthcare services and organisational culture in each trust, so at a local level. And, secondly, to develop and share learning from the process to support the organisations involved in the trust, ie, the five trusts and the wider system to maximise learning from the partnership. Specifically, this will involve examining the effect of the local improvement approach on specific value streams included in the process; exploring the effect of the approach on the overall quality and efficiency of care in each site. And examining the impact of the improvement approach in building a sustainable culture of continuous improvement in each trust.

As the localised improvement approaches are developed in each site, the evaluation partner will also be responsible for gathering and sharing best practice and learning across the sites, so that the trusts gain the maximum benefit from the partnership. And, as the programme matures, we will also look to the evaluation partner to develop recommendations on how best to build sustainable and lasting culture change through systems alignment and engagement. And also provide recommendations on how national system leaders in the NHS can support and foster spread of continuous improvement in the NHS.

We recognise this is obviously a very broad remit and, to help frame the evaluation, we have developed a series of specific evaluation questions. These are as follows. How are the local versions of the improvement approach implemented in each trust? And how has that evolved over time? How does the approach compare across the five trusts? What are the barriers and facilitators to successful implementation of the improvement approach in each trust? What is the learning, at individual trust and programme level, about how best to

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overcome these barriers? And how has the shared learning helped trusts address these barriers?

What is the effect of the local improvement approach on value streams being included in the process? What is the effect of the process on the overall effectiveness and efficiency of care within each trust in respect of quality, safety, patient experience, equity, and productivity? What has been the effect of the improvement approach on building a culture of continuous improvements? How have these changes impacted on the staff in each trust? And then, at a programmatic level, what is the learning and recommendations from the programme about how systems alignment can be used to support and sustain a lasting culture change within the NHS? And what support can national leaders give to providers of services to foster and spread a culture of continuous improvement in the NHS?

And to address these questions and meet the aims of the evaluation we would expect the evaluation to comprise the following elements.

 A process evaluation to understand how the improvement approach worked. What happened in practice and how people reacted to it.

 An outcome evaluation to understand the effect of the improvement approach on the areas in which it was being deployed and the overall impact.

 And an economic component to understand the resources used in developing and implementing the local transformation approaches.

We envisage the evaluation will require a combination mix of formative practices and summative assessments. The evaluation will also need to combine an assessment of the progress and activities in each site, with learning at a programme level particularly, to provide sufficient details with regard to the latter of the two evaluation questions. This will require the evaluation partner to capture both horizontal and vertical learning across the partnerships.

As mentioned, the programme began in autumn 2015, and the trusts have already begun the process of developing and implementing their localised versions of the VMPS. The evaluation partner will, therefore, need to be comfortable combining retrospective and prospective analysis of the partnership in each site.

When completing your tender response, applicants should include a detailed description of your proposed evaluation methodology, addressing each of the aforementioned points. These are also included in the invitation to tender. Your submission should include details of the specific research tools, sampling framework, and analytical techniques. And the approach for sharing learning and best practice and developing recommendations from the evaluation at both a local site level and programme level. As outlined in the ITT, we will favour evaluation approaches that include a control group or groups, and applicants should seek to include this in their response.

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It's obviously an involved programme and a key factor for success will be working closely with the evaluation partner and the trusts involved in the programme. We are, therefore, keen to recruit a partner who can demonstrate experience in managing and delivering complex intervention studies in a health- service setting and who bring a flexible approach to the partnership. Applicants should also include in their application details of how they'll work with each trust to deliver the evaluation. And applicants should also include in their tender response a plan to develop a concordat with partners.

And we recognise that the outcome measures included in the evaluation will depend on the value streams and RPIWs. And, following appointment, we'll be working with the evaluation partner to develop and agree the protocol for the work.

In terms of the overall deliverables for the evaluation, over the course of the programme, we would expect the following.

 A finalised research protocol developed in conjunction with the Health Foundation to be delivered in December 2017.

 Localised learning sets to be delivered in June and December of each year of the evaluation, enabling trusts to understand how the initiative is progressing, and the impact it's having.

 An annual interim report in December 2018, 2019 and 2020, providing observations of the roll-out and development in each trust.

 A final evaluation report, due in March 2021, detailing learning from the initiative and how the model could be used to deliver positive change in the wider NHS.

 Also a series of stakeholder engagements in the spring of 2021 to share learning. And these will be developed with the evaluator nearer the time.

 And academic publication throughout the programme to disseminate learning from the partnership as it develops.

