The universal GP Training website for everyone, not just Bradford.   Created in 2002 by Dr Ramesh Mehay

Quality Improvement Activity

PDSA cycles

The 3 fundamental questions for Quality Improvement

1. What are we trying to achieve?

Understand the problem. Know what you are trying to achieve. Have clear and desirable aims and objectives

2. How will we know that a change is an improvement?

Measure processes and outcomes

3. What changes can we make that will result in an improvement?

What have others done? What hunches do we have? What can we learn as we go along and how?


We need a structured approach to Quality Improvement.  Why?  Let’s examine what has gone before…

Trial and Error

Too much action, not enough thinking!

Detailed Studies

Too much thinking & study, not enough action

So – neither of these have helped that much in the past.  We need something that does not result in chaos – i.e. is structured, and something which is not too theoretical, and results in action!   Welcome to the world of PDSA cycles.

What is a PDSA cycle?

It’s a really simple yet structured way of identifying what will improve quality and of course, implementing them.   Look at this example.

Can you see the simplicity of this model?
Of course if you can pick an area where the PDSA has to be completed in no more than 2 weeks – even better!  It will make you want to do it.

The GP World of PDSA cycles

Once you get into the hang of doing PDSA cycles, you will see how easy yet powerful they are.   And they do not take a lifetime of study to do and implement.

And that’s when you’ll find yourself doing them again and again and again – the world of PDSA cycles – doing another cycle as you spot new things in your clinical practice that you think could do with improving.   

They are small in scope BUT they build and improve on quality incrementally!

Summary (PDSAs)

  • Improvement requires change to systems
  • PDSAs are a tool that help you bring about change in a practical, useful, manageable and managed way
  • Starting points: remember the three fundamental questions to guide change
  • Remember that you will never know whether the change is better unless you measure
  • Keep up the momentum and don’t forget to record what happens

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Bradford VTS was created by Dr. Ramesh Mehay, a Programme Director for Bradford GP Training Scheme back in 2001. Over the years, it has seen many permutations.  At the time, there were very few resources for GP trainees and their trainers so Bradford decided to create one FOR EVERYONE. 

So, we see Bradford VTS as  the INDEPENDENT vocational training scheme website providing a wealth of free medical resources for GP trainees, their trainers and TPDs everywhere and anywhere.  We also welcome other health professionals – as we know the site is used by both those qualified and in training – such as Associate Physicians, ANPs, Medical & Nursing Students. 

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