Quality improvement (QI) aims to tackle the shortcomings of health services, but improvement initiatives do not always work and sometimes create new problems. One reason for these failures is that people have different ideas about what counts as good quality, and quality is often interpreted in ways that fail to capture aspects of healthcare (including healthcare experiences) that matter to people.

The “But why is that better?” project uses the tools of applied philosophy to help deliver on the promise, and avoid the pitfalls of quality improvement in healthcare. It is funded by a Wellcome Trust Collaborative Award to Professor Alan Cribb (King’s College London) and Professor Vikki Entwistle. The project includes interviews with QI leaders, collaborative working with QI partners, knowledge exchange events, and reflection on the methodological challenges of building applied philosophy into QI.

To find out more visit or Twitter @phil4hcq.


Vikki Entwistle;


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Walker MJ, Rogers WA, Entwistle VA. The ethical and epistemic roles of narrative in person-centred healthcare. European Journal for Person Centred Healthcare. 2020; 8(3): (forthcoming)

Cribb A, Mitchell P, Entwistle VA. What does ‘quality’ add? Towards an ethics of healthcare improvement. Journal of Medical Ethics, 2020; 46(2):118-120. doi:10.1136/medethics-2019-105635

Mitchell P, Cribb A, Entwistle VA. Defining what is good: pluralism and healthcare quality. Kennedy Institute of Ethics Journal, 2019; 29(4): 367-388.