: a grounded theory of how to achieve large-scale, sustained change, co-created with improvement organisations across the UK.

Background: Various theories provide guidance on implementing, sustaining and evaluating innovations within healthcare. There has been less attention given, however, to personal theories drawn from practice and the expertise of managers and front-line staff is a largely untapped resource. In this paper, we share learning from experienced improvement organisations to provide a conceptual level explanation of the conditions necessary to facilitate and sustain improvement at scale.

Mental health quality and outcome measurement and improvement in Scotland.

Purpose Of Review: This review considers Scotland's approach to improving the quality of mental health services.

Findings: Scotland's mental health quality and outcomes framework focuses on improving both the effectiveness of care delivered and the experience of using services. It now has to deliver this within the context of an increased drive to improve efficiency.