7 pillars of improvement at scale: Key questions for boards and exec teams

Forum Strategy is providing free access to a number of resources, including our key questions for boards and executive teams on ‘scaling up an improvement model’. This is based on Forum’s 7 pillars of improvement at scale.

We are very happy for trusts and organisations to use this document, but please not reproduce it as it is subject to copyright. Thank you.


To find out more about our 7 pillars of improvement at scale, including summaries and thinkpieces, please visit: 7 Pillars of Improvement at Scale


7 pillars of Improvement at Scale:

Key Questions for Boards and Executive Teams


  1. Vision for Improvement (The improvement narrative)

It is essential that leaders of large organisations (the board and CEO) can set a clear vision which goes further than warm words, and translates into key measures of organisational success and specific strategic improvement priorities. These will include, but will certainly not be limited to, government set KPIs. The organisation should also define its own goals and targets based on its vision, and be publicly accountable for them where possible.

  • How do you define ‘success’ in accordance with your organisation’s vision? What does success look like in terms of outcomes and outputs?
  • Do your organisation’s KPIs truly reflect the vision for improvement? Are they ambitious and inspiring enough to mobilise both staff and those beyond the organisation to support improvement activity.
  • Do ‘divisional’ improvement priorities tend to align with the organisational vision for improvement?


  1. Capacity

Improvement across a large organisation depends on employing people at all levels with the right skills, experience, and attitude to take ownership of improvement. The ‘delivery’ of improvement is a different discipline to the ‘leadership’ of improvement. The organisation must foster capacity for both, providing people with the necessary training, experience, and quality assurance at all levels.

  • Does your organisation have (enough) sufficiently experienced and skilled improvement leaders who are not only experts in their field, but can project manage, broker, motivate, and quality assure the process of improvement?
  • Is your organisation ensuring sufficient geographical proximity for improvement projects and providing opportunities for staff at all levels to work together on focused ‘improvement’ tasks and professional learning?


  1. Collective Commitment

Improvement at scale depends on a culture of professional generosity and reciprocity, a commitment to supporting the improvement of others – seeing areas of commonality before differences. Organisations that fail to foster this culture can struggle to mobilise people to support the improvement process, sharing capacity and transferring good practice.

  • Do leaders across the organisation use the language of ‘we’ rather than ‘us and them’. Does the CEO, board and senior team model that language and a shared vision for improvement?
  • Is there a sense of collective accountability amongst leaders across the organisation, at all levels, for its wider success and improvement? Is this reflected in performance management?
  • Is there a culture of peer review, which encourages leaders and staff to support and inform one another’s improvement, based on sharing professional expertise and embracing learning?


  1. Intelligence and data

An improvement model at scale depends on the quality of data – how timely, robust and relevant it is. Not only must data be triangulated, drawing on a range of sources – the all-important views of end users, insights from peer review, staff absence/survey data, monitoring by expert practitioners – it should also be timely enough to inform and review the improvement process in real-time. A CEO and their executive improvement leaders must have confidence in the robustness and timeliness of data in order to ask the right questions and take informed decisions

  • Are you relying on one or two sources of intelligence, or are you informed by a wide-range of sources, which can be triangulated to provide more robust insights?
  • Is data not simply reported, but interrogated and acted upon in a timely way by improvement leaders?
  • Is the data captured justified by alignment with the vision (see 1) or is it simply adding to workload?


  1. Project and process management

A scalable improvement model cannot be co-ordinated by a handful of individuals based on their professional instincts. It needs to be systemised, not only through the routine capturing of key data, but through processes and project management. Key players must understand their role within the improvement process, and senior leaders must be able to ‘deep dive’ into the process, and quickly understand the progress of the improvement process, the key players, and timelines and objectives that are being worked towards.

  • Does your organisation have sufficient systems and processes in place that ensure improvement is based on project management principles?
  • Do those involved in ‘delivering improvement’ understand the improvement model they are working within and how they fit in?
  • Can senior executives and board members readily access information on the progress of improvement projects?


  1. Staying at the ‘cutting edge; innovation and research and development

A scalable improvement model can often become complacent, turning to the same people and sources without questioning whether the quality of improvement activity is being sustained. People involved in leading and delivering improvement should be quality assured and constantly learning from external sources of evidence and best practice – staying at the cutting edge. Meanwhile, a culture of innovation depends on the support and encouragement of the board and executive, who must encourage it, whilst ensuring it remains disciplined and strategy.

  • Do those involved in delivering and leading improvement have key external relationships that contribute to their continuous learning and development? Is their work informed and refined in light of the highest standards of new evidence and practice?
  • Are those involved in improvement activity subject to quality assurance? Is their practice and thinking open to peer review, for example? Are improvement practitioners sufficiently accountable for the impact of their work?
  • Are disciplined and strategic innovation projects encouraged by the CEO and executive team? Is this supported by sufficient investment of money and time? Do CEOs model a learning culture, including calculated and ethical risk-taking, at the top?


  1. Quality Assurance

The improvement model must not only be the mechanisms for improvement, but it must embody improvement – continually improving itself!

  • Does the board sufficiently review the impact of the improvement model with reference to the objectives and outcomes identified through (1), (4) and (5) above;
  • Is the improvement model subject to sufficient high quality peer review, drawing on a set of principles such as these 7 pillars upon which to undertake meaningful review? Are recommendations of the review process considered and actioned upon with care?
  • Are there sufficient opportunities for those involved in the delivery and leadership of improvement to feedback on the model, without fear or favour, informing its refinement over time?


Further reading:

Find out more about Forum Strategy’s 7 pillars of improvement at scale, including summaries and more detailed thinkpieces, here: http://hippofish.co.uk/7-pillars-of-improvement-at-scale/