Overall approach

The high impact change model is not designed to be a performance management tool. Instead it takes as its starting point a recognition that even the best-performing systems will be experiencing challenges in relation to hospital discharge.

The model is underpinned by a sector-led improvement approach which emphasises the importance of triangulating both hard and soft types of data to tease out local stories within a culture of openness and trust. The model supports genuine, honest reflection and discussion between trusted colleagues within local health and care systems.

Some things that people have told us – about what works and how to overcome the challenges

• cross system leadership that champions the necessary culture change, supports risk-taking and empowers staff to make changes happen
• involving partners as equals from the outset so that changes are co-produced, with shared funding and shared risks
• developing a shared narrative or vision across the system that is person-centred, not process-centred
• establishing a no-blame culture and encouraging a learning and enabling environment that fosters innovation.