Diabetes quality improvement at scale: how Barking and Dagenham, Redbridge, and Havering CCGs tackled the ‘Seven Spreadly Sins’

The potential benefit of any quality improvement scheme can be increased manifold if it is consistently and systematically applied across organisations and systems. However, this is not easily achieved. Across the UK, a third of healthcare improvement projects never spread beyond their particular unit, a further third are embedded within their own unit and spread across an organisation, and only a third are spread across their own and other similar organisations.1,2 The Institute of Healthcare Improvement (IHI) has branded the ‘Seven Spreadly Sins’ as common slip-ups that organisations make that prevent the successful spread of quality.3 In 2016, Barking and Dagenham, Havering, and Redbridge Care Commissioning Groups (BHR CCGs) embarked upon a programme to improve the quality of care provided to diabetes patients. The three CCGs are challenged by escalating diabetes prevalence, poor uptake of the National Institute for Health and Care Excellence’s (NICE) recommended eight care processes,4 and an increasing rate of complications. Encouraged by the rapid improvement of quality in one area,5 we sought to …