As mentioned, the application deadline is 12 noon on Tuesday, 8^th August. When applications are received they will be initially sifted by the Heath Foundation and NHS Improvement looking at eligibility and fit with the assessment criteria as outlined in the ITT. If you're unsuccessful at this stage you'll be notified by email by the end of August but, unfortunately, we won't be able to give detailed feedback at this stage. Following this, successful long-list applicants will be sent out for review, by experts in the field. Those that are successful at this stage would then be invited for an interview at the Health Foundation office in central London to select a preferred partner. This will take place on Monday, 30^th October, 2017.

So, to summarise, the deadline for the response is 12 noon, Tuesday 8^th August, 2017. We will not be accepting applications after that time. Assessment is throughout August and September. Interviews will take place on the 30^th

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October. And please ensure that you're available for interview on that date as we are unable to offer alternative dates. And the successful applicant will be made aware of their success, early November 2017.

Best practice for completing your proposal

Finally, before I open up for questions, I'm just going to run through some of the key criteria for applications and pick up any overall questions we have already received. Much of this may sound obvious, but, there are some key elements that are often omitted from applicant submissions.

First of all, you should ensure your proposal provides a suitable methodology to address each of the aims, and evaluation questions. Invariably, applicants fail to address one or more of the aims of the project, and we're keen that the evaluation of the NHS partnership with VMI addresses each of the aims outlined today and in the ITT. And it's important that you provide a suitable methodology to address each of these.

Secondly, please ensure that you complete all sections of the tender response form, because proposals will be assessed against the following criteria;

knowledge of the topic; appropriateness of the proposed methodology;

experience, expertise, and connection to the relevant community of practice to be able to conduct the work; appropriate project management, risk management and quality assurance; capacity to deliver the evaluation on time, on budget, and to the required standard; value for money. And, finally, potential for the evaluation findings to build capacity and share learning.

The tender response provides the opportunity to demonstrate how you meet each of these criteria. And it's important that you demonstrate suitable knowledge, experience and expertise to deliver the evaluation, within the form.

Thirdly, please, ensure that you provide an accurate and realistic costing of the evaluation. And please ensure that you include all costings in your proposal as outlined in the budget template provided. The budget available for the evaluation is £400,000 and that's inclusive of any VAT chargeable on the work. And we will not consider submissions above this amount. It's also worth noting that our maximum allowable day rate is £1,000 plus VAT. However, one of the key assessment criteria is value for money, and you should ensure that your proposal represents good value for money.

Fourth, it's important, that you demonstrate a strong approach to partnership working. As mentioned, a key factor in the successful delivery of the evaluation will be a close working relationship with the evaluation partner and the trusts involved in the programme. And you should include in your submission details of how you'll work with each trust to deliver the evaluation. And given that this is a complex, multi-site evaluation, we also welcome proposals that recognise the potential of local embedded partnerships. And we would encourage you to consider collaborations where appropriate.

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And, finally, thinking beyond the evaluation, this is an important area and you'll be asked about this in some detail if you're invited to interview. And you should be thinking early about how you plan to share learning from the evaluation with key system leaders and decision-makers, both during the evaluation, and beyond the life of the programme.

That brings us to the end of the information. I will now open up the call for questions. As stated, please note we can't go into detail about your individual proposals, today. But if we feel we need further information to clarify we can do this outside of the call. We want this session to be as useful to all attendees, so, please try to keep your questions as short as possible and seeking general information only. I'll now open up the call.

Question and answer session

Op Ladies and gentlemen, if you would like to ask a question, please press star, one, on your telephone keypad. If you change your mind and wish to withdraw your question then please press star, one, again. Please ensure that your line is un-muted locally so I can retrieve your name.

Q1 Hi. Thanks for that. Really interesting. You said that you're expecting to evaluate the impact on the healthcare services, cultures, quality of delivery, those kinds of issues. Are each of the trusts involved collecting a common set of data that might be used to underpin some of that?

A1 Greg here. Yes, I think, is the answer to that. They're collecting data on service outcomes, particularly at value stream and RPIW level. And, of course, we have a standard set of performance measures that we collect on all of these trusts across NHS Improvement's scorecard. We also are conscious that it's important to measure changes in culture, so, in April 2016 each of the trusts underwent the culture assessment tool by Aston University and the plan is to rerun that every two years. We also collect standard information on culture in relation to the NHS Staff Survey questions.

And then, finally, to track the diffusion of the method in the organisations from the Lean for Leaders course that cohorts are doing in the trusts, we've created a standard survey tool that will be used across all five as people graduate from that course, to test the roll-out of the tools that they've been learning in that and the projects they've undertaken.

