Enabling continuous improvement across the National Health Service with The Flow Coaching Academy

How The Flow Coaching Academy uses social franchising to spread improvement training across the UK’s health service

The Flow Coaching Academy (FCA) program is based on the rationale that patients typically experience care in condition-based pathways, and how they move along these pathways has considerable implications for patient experience, care outcomes and pressure on staff and resources.


The FCA was established at Sheffield Teaching Hospitals NHS Trust in 2016. Built from within the NHS for the NHS, It exists to enable staff in every healthcare organization to continuously improve patient care and experience. The FCA program empowers health and care staff to improve patient flow in the health care system, through spreading a common purpose, language and method for quality improvement. A central hub enables regional academies to deliver Flow Coaching courses, which equip their participants with team coaching skills and practical methods to achieve sustainable improvement. 


After successfully training coaches in Sheffield, the FCA team recognized that this training model could be replicated and scaled up across the UK to help build capability in staff in every NHS organisation. The team therefore wanted to explore how they could work with organizations in other areas to deliver the training program. 

When the FCA first began working with Spring Impact, they were training their first cohort of coaches which included staff members from Sheffield Teaching Hospitals and other locations from across the UK. Having funding secured for another 5 years, they wanted to know how they could scale the program across the UK and what they needed to do to be ready to scale when the time is right. 


Spring Impact worked with the FCA in two phases in 2016 to design their replication strategy. We co-created scale objectives and designed a plan to replicate the Flow Coaching Academy to new locations, evolving the design from an accreditation model to a social franchising model. The FCA team later told us that Spring Impact’s guidance to spend time codifying the program and really understanding the value proposition has helped them to adapt their work to a digital platform during the COVID-19 pandemic, enabling them to scale even more rapidly. In addition, the FCA team says that our work together enhanced their ability to create their own continued learnings:

“Not only did we learn from the program, it has also helped us to understand why other things in NHS have been less successful.”


Over the past five years, the FCA has successfully replicated its model and has established 10 Flow Coaching Academy providers across the UK. Through their work, the FCA has been able to measure improvements in various healthcare pathways including medical, surgical, elective and emergency pathways. 

Additionally, using the work completed with Spring Impact on the core of their replication offering, and in the wake of the COVID-19 pandemic, the FCA has since adapted its program to be delivered digitally. This has meant changing the teaching format change from 18 face-to-face sessions to a combination of e-learning modules, face-to-face teaching sessions hosted in person or virtually, and activities on its online community platform. This new format means its program is less defined by geography, meaning greater opportunities for collaboration across its franchise sites.


The FCA continues to work closely with its academies throughout the COVID-19 pandemic. It is anticipated that four training cohorts are set to begin in Autumn 2021 at four different franchise sites. This will build improvement capability in over 100 coaches.

Photo: Flow Coaching Academy

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