Outcomes Framework from 2023/24

Implementing the Quality and Improvement Outcomes Framework from 2023/4

The paper outlines the service improvement focus for the Quality and Improvement Outcomes Framework. 

It was approved by Knowledge for Healthcare Board on 30 August 2022.

A group of library professionals and clinicians
A group of library staff and clinicians discussing the evidence for outcome 2 as part of the Quality Improvement and Outcomes framework.

Frequently asked questions 

September 2022

Outcomes Framework Baseline Reports September 2022

What is a Development Plan?

During the review, required actions to address areas for development were identified.

The development plan is the new name for an action plan, it is required to show how any areas for development are being addressed by the organisation.

The name of the plan has been changed, from action plan to development plan, to align with the requirements of the NHS Education Contract, schedule 1, section 14.7.

Do all organisations need to submit a development plan?

Any actions required to address areas for development are set out in the September 2022 Baseline Report for the organisation.

These are included in the section titled 'Required Actions and Recommendations for Service Improvement.'

When do I need to submit my Development Plan?

If an organisation is required to produce a development plan this needs to be submitted by 16 January 2023.

The development plan needs to be sent to the Knowledge for Healthcare team on [email protected].

Organisations can submit the development plan at any point up to 16 January 2023.

If you have already submitted an action plan, you do not need to submit a development plan.

How is a Service Improvement Plan different from a Development Plan?

A service improvement plan sets out the strategic steps the organisation will take to demonstrate progress in line with the Quality and Improvement Outcomes Framework.

Service improvement planning by organisations for knowledge and library services is an integral requirement of the NHS Education Contract, see schedule 1 section 14.6.  All organisations with an NHS Education Contract will require a service improvement plan for knowledge and library services.

It will be helpful for an organisation’s service improvement plan to include how it will address any recommendations made in the Outcomes Framework detailed report, as sent to the knowledge and library service manager.

See FAQs on Service Improvement Review and Service Improvement Plan for more detail.

Can I request a copy of the national and/or regional baseline graphic to use in other reports?

Yes, please get in touch with your regional team contact.

Can we have a copy of the national baseline graphic set out by organisation type?

These are currently in development. We will notify knowledge and library service managers once these have been created

Will the good practice and innovation identified be shared?

Yes, we will actively encourage local services to share the learning, good practice and innovation identified through the Quality and Improvement Outcomes Framework baseline assessment.  This will include, sharing through knowledge and library service manager meetings, blogs and podcasts, facilitating platforms for organisations to share and a national knowledge and library service event in 2023.

Who is the baseline report being shared with?

The report is going to the KLS Manager, where in post. Where there is no KLS Manager in post, then the report is going to a named contact in the NHS organisation. Where there is a new KLS in development, then the report is going to the named contact.

Why is the baseline report not being shared with Chief Executives?

Listening to the feedback from knowledge and library services we are no longer sharing the baseline report from HEE with organisation senior managers and Chief Executives on this occasion.  The report has however been written with senior stakeholders in mind so that it is in a format you can share with an organisation.  Please do take time to review the new baseline report, consider how you might share this within an organisation to support development plans and future service improvement plans.

Validation of submission of additional evidence

Is the baseline consistent and accurate when not all organisations have submitted additional evidence? 

Throughout the extended period, with the opportunity for organisations to submit additional evidence, we have worked towards ensuring a consistent approach to the Quality and Improvement Outcomes Framework. 

The same validation approach and principles were applied to the review of the additional evidence submitted, please see the FAQ on how the submission of additional evidence was validated. 

The baseline is focused on narrative and evidence of activity undertaken by organisations and knowledge and library services during 2020-21(2019-20 where Covid had resulted in services/activity being postponed) to ensure it is comparable across the country. 

What was involved in the validation process for submissions of additional evidence?

The validation process was the same as that carried out for the initial submissions:

A consistent national process based on the learning from undertaking the pilot of 12 services in 2018: 

  • the validation review was conducted using the guidance and principles in the validation section of the Framework Handbook, and the Evidence and Outcome Levels section of FAQs
  • the validation was based solely on the narrative and all supporting evidence provided in the return
  • each self-evaluation was reviewed by two validators to ensure consistency

The validation for each self-evaluation was undertaken in two stages: 

  1. An individual review of the submission documentation and evidence.
  2. A meeting at which the validators discussed and reviewed their findings for each of the outcomes, agreed validated levels and compiled both the detailed and baseline report.
  • where queries arose, the validators escalated these to the national consistency panel
  • throughout the validation consistency processes were put in place. These included sampling reports and validation decisions to ensure a consistent approach
  • all baseline reports were reviewed to ensure consistency

21 September 2022 

All NHS knowledge and library services will receive a Quality and Improvement Outcomes Framework Baseline Report. For organisations that submitted additional evidence they will also receive a detailed report

16 January 2023 

Submission of Development Plans - For organisations with required actions identified in the Baseline Report

By 31 March 2023 

All organisations will be notified regarding which year, 2023/24 or 2024/25, the first Service Improvement Review will take place

From 1 April 2023

Biennial Service Improvement Reviews will be introduced

Full self-evaluation

Why are organisations asked to submit a self-evaluation using the Quality and Improvement Outcomes Framework for Knowledge and Library Services?

Health Education England (HEE) is responsible for ensuring that the NHS, its staff and learners in England have access to high-quality education and learning environments. HEE seeks assurance that organisations are enabling knowledge and library services to develop in line with Knowledge for Healthcare and HEE’s Knowledge and Library Services Policies, and HEE’s Quality Strategy and Framework.  

