Can you make a difference to people’s lives?

Thomas Monaghan, Portfolio Lead for Living Well in Communities

15 June 2015. That’s the day I became part of Healthcare Improvement Scotland.

What attracted me to work in Healthcare Improvement Scotland? I wanted to help people have better lives. People like my late sister, who due to her long list of mental and physical conditions spent the last few years of her life ping-ponging between hospital and home. She could barely live her life because the services that supported her, my family and I were so busy trying to keep her safe that we effectively stopped her from living. I don’t want anyone else to experience that. I want everyone, no matter their background, to have the same opportunity to have a better life. And that’s why I’m part of Healthcare Improvement Scotland, because I’m helping people have a better life.

As my third work anniversary approached I started reflecting about the roles I’ve had in the past, from teaching undergraduates during my biomedical studies to service improvement in a large social housing and care group. And I realised that working in Healthcare Improvement Scotland combines the best parts of all my previous roles. I have the methods and thought-provoking challenges of scientific research. The buzz from helping people put new skills into practice. And the heart-felt satisfaction of helping people have better lives. And that’s with the pleasure of working with like-minded people.

My work

I started out at Healthcare Improvement Scotland as an Improvement Advisor. With the help and support of the team at Healthcare Improvement Scotland I developed my own skills and knowledge, growing my experience and confidence to enable me to develop with the organisation to become the team lead of Living Well in Communities. The team delivers a wide range of improvement programmes that work with health and social care organisations to help people have a better life at home, wherever that’s their family home or a care home.

There are many aspects to having a better life. One of them is avoiding time in hospital. Hospitals are great places to be when you need them, but many people have a similar experience to my late sister and have episodes where their lives are put on hold as they ping-pong in and out of hospital. But it’s not inevitable.

Helping people to live well in their community

The Living Well in Communities team have been working with services in over 20 health and social care partnerships (HSCPs) to find ways to improve support for people in the key population groups below to help them live well at home for longer.

We have been doing this by:

  • testing ways to identify people in these groups before a crisis occurs leading to repeat hospital admissions,
  • developing tools and approaches to help practitioners have a conversation with people at risk of crisis about what they want for their future, and
  • implementing preventative models of care to support people live well in their community for longer.


Scaling up change across Scotland

Much of our early testing work, particularly around frailty, is now complete and we are about to offer all HSCPs support to change their local systems to help people to live well in their communities for longer. We have already started working with the ten HSCPs in the north of Scotland and we will soon be able to support the HSCPs in the east of Scotland.

To further enhance our work, we are seeking to appoint a new Improvement Advisor to join our dynamic and driven team of liked-minded individuals to offer support to the HSCPs in the west of Scotland.

Could that be you?

Join us and help change lives

You would be joining a great team with a mix of people from various sectors. Some of the team have traditional health backgrounds, but others have joined us from local authorities, the Mental Welfare Commission, third sector providers and even a national sports association. I value that diversity and we’d like to continue to invite applications from a wide range of backgrounds.

There are some essentials for joining the team. You need practical improvement skills that you have used to help professionals change the way they work by using structured methods to systematically drive improvement. Methods such as the IHI Model for Improvement, system thinking methods such as Lean, experience based co-design or even RADAR from the EFQM Excellence Model. Data skills are also incredibly useful, not just traditional quantitative data for run charts, but also using qualitative data to drive improvement.

Key to the success of this role is the ability to establish and maintain good relationships. You will need to form and manage excellent working relationships with the Health and Social Care services you serve throughout the west of Scotland. You will also need to work closely with the rest of the Living Well in Communities team, especially the National Clinical Leads, National Professional Leads and national partners who bring substantial health and social care subject matter expertise to our work.

As you will be leading regional improvement support, it is important that you have some practical experience managing large projects or programmes. Our regional work is more responsive to local needs than traditional national programmes, which means you need to be comfortable managing programmes that will change with local needs and often start with a lot of ambiguity.

And finally, what we need is a passionate leader. Someone who truly cares about helping people have better lives and can use that passion to inspire others to change. We need someone who can persuade others to break old habits and try something different. We need someone who is self-aware and is driven to continuously develop their own skills, experience and behaviours as they strive to improve the support they provide to HSCPs.

If you have these skills, the energy and drive to be part of the Living Well in Communities team, then we would love to hear from you.

Apply now at our website. If you’d like have an informal chat to a current Improvement Advisor about their experience in the role, then please email Nathan at You can also find more information about us on our website and on our blog.

If you join the team we’ll put your skills to good use to work with health and social care services to shape the care experience of tens of thousands of people. That won’t reverse my late sister’s experience, but it will help thousands of others to have better lives.


What is it like being an Improvement Advisor?

ND_bwNathan Devereux shares his experience of being an Improvement Advisor in Living Well in Communities team.

