{
  "abstract": "Background Despite strong evidence for cardiovascular prevention, implementation in primary care is limited by workforce pressures, variable confidence, and limited capability to lead quality improvement (QI). Traditional educational interventions often increase knowledge but fail to deliver sustained changes in practice. There is a need for educational models that explicitly build clinicians’ skills, confidence, and agency to improve care within complex systems.Innovation We developed a longitudinal cardiometabolic fellowship that embeds QI capability as a core educational outcome. The programme integrates structured clinical education with formal QI training, supported project delivery, and faculty supervision, enabling clinicians to develop the skills and confidence required to lead improvement activity within their own organisations.Implementation Between 2022 and 2025, four cohorts of a 7-month fellowship were delivered across South London. The programme combined monthly clinical webinars with structured QI teaching, peer learning sessions, and one-to-one supervision. Fellows designed and implemented locally relevant improvement projects within their practices or primary care networks, applying QI methodology in real-world settings.Evaluation Programme evaluation focused on capability and confidence outcomes. End-of-cohort surveys from 108 fellows demonstrated high perceived impact: 98% reported increased confidence in managing patients at cardiometabolic risk; 94% reported increased confidence in undertaking QI projects; and 88% reported improvements in how their practice or PCN approaches cardiometabolic risk management. Qualitative feedback highlighted increased confidence, leadership skills, and sustained engagement with improvement activity beyond the fellowship.Conclusion Embedding QI training within a longitudinal fellowship can build clinician confidence, skills, and capability to lead improvement in preventive cardiovascular care. This model supports sustainable behaviour change and may help close the gap between evidence and delivery in pressured primary care environments.",
  "authors": [
    {
      "affiliations": [
        "Health Innovation Network South London, London, United Kingdom"
      ],
      "name": "Stephanie Atta"
    },
    {
      "affiliations": [
        "Health Innovation Network South London, London, United Kingdom"
      ],
      "name": "Natalie Stowell"
    },
    {
      "affiliations": [
        "Health Innovation Network South London, London, United Kingdom"
      ],
      "name": "Lewis Manning"
    },
    {
      "affiliations": [
        "Health Innovation Network South London, London, United Kingdom"
      ],
      "name": "Oliver Brady"
    },
    {
      "affiliations": [
        "Health Innovation Network South London, London, United Kingdom"
      ],
      "name": "Rod Watson"
    },
    {
      "affiliations": [
        "Health Innovation Network South London, London, United Kingdom",
        "Kingston Hospital NHS Foundation Trust, London, United Kingdom",
        "Imperial College London, London, United Kingdom"
      ],
      "name": "Roy Jogiya"
    }
  ],
  "title": "264 Embedding quality improvement capability into a longitudinal fellowship to build preventive cardiovascular skills and confidence in community clinicians",
  "uid": "cf92d411-4deb-5515-902d-da21293061b9"
}