Advancing Quality NHS Advancing Quality Alliance

About Us

In this section you can find out a bit more about Advancing Quality, what is Advancing Quality? and how we measure performance.  You can also learn where the idea came from and read how the programme is making a difference.

What is Advancing Quality?

Advancing Quality is the flagship programme of AQuA (Advancing Quality Alliance) the North West’s health care quality improvement body.

Advancing Quality aims to give you a better experience of the NHS by making sure every patient admitted to a North West hospital is given the same high standard of care no matter which hospital you attend.

The basic idea of the Advancing quality programme is that if every hospital achieves the appropriate measures it will help to: save lives, reduce the number of people being re-admitted into hospital; reduce complications and decrease the length of time patients have to spend in hospital. From this simple foundation Advancing Quality can then enable hospitals to reduce costs and the money saved can be used to improve care and facilities.

The programme was launched in 2008 across all North West hospitals and independent research evaluating the impact of the programme has shown it is working;


Fewer deaths during the first 18 months


Bed days saved


Saved due to the reduced length of stay

Advancing Quality originally focused on five clinical areas which affect a lot of patients in the North West. These were heart attacks, heart bypass surgery, heart failure, hip and knee replacement surgery and pneumonia.

Following the early success of the programme Advancing Quality expanded into the treatment of stroke patients in October 2010 followed by dementia and first episode psychosis in January 2011.

In 2015 Advancing Quality grew to cover 14 clinical areas when 6 new areas are introduced, these areas are; acute kidney infection, alcohol related liver disease, chronic obstructive pulmonary disorder, diabetes, hip fracture and sepsis.

Advancing Quality Listening Exercise

Over the next three months we want your views on our flagship reliability of care programme, Advancing Quality (AQ).

We’re asking all our members, including those not currently participating in AQ, to share their thoughts and help us shape our 2017/18 plans for the programme. You can do this through our short online survey, or by taking part in 1-1 meetings and telephone interviews.

For more information, please download the flyer. To take part in the survey please click here, or contact to arrange a meeting or phone call.


How does Advancing Quality measure performance?

Although the care you receive when you are in hospital is tailored to your own individual needs, clinicians from across the North West have agreed a number of key things should happen, which, if carried out at the same time and in the same way for every patient, will ensure all patients are receiving the best possible care. These are what Advancing Quality refer to as the Clinical Process Measures and trusts aim to achieve 100 per cent success rate. For example if you are admitted to hospital suffering from pneumonia two of the key Clinical Process Measures would be to have your oxygen levels assessed when you arrive in hospital and if you are prescribed antibiotics to receive these within six hours of arriving at hospital.

To determine how well an NHS trust is performing Advancing Quality monitors the Appropriate Care Score (ACS). The ACS is calculated by counting the number of eligible patients that received a measure divided by the number of eligible patients in total. This measurement ensures that the best clinical processes are being followed and delivered at the same time in the same way for every patient. Click here to view measures.

Patient Reported Outcome Measures (PROMs); measuring a patient’s personal view of their improvement in the quality of life following their treatment or surgery.

Patient Experience Measures (PEMs); measuring a patient’s personal view of their own experience in hospital and of the care they received. From 2008 to 2013/14 the results for each NHS trust are published annually once they have been fully audited.

From 2014/15 onwards we will publish the results for each participating trust on every six months.

Where did this idea come from?

Advancing Quality builds on the experience and knowledge gained through the Hospital Quality Incentive Demonstration (HQID) programme launched in 2003 in the USA. HQID was proven to save lives in participating hospitals It is now operating in more than 250 hospitals in the non-profit healthcare sector in the US.


Hopsitals in the US are now participating in the HQID programe

Is it making a difference?

The programme is being independently evaluated by a team of economists and health experts from the universities of Manchester, Nottingham, Birmingham and Cambridge. Their aim is to evaluate how Advancing Quality has impacted on financial savings; lives saved; reduced length of stay in hospital; reduced complications and reduced admissions.

In a paper published in the New England Journal of Medicine (ref: N Engl J Med 2012; 367:1821-8) they found there had been a significant fall in the number of patients in the North West dying from pneumonia, heart failure or heart attacks and estimated 890 lives had been saved within the first 18 months of the programme. You can read more about the paper in our News section.

An additional paper from the same research team has been published in Health Economics (ref: Health Econ. (2013)DOI: 10.1002/hec) and assessed the cost-effectiveness of Advancing Quality attributing it to health gains of £105m for the North West region.


lives have been saved within the first 18 months of programme


health gains for the North West region

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