Cressbrook Limited

Nick Downham – Independent Improvement Expertise

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About Nick

About Nick

I am an independent organisational development (od) and improvement expert, specialising in health and social care improvement. I provide support and expertise for teams, organisations and systems. I help not only make things better, but also help organisations do better things.
You can find out about who and how I have helped here. I offer a powerful mix of exemplary interpersonal skills, core social values, engineering experience, NHS experience and deep improvement knowledge.
I take great pride in helping improve our great public services because of the role they play in supporting and caring for people when they are at their most vulnerable. I have worked with general practices, acute trusts, mental health providers, CCGs, hospice groups, local authorities, thought leaders and universities and with professionals at all levels.
You can also find out more about me on my linked in page.
Finally, I have documented a number of useful insights into improvement here.
About Nick
My Work

My Work

Examples of my work:

  • London Primary Care Quality Academy Programmes

    For London South Bank University Team, I have developed a number of the central elements of the programme. This includes: Designing and delivery of a three day core concepts of quality course for GPs and other practice staff. Supporting the development of data systems to capture the rate of failure demand which GPs encounter. On-site ...
  • Darzi Fellowship Programme – QI and Flow Workshops

    Development and delivery of a week long Core Concepts of Quality workshop. Run by London South Bank University, the London Darzi programme is a high profile programme designed to develop emerging NHS leaders' confidence and capability in leading complex change. I contribute to the programme in two ways: Coaching individual Darzi fellows around their project ...
  • Measurement and Monitoring of Safety E Guide – Author

    Working with my friends at the Office of Public Management. I was the author of an E Guide detailing the learning around the practical application of The Health Foundation’s Measurement and Monitoring of Safety Framework. This included the whole production process from writing to design. Funded by the Health Foundation, the content was derived from ...
  • Centre for Innovation in Health Management (CIHM) – Flow and Measurement Workshops

    Bespoke flow and measurement workshops delivered as part of junior doctor development programme in a large foundation hospital trust. CIHM is part of the University of Leeds.
My Work
Areas of Expertise

Areas of expertise

Offered through consulting, coaching, workshop, training or bespoke publications:

Large scale improvement programmes

Learning capture

Process improvement

Measurement for improvement


Professional development programmes

Community of practice

Quality improvement

Failure demand

Theory of Change

Organisational development

Learning events and workshops

Lean thinking

Demand and capacity

Bespoke improvement publications

Areas of Expertise
Contact Nick
Contact Nick
Improvement Insights

Improvement Insights

Quality Improvement Traps

Using the English NHS as an example, this article focuses on the weaknesses of much current Quality Improvement (QI) thinking and application within healthcare settings.

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Improvement Insights

Contact Nick