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The Q Lab approach is distinct from other health and social care improvement efforts

• The Q Lab's mechanisms, particularly its convening function, and its combination of principles of collaboration, creativity, time-boundedness and topic-specificity, distinguish it from other improvement approaches.

A dedicated Q Lab team and a range of stakeholders contributed to effective delivery

• Having a dedicated Q Lab team was likely essential in creating the momentum around the generation of ideas with the potential for impact. Engaging a range of stakeholders contributed to achieving a holistic understanding of the peer support challenge.

The varied engagement approach and networking opportunities were valued by Q Lab participants

• The Q Lab team successfully maintained engagement throughout the pilot Lab. Participants had different motivations and faced different barriers to engagement, but valued the relationships nurtured through the Q Lab.

There were benefits as well as the potential for tension in the links with Q, the Health Foundation and NHS Improvement

• The tight link between the Q Lab and Q benefitted the former, though there is a potential for tension given that membership for both initiatives is not directly linked. The financial support from the Health Foundation and NHS Improvement was vital to the Q Lab.

The Q Lab consolidated learning and knowledge on, and raised the profile of, peer support, and motivated participants to take action

• Notwithstanding these achievements, participants and stakeholders felt that the Q Lab may not have been able to achieve impact and spread locally and nationally in its pilot year.

Around the world social labs are being established as a way of tackling complex challenges. The aim of these labs is to work creatively and collaboratively to formulate and test new ideas. Most commonly the labs claim to support innovation (a step change in delivery and performance) in policy or delivery rather than improvement (incremental change in performance), but in practice there is considerable overlap. Labs use various approaches, often rooted in the disciplines most relevant to their work, for example design or behavioural science.

The first Q Improvement Lab ('Q Lab'), funded by the Health Foundation and NHS Improvement, was launched in the spring of 2017. The aim was to test whether the Q Lab approach is likely to become an effective, valuable way of developing ideas or interventions to support positive change at multiple levels of the health and care system in the United Kingdom. The Q Lab is distinctive not only for its focus on improvement but also for its concerns with UK health and social care issues.

RAND Europe and the University of Cambridge were commissioned by the Health Foundation to undertake a real-time, formative evaluation to support the Q Lab pilot. The evaluation addressed the overarching question: 'Is the Q Lab approach likely to become an effective, valuable way of developing ideas or interventions to support positive change at multiple levels of the health and care system?' Starting in May 2017, the evaluation was conducted over 15 months.

• Chapter One

  Context, aims and methods of the evaluation

• Chapter Two

  The Q Lab approach: origins, phases and programme theory

• Chapter Three

  Findings

• Chapter Four

  Reflections and recommendations

• Annex A

  Overview of data sources

• Annex B

  Interviewee selection approach

• Annex C

  Interview and focus group topic guides

• Annex D

  Survey 1 instrument

• Annex E

  Survey 2 instrument