An evaluation of the practices of, and barriers to, continuous improvement through learning on NHS LIFT projects

The Department of Health (DoH), which is responsible for maintaining the overall health of people living in England through the National Health Service (NHS), introduced the Local Improvement Finance Trust (LIFT) initiative in 2000 to reverse the declining state of primary care infrastructure. The initiative involves partnerships between diverse public and private sector organisations to deliver improvements in facilities that will be suitable for modern primary and social care services over a 20 – 25 year period. The initiative contractually demands for continuous performance improvement from the demand and supply sides, but the attainment still remains elusive. This paper is aimed at describing the investigation into the practices of, and barriers to, the achievement of continuous improvement through learning on NHS LIFT schemes. The investigation is part of a study aimed at developing a continuous improvement framework that will ensure that current and relevant knowledge is captured and reused during the execution of long-term partnering (LTP) relationships. The methodology adopted for the investigation involved semi-structured interviews with ten senior officers of six organisation working across three LIFT schemes following the review of relevant literature. The study revealed that ad hoc procedures were mostly used for capturing lessons learned during the planning and implementation of the various LIFT projects. Although a variety of techniques and few technologies were being employed in capturing relevant project knowledge, the study revealed that the reuse of the captured knowledge have been largely ineffective. The key barriers to the achievement of continuous improvement on NHS LIFT projects identified include distrust and lack of mutual understanding, difference in modus operandi and timeframes of the key participants, lack of clarity and communication, lack of appropriate skills and competencies; and adversarial contexts.