Being an Improvement Advisor is an incredibly diverse role which constantly keeps me on my toes! I spend most of my time working with people to bring their ideas and creativity out so that everyone can work towards improving what they do.

Day-to-day that means supporting people to:

  • understand their challenges and opportunities, by using their experience, data and evidence,
  • generate ideas for doing things differently by facilitating workshops with teams, having one-to-one conversations, and, connecting teams from different parts of Scotland, and
  • evaluate how those changes are tested and what the impacts are for people who require care and support.

As an Improvement Advisor I spend a lot of my time working with people to help improve what they do, whether that’s with service managers, frontline staff, or strategic leaders in health and social care partnerships. The time I spend can be looking how to improve identification of people with frailty, or sharing the learning from our programme nationally. So it’s important that you enjoy working with people, as the technical aspects of improvement can only result in positive change when used to help people change and improve what they do.

One of the biggest challenges, but also the most interesting part of the role of being an Improvement Advisor is the diversity and scope of the work. My job is to meet the needs of the organisations I work with and help them to improve. This broad focus can be overwhelming so you need to be able to use a combination of quality improvement and project management skills to understand the situation from the point of view of those you support and then plan and deliver a programme that will focus on achieving outcomes you and your partners want to deliver.

This is also why it’s really important to have a generic set of improvement skills, because the topic or area is determined by the priorities of the organisations I work with. For example, I can go from working with a health and social care partnership to improve how people with palliative care needs are identified and cared for, to advising organisations how to evaluate their intermediate care services.

I don’t think there is a standard route to becoming an Improvement Advisor. The broad set of skills needed means that you can transfer from so many backgrounds and professions.

I started my career working with political groups in a local authority in England before deciding to travel and work abroad, including teaching English in Korea. After relocating to Scotland I then joined Healthcare Improvement Scotland to undertake a number of project roles.

While working on a number of projects related to the assurance and improvement of care, I became increasingly interested in quality improvement itself. I therefore decided to complete online courses and took the opportunity to shadow colleagues who provide improvement advice directly to teams who deliver care and support. I wanted to test my new-found learning, so I used the improvement methods to improve my project work and also got involved in internal improvement projects. These experiences showed me that improvement was something I wanted to pursue, and that I had the generic skills that could be developed to work in improvement. After a little while I eventually secured a place on a formal quality improvement training programme and shortly after secured a post as an Associate Improvement Advisor.

This role enabled me to work directly with health and social care partnerships, using my expertise to improve service provision. I really focused on developing my quality improvement, project management, communication, and, crucially, leadership skills, so that I could become a more effective leader of change. A key part of that development was taking responsibility for national programmes, such as work that looked at how to plan services to meet the needs of a population group. After a couple years working as an Associate Improvement Advisor I then progressed to the Improvement Advisor role, and I have really enjoyed leading programmes, developing others in improvement, and experiencing even more subject matter areas.

Hopefully that gives you an idea of what it’s like to be an Improvement Advisor. It’s such a diverse role, so beyond skills and experience it’s really important that you have the right attitude for the role. The key things for me are that you are adaptable and genuinely open about your strengths and weaknesses. I’m always developing and think that will continue as I aim to improve how I meet the needs of the organisations I work with.

If this sounds like something you would enjoy then I’d recommend you submit an application, or get in touch to discuss more about the role! My email address is

For more information about the role or to apply please visit the Healthcare Improvement Scotland’s website.

Improving Care for People with High Levels of Need


(Source: Information Services Division Integrated Resource Framework. Data from 2012/13)

The High Resource Individuals team within Living Well in Communities is supporting Health and Social Care Partnerships (HSCPs) through a series of data Deep Dives, to understand how those with the highest level of need interact with services.

Thomas Monaghan, Improvement Advisor, from Healthcare Improvement Scotland’s ihub, and Nathan Devereux, Associate Improvement Advisor, have been contributing to the wider work on High Resource Individuals by exploring ways of improving pathways of care, with support from the Local Intelligence Support Team (LIST) and Information Services Division (ISD).

These Deep Dives help partnerships explore their data on these individuals and identify areas for improvement.

Who are High Resource Individuals?

High Resource Individuals (HRIs) are the small number of people who use a high percentage of hospital and community prescribing resources and inpatient bed days.

Continue reading “Improving Care for People with High Levels of Need”

Living Well In Later Life

What sorts of things come to your mind when you read the phrase ‘Living well in later life’? How can quality improvement help achieve this and why is the QI community across health and social care getting involved?

Surely how one lives, is not something that anyone other than the individual can control? Living well is about making your own decisions, about exercising choice. So why, one might ask are the health and social care organisations developing a programme that seeks to focus attention on this?

In a nutshell, what we are trying to do, through a series of projects is to empower older people and their loved ones to make decisions about how to live well in later life and provide guidance to help them navigate through the maze of choice of care solutions so that informed decisions about how one wishes to live well can be reached.

Continue reading “Living Well In Later Life”