The Dudley Group NHS Foundation Trust (DGFT) is the main provider of hospital and adult community services to the populations of Dudley, significant parts of the Sandwell borough and smaller, but growing, communities in South Staffordshire and Wyre Forest. Our hospitals are among some of the most technologically advanced in the country. In 2018 DGFT made a long-term commitment to building a system for Continuous Improvement and was selected by NHS England and Improvement to be part of the first national cohort in the Vital Signs programme.  Supported by NHSE&I, eight trusts have co-produced an approach to developing a culture of Continuous Improvement which is founded on supporting and empowering staff to improve the services they are passionate about.