Q2 Hi everyone. Thanks for that. That was really interesting. I have a couple of questions if that's okay? Firstly, you talked about the need to be providing recommendations for senior leaders about achieving a culture of learning and so on and there was a mention in the ITT about the roll-out, as well. Do you have future plans for the roll-out of the programme beyond the original five trusts? And any strategy in mind for that?

A2 Hi. I'll pick that up again. It's Greg. First and foremost, this is a programme that's focused on the five trusts, and to support them to develop and embed a Lean

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culture of continuous improvement. It's a five-year programme because we recognise that process takes time. Whilst we want them to share their learning and experience with each other and with others in the system they're not, technically, pilots. There isn't another pot of money that we've got a clear plan to roll this out further across the country.

But, clearly, we want to learn from what works across these to understand whether this is something that we should replicate again at national level. So, part of that, we will discuss in the evaluation.

Q3 You said that you would encourage proposals that included a control group. Just to clarify, is that compared with not doing anything, at all? Or were you interested in comparisons with other similar methods, other improvement methodologies, for example?

A3 I think we would be keen to hear your suggestions on that within your proposal.

But I think, ultimately, we would be interested to see how this compares with normal care and normal processes rather than to look to build in a third arm where there's other methodologies going on. But I'd be interested to hear your thoughts on that within your proposal.

Q4 Hi everyone. Thank you for your details. I was just wondering if you could share a bit more information about the localised learning sets that you're hoping to have provided as part of the output.

A4 Sure. As I mentioned, these are likely to be in June and December 2018, 2019, 2020, so at midpoint and end of year of each from when the evaluation starts.

And they're principally about enabling the trusts to understand how the initiative is progressing, and the impact it's having, at both the local level and the programme level. So, primarily, it's about regular and recognised feeding back of the progress and the achievements in each of the sites, but, also about the information that can be shared across the overall programme.

But there would be the ongoing development and sharing of learning from the evaluation team, but, these would be more formalised in recognised events a couple of times a year to share that learning. What that might look like in principle and in delivery, again, is something that we would expect the evaluation partner to develop based on their expertise and experience. But also maybe in some discussions with the trusts once the work starts, how they look and what would be the most beneficial ways to feed those back, so that all partners get the maximum benefit, rather than us dictating what they should look like.

Q5a Thank you. In regards to the value streams, because this is being done over three years, so I would assume that some of these value streams would hit a maturity level probably before then. What would happen in that regard?

A5a Yes, you're right, and I'll pick this up. I think value streams through the VMI method are intended to be long-term projects, so two to three years, I think. So, I

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would expect that the trusts will identify additional value streams, as they get further through the process.

Q5b Will we pick those up as we go along? Or would they just be outside of the scope of the study?

A5b No. We would expect that where amenable… and I think that's why I said it's a retrospective and a prospective element. So, there would be the value streams that are currently live at the moment, and, as Greg mentioned, there's data that's being collected standard across the programme to help people measure the short-term impact, certainly the outcomes, of those. But as the value, additional value streams come on throughout the programme, we would be keen that the evaluation partners also picked up those because you have that before and after element there.

And we would also be keen to hear about any additional information. As Greg mentioned, there is the common evaluation dataset that's being produced, but we'd also be keen to hear from the evaluation partners about any additional information that we felt was needed to measure progress that may not be within some of those common datasets. And to look to build and strengthen those, if necessary, following discussions with the trust.

Q6 Hi everybody. I just have a question on the deliverables in the ITT under 6.1, and actually linking up what you said earlier. The last item, the academic publications, and it talked about publications from the programme to inform the further community on it. But, in the ITT, it says academic publications are an ongoing thing. So, could you just clarify some more about what you mean by that and how many, etc? That would be really helpful. Thank you.

A6 So, as a programme and a partnership across five trusts, VMI, NHS Improvement and the Health Foundation, we're keen to collect and share learning and we've committed to doing that. And, as part of that, there will be the ongoing feedback to the trusts initially, but, we're also keen that that is released wider. And, as part of that, we would expect that to be published within peer- review publications as the programme develops and is amenable.

So, for example, what we quite often do with some of the work that we support here at the Health Foundation is that we might encourage, say, the publication of the methodology within a peer-review journal so that it gets out there early to peer-review scrutiny; the work is ongoing and how it's being measured. That might be an early peer-review deliverable that could be released before we move more into the mainstream side of the evaluation.

But what we don't want to do is wait for the full five years before releasing some of the learning. Obviously, we need to wait until the end of the programme to bring the overall learning together, but we're keen that the learning is released and supports the system as the programme develops.

