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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 will run from 2018–2024.

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


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.


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


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


Project status: Ongoing

Principal Investigator



Funding Body: Wellcome Trust

Amount: £721,710

Period: December 2018 - December 2024

Contact us

Twitter: @phil4hcq