Project Summaries

People 1st Plymouth

People 1st Plymouth is a cultural change programme with people and improvement at its heart. We didn’t want to launch it with a big fanfare, instead we wanted to let things get underway on the ground before we started to talk about it more widely.

People 1st brings people together – staff and patients/clients – in huddles to define and solve problems and make improvements, big and small. Crucially the improvements are ones that matter in the eyes of those we care for.

People 1st Plymouth has three core principles:

  • Respect for staff (deeper than courtesy – make time at work rewarding)
  • Seeking value in the ‘eyes of people we care for’ – what matters to them
  • Teams are able to drive improvement

People 1st offers a standard method to support teams in defining a problem, working through possible solutions and creating a better future.

Teams choose which problems they want to work through and meet regularly to track progress against visual metrics, displayed on a wall or whiteboard for everyone to see.

Together University Hospitals Plymouth NHS Trust and Livewell Southwest are one of seven hospitals/health and social care systems in the country which have been given the opportunity to embark on this three-year cultural change journey, working with our own team of experts from NHS Improvement.

What we’ve achieved so far:

  • Brought together around 50 people involved in delivering frailty, respiratory and cardiology services for a week to design a new end-to-end pathway using the improvement methodology
  • Started training people as improvement coaches
  • Started improvement huddles in ++ areas including Acute Assessment Unit, respiratory and other areas
  • We’ve run a pilot to improve heart failure support for emergency patients. This successfully reduced the number of patients admitted who were then cared for in the community

Both organisations have followed up some quick wins from the week-long event with some great yet simple work saving time and delays for respiratory spacers in the community and some interesting work reducing admissions for heart failure and chest pain.


We are now working on a few ‘exemplar’ areas across both organisations, who will receive some bespoke help and support. These will be Kingfisher at the Local Community Centre at Mount Gold and Monkswell Ward in Derriford. The aim is for staff in those two areas to feel:

  • Team-driven change is the norm
  • Value in the eyes of the person being cared for is clear and strong
  • Work is aligned to organisational goals
  • Daily routine is visual and based on a standard approach to work
  • Daily learning which is shared
  • A coaching ethos supports the team

These will be our first areas but we may be able to offer additional support. Contact Samuel.stocker@nhs.net if you would like to have arrange a discussion about your ward/department.

If it hasn’t already done so, the People 1st team-driven approach to improvement should be coming to where you work soon. It will give everyone a chance to be involved in making improvements. We hope you’ll want to get involved.


Ann James
Chief Executive
University Hospitals Plymouth

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