On Friday 6th September, CLIC hosted a visit from Hugh McCaughey (National Director of Improvement for the NHS), enabling him to see first-hand some of the work that has been taking place to transform the health and care services in the area.

For part of the visit, staff from Maple B/C/D Wards at Cumberland Infirmary welcomed Hugh and shared details of a Rapid Process Improvement Workshop (RPIW) that they participated in a little while ago, which focused on improving discharge from the ward. They were able to demonstrate how their work has continued to have a positive impact on care and treatment of patients accessing the ward. Notably this includes the use of fully electronic, Realtime notes during muti-disciplinary board rounds, removing the requirement to photocopy all patient notes prior to transfer to community settings.

Hugh also visited the Learning & Improvement Hub, a new learning space that is being developed by North Cumbria NHS Library and Knowledge Services as part of the Trust’s Engaging with Improvement programme, funded by HEE North Healthcare libraries and Doughty Charitable Trust fund.

The learning space will be next to the restaurant within the hospital at CIC and will accommodate workshops and drop-in sessions, and when vacant will provide staff with a place to study, including access to Wi-Fi and PCs. It will host training and workshops next month, and will be open for all staff to use after its official opening on 1st November. Look out for further information in Staff News, and you can also contact sheila.marsh@ncuh.nhs.uk directly if you have any queries.

For the final part of the visit, Hugh met with colleagues from ICCs and Primary Care who shared examples of collaborative working, and discussed the unique challenges that have been faced during work to integrate health and care services in the region.

Thank you to everyone who helped to host Hugh on the morning; it was a great opportunity to share examples of improvement work taking place in North Cumbria.

We are looking for new schemes that enable staff to take forward improvements within their service aligned to the system objectives and priorities and organisational values.  

Engaging for Improvement puts the patient at the heart of everything we do; by identifying an idea for improvement, gathering information to understand and measure the current state, engaging with your team and wider stakeholders to gather their ideas and answer their concerns. The success of any improvement lies in engagement and involvement of the right people from the beginning.  

It is a six step approach designed to be worked through over a period of 20 weeks. Wave 12 will take place between December 2019 and April 2020, during this time the CLIC Team will actively support you to lead your improvement.

If you think Engaging for Improvement is something you are interested in follow THIS LINK to access an Expression of Interest Form complete and return this to the CLIC Team at info@theclic.org.uk by the 25th October 2019.

The 2019 Golden Apple Awards recognise and reward excellence in education and learning.

We're delighted to share with you that CLIC has been selected as a finalist in this year's Golden Apple Awards 2019 'Best Learning, Development and Training' Category.

The presentation will take place on Friday 4th October at Energus, Workington - wish us luck!


By Danielle Smith, Service Improvement Analyst with CLIC

In advance of the Trust merger, the recruitment teams from both the Cumbria Partnership NHS Foundation Trust (CPFT) and North Cumbria University Hospitals NHS Trust (NCUHT) came together to make many improvements in the recruitment process for applicants and recruiting managers. 

Cumbria Learning and Improvement Collaborative (CLIC) facilitated a week-long Rapid Process Improvement Workshop (RPIW) during the 12th – 16th August 2019, focusing on streamlining, integrating and standardising the recruiting process, and improving the onboarding experience.

Past experience has shown that in order to make sure that any improvement is sustainable, sufficient preparation beforehand is absolutely key. Therefore prior to the workshop, the CLIC team worked closely with the recruitment team to identify targets for improvement, capture the current state through observation, measurement and process mapping. This meant that everyone entered the workshop ready to hit the ground running.

The week itself kicked off with participants learning about improvement tools and approaches that form part of the Cumbria Production System and using these tools to improve their current processes. One of the tools used throughout the week was process mapping, where the flow of all of the separate processes within recruitment was visually displayed. This allowed the teams to identify waste and add value to the recruitment process. A value-stream map was also created to measure the time taken and identify value from the customer perspective. This tool was used by the teams to help with streamlining and to establish the lead time for recruitment.

During the rest of the week, members of the recruitment team worked alongside customers and their colleagues from other departments to problem solve the various recruitment and onboarding processes and redesigned an improved future state. Using a Plan Do Study Act (PDSA) tool, they were able to test out ideas for improvement.

There were a significant number of improvements which included:

  • A 20% reduction in overall time to recruit
  • The approval process was streamlined from 192 to 48 hours
  • Processes were integrated and standardised between the two recruitment teams, with 22 of 27 differences between the two teams’ processes being addressed
  • Establishment of a uniform ordering process which removes over 200 hours waste (equivalent to £2,000 a year)
  • A new, unified, recruitment team standard operating procedure was brought together, updated, and standardised, and further guidance for recruiting managers was created, with a bespoke training program planned for the future


The RPIW doesn’t end here, the teams have a plan for further improvements over the next 30-60-90 days and CLIC will provide support and follow up to embed the improvements and achieve the targets agreed at the outset.

If you would like more information on a RPIW with the CLIC team, please contact: info@theclic.org.uk 

For more information on Process Mapping, Value Stream Mapping and other improvement tools, please go to the Cumbria Production System Toolkit.

By Amy Aitken, Senior Administrator | MBTI & Insights Practitioner | Coach with CLIC

Knowing where to start with your goals can be a real challenge – you have identified what you ultimately want to achieve, and you might have some ideas about action to take, but do you truly know and understand all the forces that are at play in your current situation? It’s only by recognising the things that keep a situation as it is, that maintain the ‘status quo’, we can begin to take the relevant, necessary action to change our behaviour.

I wanted to share a tool with you which I have found particularly useful in this area, both for myself personally, and when working with coaching clients… 

Developed by American-German psychologist Kurt Lewin, Force Field Analysis is a technique which enables you to consider all of the factors that may help you in achieving your goal, as well as the factors that might hinder you. It’s a straightforward process that’s easy enough to do on your own – the real trick is being completely honest with yourself! By doing this, you can begin to identify strengths, blindspots, advantages, fresh perspectives, and establish feasibility and overall commitment to your goal.


The technique:

  • First, draw a line down the middle of the page to represent your goal. In the below example, this is ‘By the end of 2019, I will be practicing yoga at least 3 hours per week, every week’ (notice how the goal is Specific, Measurable, Achievable, Realistic, Time-Bound – SMART)
  • Next, write ‘Hindering Forces’ above the left-hand column, and ‘Helping Forces’ above the right-hand column
  • Under each column, begin to list the factors that either help or hinder achievement of your goal. Think about things within your control (e.g. yourself), outside of you control (e.g. other people), and your wider environment (e.g. your organisation)
  • When you think you’ve finished listing, ask yourself again: ‘Have I captured everything?’
  • Assign arrows to each of the forces listed, making their size relative to the power they have


In the above, you can see that the hindering forces are greater than the helping forces, so some real commitment and effort will be needed in order to achieve the goal.


  • Now take some time to reflect on what you’ve written. Think about which of the forces can be increased, decreased, or perhaps even completely removed – challenge yourself! In relation to the example, a family planner was introduced to diminish the impact of a busy schedule, the fact that yoga classes don’t run every week, and to encourage motivation


Whilst a personal example has been used here, this tool can be applied to many, many different situations. Happy Force Field Analysing everyone!