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Q7 Thank you. It's just a question that's prompted by the first line of the summary in the ITT. You say this is an independent evaluation. I just wondered what that phrase meant when it's says the Health Foundation in support of NHS Improvement. What's the relationship between the Foundation and NHS Improvement in regard to the project?

A7 We, the Health Foundation, are working with NHS Improvement to support the evaluation of the programme. But it is fully independent. The Health Foundation will be contracting and managing the evaluation completely separate of the partnership between the NHS and Virginia Mason Institute. It does have true independence and all the reporting will go to the Health Foundation in the first stage. Obviously we would want the evaluation partners to be fully embedded and supported within the wider partnership, so, it is about feeding back that information on an ongoing basis.

But, as I said, we have put together a (when I say ‘we’ I mean the Health Foundation and NHS Improvement and the trusts) Ways of Working document which commits each partner to, first of all, the independence of the evaluation.

But also commits each partner to sharing the findings in a timely fashion, obviously, giving each partner time to reflect on the findings. But it is a truly independent evaluation.

Q8 I was just wondering the degree to which the individual trusts have adopted the methodology across the piece. Or, whether there are pockets of adoption, and each in trust is quite different in which bits of the trust have taken it up and which bits haven't.

A8 I'll take this one. It's Greg. I think the way in which this is rolled out with organisations is very gradual. So, I guess it's a twin-track approach, first of all they concentrate on the value stream and the RPIWs that they undertake within that. So, those are the work areas that are exposed to this, within the organisation. Alongside that, a bit further down the track but currently on the way, is the Lean for Leaders course which is where they start to get some greater spreads across organisations to train various leaders across the trust in daily Lean techniques, so, not the intensive five-day RPIWs.

I think it's fair to say that every trust is connecting this to its overall organisational development strategy. And so they are exposing more staff to the work through their creation, at trust level, of things like introductions to Lean methods and inductions to the method that they're trying to deploy in the organisations. And I guess at the heart of this is the attempt to embed a methodology, to learn a methodology, but then to turn that, to make the transition, to that being a management system, ie, the way things are done within an organisation. And I think there's an acknowledgement that that will take some time to do.

Q9 Good afternoon. It's a quick question more on a commercial front. Are you planning to share the names of the interested organisations, and perhaps the contact details, just in case there's any organisation that feels there

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may be an opportunity to partner where, perhaps, there's complimentary skills in the organisations concerned?

A9 Indeed. You read my closing statement. Yes. The plan is if you would like your contact details to be shared with other attendees on the call today, if you could email the email address [email protected] confirming that you're happy for your contact details to be shared, when we release the document next week I will also email round the contact details of people who consent to that.

But we will need an email from people consenting to that before we can share your contact details.

Q10 Thank you. Hi. I was just interested in terms of how sharing is happening at the moment prior to this evaluation. What's the existing relationship between the five trusts? And how do they share any knowledge or learning at the moment?

A10 Happy to pick that up. Just to give you a sense of the governance of this, each trust has what they call a trust guiding team, which is chaired by the chief executive, includes representation from Virginia Mason Institute, and it generally has executives on it but not exclusively. They meet once a month and their role is to oversee this work within their organisations.

But at national level we have what we call a transformation guiding board, which meets again once a month, and is an opportunity for the chief executives of each of the trusts to come together with senior colleagues in NHS Improvement and Virginia Mason Institute to share learning experience and to oversee the partnership at national level.

And, I guess, beyond that we very much encourage and support the connections of different peer groups within the organisation, principally the Kaizen Promotion Office leads, who are those that are most involved in this work. But also we look to establish links between the communications directors, the medical directors and others, where those links are natural and people are ready for it.

I think the answer is there's quite a lot of sharing of learning going on across the organisations that they do off their own bats, but, also that we look to support as NHS Improvement in partnership with them.

In terms of the shared learning from the evaluation partners, as well, one of the expectations would be, in addition to the learning that goes on locally, we would expect the lead evaluator to attend part of that national guidance board meeting up to a couple of times a year, just to share the learning at that very strategic level, and how the evaluation is developing as well.

Op There are no more questions coming through, Shaun.

SL Yes. If we've got no further questions… if anyone else wants to raise one please ask them now. If not, just a reminder of the email address again for questions, enquiries and also submission of your tender responses;

[email protected]. And, as I said, if you're happy for us to share your

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contact details with other attendees if you please confirm that to me via that email address.

And, if there are no more questions, I look forward to receiving your applications by the 8^th August. Thank you very much and good afternoon.

Information call transcript

Information call transcript

Contents