Getting started

Practical steps for putting this theory into practice.


A learning system driver diagram

Suggested primary and secondary drivers for a learning system outlined. Adapt to programme and context for local engagement. Change ideas and prioritisation will be specific to every context.

Access and download a PDF version of the diagram by clicking here.


How did we develop the learning system?

From the outset we knew that successful learning systems can, and do, look and feel different to one another. We do not intend to restrict them, instead create a useful starting point. By clarifying terms and detailing concepts we aim to offer a practical approach to the theory.

The first phase of this work, in late 2020, built on the extensive theory developed across Healthcare Improvement Scotland's directorates. Our project team included colleagues from a wide-variety of teams, many of whom were working on topic-specific learning systems. By analysing preferred terminology and assessing which components were universal or related only to certain contexts, we were able to draft the essentials.

Key exploration in the first group meeting was the separation of core components from supporting processes. So we were able to illustrate the dynamic nature of learning.

Various iterations and diagrams were considered and refreshed following input from the project group and senior management.  From all the analysis and discussion it was clear that a learning system was not linear, but following investigation neither was it cyclical. Feedback loops enable non-linear exploration, practice and testing and this was best illustrated using a knot, with directional arrows indicating how data insights and evidence circulate to build knowledge.

There is also a symmetry between the Learning System knot and the Healthcare Improvement Scotland logo, illustrating our organisational breadth and role in national learning.

There was consensus that “outputs” from the learning system would be context specific, thus they are not illustrated in the diagram. Yet, as a core component of the QMS Framework, the learning system provides the opportunity to reflect and make decisions about next steps for good quality management.


Practical examples of learning systems

Health and Social Care Learning in Scotland

Health and Social Care Learning System

Scottish Patient Safety Programme Learning System

UCLPartners Report on the London vaccine programme as a learning health system 


Get in touch

For more information, questions or comments please email