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'But why is that better?'

‘But why is that better?’ An investigation of what applied philosophy and ethics can bring to quality improvement work in healthcare is a research project funded by a Wellcome Trust Collaborative Award in Humanities and Social Science. The project runs for five years, from 2018–2023.

Quality improvement (QI) aims to tackle the shortcomings of health services, but QI initiatives do not always work and sometimes create new problems. One of the reasons for these failures is that people do not agree about what counts as good quality, and quality is often interpreted in ways that fail to capture the aspects of healthcare that matter to people.

This project uses the tools of applied philosophy to help deliver on the promise, and avoid the pitfalls, of healthcare QI. We think that applied philosophy can help elucidate and address the conceptual, ethical and practical challenges faced by researchers and quality improvement practitioners, with potentially transformative implications.

Read more about our activity including conferences, workshops, talks and publications by clicking on the 'Activity' tab below

Aims

We will work with QI partners from diverse healthcare settings to address debates about quality and to understand how the potential harms and ethical challenges produced by QI can be better managed. We will pioneer a partnership approach to building applied philosophy into QI.

Methods

We will address these goals by integrating our applied philosophical scholarship with literature-based work; interviews with QI leaders; partnership working with QI sites; knowledge exchange events; and methodological innovation and reflection.

Project team

Professor Alan Cribb

Principal Investigator

School of Education, Communication and Society, King’s College London
Professor Vikki Entwistle

Co-Investigator

Health Services Research Unit and School of Divinity, History and Philosophy, University of Aberdeen
Dr Polly Mitchell Research Fellow School of Education, Communication and Society, King’s College London

Advisory group

Name Affiliations
Professor Natalie Armstrong

Department of Health Sciences, University of Leicester

Mr Jono Broad Quality Improvement Patient Involvement (QIπ)
Dr Sibylle Erdmann Ei SMART BMJ Patient Panel and parent carer to two children with healthcare needs
Professor Soren Holm Centre for Social Ethics and Policy, University of Manchester; Manchester Institute for Collaborative Research on Ageing, University of Manchester
Professor Christian Munthe Department of Philosophy, Linguistics and Theory of Science, University of Gothenberg
Professor Craig Ramsay

Health Services Research Unit, University of Aberdeen

Professor Rosamund Scott Centre of Medical Law and Ethics, King’s College London
Professor Nick Sevdalis

Centre for Implementation sciences, King’s College London; NHS National Institute for Health Research

Collaboration for Leadership in Applied Health Research and Care (CLAHRC) South London

Professor Justin Waring Centre for Health Innovation, Leadership and Learning, Nottingham University Business School
Professor James Wilson Department of Philosophy, University College London; Health Humanities Centre, University College London

Conferences

  • The ethical implications of improvement science research and practice: developing a research agenda.
    Conference: University of Liverpool, London campus. In conjunction with Dr Lucy Frith (University of Liverpool) and Professor Stacy Carter (University of Wollongong). Supported by the Institute of Medical Ethics
    29 April 2019
  • Development of ethical guidance for WHO on person centred approaches to healthcare
    Videoconference: Hosted by Centre for Biomedical Ethics, National University of Singapore. In conjunction with WHO Health Ethics and Governance Unit and Integrated Health Services Team, and National University of Singapore Centre for Biomedical Ethics
    27 February 2020
  • But Why Is That Better?’ A healthcare improvement workshop
    Online workshop:
    King's College London
    30 November 2020
  • How can we tell if it’s good…without making it worse?
    Online workshop:
    King’s College London. In conjunction with with colleagues in the Centre for Public Policy Research, King's College London.
    27 January 2022
  • ‘Person-centred healthcare: philosophical and practical perspectives’
    Online workshop:
    for National Clinical Advisers, NHS England and NHS Improvement, London
    29 September 2022
  • ‘But Why Is That Better? Philosophical issues in healthcare
    Improvement’
    Online workshop: hosted by The Health Foundation ‘Q’ community
    29 November 2022