Are you planning to review the Quality and Improvement Outcomes Framework assessment process?

Yes. Health Education England regularly reviews all our quality assurance processes. We have listened to feedback from knowledge and library services and the national Quality Team to inform the approach going forward.  The aim is to simplify and streamline documentation and processes using the following principles:

  • supporting the NHS to bring benefits to organisations, the workforce and through them to patients
  • achievable and sustainable for NHS organisations, NHS knowledge and library services and validators
  • aligned and proportionate to the quality processes for organisations in receipt of NHS Education Contract funding
  • supportive of service improvement and development
  • enabling active engagement and good working relationships with a nominated development lead identified for each organisation

How will you work with organisations to continually improve knowledge and library services over the next few years?

On 30 August 2022, the Knowledge for Healthcare Board approved the adoption of a 2-year cycle of Service Improvement Reviews for a minimum of the next four years, until 2026/27.  See Implementing the Quality and Improvement Outcomes Framework from 2023/4.  The aim is to focus is on working with organisations and knowledge and library service teams.

When will organisations with an Education Contract next be asked to submit a full self-evaluation of the Quality and Improvement Outcomes Framework?

Organisations will not be asked to submit a full self-evaluation using the Outcomes Framework before 2027/28.

When will the Quality and Improvement Outcomes Framework change?

Work begins in September 2022, to revise the Quality and Improvement Outcomes Framework. We will seek input from service managers as this work progresses. The revision of the Outcomes Framework will inform the service improvement review process and the template of the associated Service Improvement Plan.

Service Improvement Review

When will the service improvement reviews begin?

The service improvement reviews will start from April 2023, and run for a minimum of four years to 2026/27.

What will be involved in a Service Improvement Review?

From April 2023, a biennial service improvement review will be introduced, meaning a review of 50% organisations in each year. The review will involve a discussion focused on:

  • recent service improvements
  • the plan for future development
  • any risks and concerns with which the team may be able to help
  • identifying good practice to celebrate and share with other knowledge services

What documentation will the organisation need to submit for the Service Improvement Review?

In preparation for the review discussion, each organisation will be asked to provide:

  1. A Service Improvement Plan for the knowledge and library service as per the NHS Education Contract (Schedule 1; 14.6).
  2. The most recent Knowledge and Library Service Annual Report.
  3. Any Service Level Agreements, where applicable.

For the service improvement review do you require an annual report for the preceding year?

Only if this is available and has been produced before the required submission date.  The most recent annual report for the knowledge and library service should be submitted.

Will all organisations have a service improvement review discussion in 2023/24?

Reviews will be undertaken with 50% of organisations with an Education Contract in each year, beginning with 50% having review discussions in 2023/24.

When will organisations having a service improvement review in 2024/25 be informed?

Each organisation will be informed, by March 2023, regarding which year, either 2023/24 or 2024/25, the service improvement review will take place.

How will HEE decide which organisations will have a review in 2023/24.

This has not yet been decided. The Knowledge for Healthcare Board is to consider whether to ‘cluster’ reviews, for example by geography or by type of organisation.

However, in the first instance knowledge and library services will have an opportunity to express interest in being an early adopter.

Will the service improvement review include a visit to the library?

The service improvement review will include a discussion with the organisation and the knowledge and library service manager.  Although visits to knowledge and library services will take place over the four-year period, 2023/24 to 2026/27, it is like that most service improvement review discussions will take place virtually.

When will I know when my organisation(s) review will take place?

The regional knowledge and library services team will be in touch with all organisations with an Education Contract before the end of March 2023, to arrange the date of the review meeting and to agree the date by which documents are needed.

Who should I work with in my organisation?

We would recommend you work with senior colleagues, the named contact on your Board, Head of Education and anyone else in your organisation you involve in service planning.

Why has this service improvement review approach been put in place?

This change is partly in response to feedback after the self-evaluation submission for the Quality and Improvement Outcomes Framework and partly informed by a review of the baseline data. This approach provides time for organisations and knowledge and library services to work together on service improvement.

The quality assurance process for libraries is fully integrated into HEE’s quality processes as part of the HEE Quality Framework. Taking a joined-up approach, the requirement for a Service Improvement Plan for knowledge and library services in the NHS Education Contract is reflected in the “ask” in the annual self-assessment survey, issued by regional HEE Quality teams to organisations.

Service Improvement Plans

What does the Education Contract say about Service Improvement Plans?

'The Placement Provider will ensure progression through the Quality and Improvement Outcomes Framework maturity model levels for all outcomes. The Placement Provider will ensure that there is an agreed and implemented Service Improvement Plan in place for the knowledge and library service. This plan is required to reflect the requirements of The Quality and Improvement Outcomes Framework.' The Education Contract Schedule 1; 14.6

What format will organisations need to use for a Service Improvement Plan?

A new Service Improvement Plan template will be developed, based on the revision to the Quality and Improvement Outcomes Framework.  The Service Improvement Plan should align to your organisation’s strategic plans as well as the Quality and Improvement Outcomes Framework.  The baseline report and recommendations to the organisation can be used to assist in informing the plan.

How will the Service Improvement Plan link to the Quality and Improvement Outcomes Framework?

The Service Improvement Plan will reflect the updated Framework, revised to align with the six Outcomes.

What can I do now to prepare for the service improvement approach?

To start preparing for a service improvement review you may find it helpful to:

  • review the recommendations in your baseline and detailed​ Quality and Improvement Outcomes Report
  • Make sure you are producing an annual report
  • Make sure that any your Service level Agreements are up to date and signed.

Page last reviewed: 2 September 2022