Table II

Common transformation programme elements

ElementPinnacle Midlands Health NetworkAchieving Clinical ExcellenceBritish Heart Foundation House of CareMacMillan Cancer Improvement Partnership
External facilitationA multi-disciplinary change management team included GPs, managers, analysts and patient partnersOne pilot funded an expert in improvement methodology to guide their approachExternal support was provided through the Year of Care Partnership and the Health and Social Care Alliance Scotland. Funding was used to employ project managersThree change facilitators with nursing / primary care backgrounds were recruited to support each practice
Leadership supportPeer leadership networks and time for reflection was provided for GPs, nurses and practice manager leadsPilot leads had time for reflection and peer challenge within learning setsEach site identified local clinical leads to champion the new approachMacMillan GPs helped develop standards and each practice needed a clinical and non-clinical cancer champion
On-going learningLeadership development programmes were availableEvaluation provided emerging insights to help shape further implementation.The Year of Care Partnership delivered training on care and support planning and also developed local trainersOpportunity for leads to meet and reflect on progress with implementation
Stakeholder engagementPatient forums and multi-disciplinary workshops are heldSharing events were held for wider GP membershipPatient representatives required on national and local steering groupsA patient engagement facilitator co-ordinated various engagement opportunities
Transitional fundingOne-off funding to provide backfill and meet additional expensesPilots received additional per capita funding for 12 months with flexibility as to how this was usedAdditional funding was provided for project management/patient engagement but not backfillPractices were offered one-off incentive payments
Robust evaluationProgress reviewed regularly against baselineAn external formative evaluation was commissionedAn external evaluation was commissioned which also supported local evaluations by sitesAn external evaluation was commissioned

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