The £22 billion question: how can improvement be spread in the NHS?

The £22 billion question: how can improvement be spread in the NHS? In the mid-1990s, the service improvement methodologies developed by Don Berwick at the Institute for Healthcare Improvement in Boston, US, were first used in the NHS. In 2001 the Department of Health established the Modernisation Agency to develop and spread service improvement skills more widely throughout the NHS. And yet there is still a mountain to climb in terms of both service improvement and productivity, and there is significant variation across the country. Why is it that the best ideas are so hard to spread? The King's Fund