Talks

  • 'Applied philosophy and healthcare quality improvement.'
    Alan Cribb
    Centre for Biomedical Ethics seminar series, National University of Singapore
    30 January 2019
  • 'The conversation between healthcare quality improvement and bioethics: where to begin.'
    Alan Cribb
    The ethical implications of improvement science research and practice: developing a research agenda, University of Liverpool in London
    29 April 2019
  • 'Equity in healthcare improvement: where and how should it feature?'
    Vikki Entwistle.
    The ethical implications of improvement science research and practice: developing a research agenda, University of Liverpool in London
    29 April 2019
  • 'Speaking out in research: ethical and practical challenges of managing disclosure of concerns
    Alan Cribb
    THIS Space, THIS Institute, University of Cambridge
    4 September 2019
  • Why healthcare improvement needs philosophers 
    Polly Mitchell
    Polygeia Annual Conference, King's College London
    9 November 2019
  • 'Equality in healthcare: why socio-relational theorising matters for healthcare improvement.'
    Vikki Entwistle
    AABHL NZB Conference, University of Orago, Dundin
    21 - 23 November 2019
  • An introduction to ethical issues in person-centred care’
    Polly Mitchell
    Development of ethical guidance for WHO on person centred approaches to healthcare, Centre for Biomedical Ethics, National University of Singapore
    27 February 2020
  • ‘Tackling disrespect in healthcare: the significance of equality within professional-patient relationships’
    Vikki Entwistle
    Feminist Approaches to Bioethics (FAB) World Congress, virtual conference
    18 June 2020
  • ‘Values and ethics in healthcare improvement’
    Vikki Entwistle
    Nordic Conference on Research in Patient Safety and Quality in Health Care, Jönköping, Sweden
    29-30 September 2022
  • ‘But why is that better?’
    Vikki Entwistle
    Centre for Biomedical Ethics seminar series, National University of Singapore
    11 November 2022

Publications

Media coverage

Conferences

  • The ethical implications of improvement science research and practice: developing a research agenda.
    Conference: University of Liverpool, London campus. In conjunction with Dr Lucy Frith (University of Liverpool) and Professor Stacy Carter (University of Wollongong). Supported by the Institute of Medical Ethics
    29 April 2019
  • Development of ethical guidance for WHO on person centred approaches to healthcare
    Videoconference: Hosted by Centre for Biomedical Ethics, National University of Singapore. In conjunction with WHO Health Ethics and Governance Unit and Integrated Health Services Team, and National University of Singapore Centre for Biomedical Ethics
    27 February 2020
  • But Why Is That Better?’ A healthcare improvement workshop
    Online workshop:
    King's College London
    30 November 2020
  • How can we tell if it’s good…without making it worse?
    Online workshop:
    King’s College London. In conjunction with with colleagues in the Centre for Public Policy Research, King's College London.
    27 January 2022
  • ‘Person-centred healthcare: philosophical and practical perspectives’
    Online workshop:
    for National Clinical Advisers, NHS England and NHS Improvement, London
    29 September 2022
  • ‘But Why Is That Better? Philosophical issues in healthcare
    Improvement’
    Online workshop: hosted by The Health Foundation ‘Q’ community
    29 November 2022

Talks

  • 'Applied philosophy and healthcare quality improvement.'
    Alan Cribb
    Centre for Biomedical Ethics seminar series, National University of Singapore
    30 January 2019
  • 'The conversation between healthcare quality improvement and bioethics: where to begin.'
    Alan Cribb
    The ethical implications of improvement science research and practice: developing a research agenda, University of Liverpool in London
    29 April 2019
  • 'Equity in healthcare improvement: where and how should it feature?'
    Vikki Entwistle.
    The ethical implications of improvement science research and practice: developing a research agenda, University of Liverpool in London
    29 April 2019
  • 'Speaking out in research: ethical and practical challenges of managing disclosure of concerns
    Alan Cribb
    THIS Space, THIS Institute, University of Cambridge
    4 September 2019
  • Why healthcare improvement needs philosophers 
    Polly Mitchell
    Polygeia Annual Conference, King's College London
    9 November 2019
  • 'Equality in healthcare: why socio-relational theorising matters for healthcare improvement.'
    Vikki Entwistle
    AABHL NZB Conference, University of Orago, Dundin
    21 - 23 November 2019
  • An introduction to ethical issues in person-centred care’
    Polly Mitchell
    Development of ethical guidance for WHO on person centred approaches to healthcare, Centre for Biomedical Ethics, National University of Singapore
    27 February 2020
  • ‘Tackling disrespect in healthcare: the significance of equality within professional-patient relationships’
    Vikki Entwistle
    Feminist Approaches to Bioethics (FAB) World Congress, virtual conference
    18 June 2020
  • ‘Values and ethics in healthcare improvement’
    Vikki Entwistle
    Nordic Conference on Research in Patient Safety and Quality in Health Care, Jönköping, Sweden
    29-30 September 2022
  • ‘But why is that better?’
    Vikki Entwistle
    Centre for Biomedical Ethics seminar series, National University of Singapore
    11 November 2022

Publications

Media coverage

Project status: Ongoing

Principal Investigator

Investigator

  • ECS-Polly Mitchell 850px

    Polly Mitchell

    Post Doctoral Research Fellow in Bioethics and Public Policy

Funding

Funding Body: Wellcome Trust

Amount: £721,710

Period: December 2018 - December 2023

Contact us

Twitter: @phil4hcq

Keywords

APPLIED PHILOSOPHYETHICSHEALTHCARE