Hello, I’m Dr Robert Varnam. I am an improvement and leadership coach with a background as a GP, improvement leader and Director of Primary Care Improvement at NHS England. I live in Manchester, UK and work across the UK and internationally.

For 25 years I worked as a doctor in inner city Manchester, serving a vibrant and diverse community. I also have a background in researching and leading quality improvement. Over the last decade, I have been at the forefront of national NHS policy for integrated care, primary care transformation and improvement leadership. 

Most recently I worked as national Director of Primary Care Improvement at NHS England and NHS Improvement. I have now stepped aside in order to spend more of my time providing hands-on support to leaders, particularly in health, care and community development. 

I am passionate about supporting leaders and teams to improve what they do without working harder. I am interested both in small and large scale change.

Some highlights of my career so far:

  • I have led service change in my own team and across Manchester, and helped catalyse the early system partnership working between the NHS and local government in Greater Manchester which led to the region’s pioneering devolution arrangements.
  • At the University of Manchester, I worked in the National Primary Care Research & Development Centre. My research focused on staff wellbeing, quality of care and patient safety, using both qualitative and quantitative methods. I helped establish a new system of research governance in the University.
  • I have been involved in staff wellbeing and development my whole career. Highlights have included conducting research into the causes of staff stress in high pressure healthcare environments, contributing to the development of the national GP Worklife Survey, helping to establish a new MSc in Advanced Nursing at the University of Manchester, and providing teaching and mentoring to nursing and medical colleagues in a variety of settings in primary care.
  • At the NHS Institute for Innovation and Improvement I helped create and deliver new QI programmes for general practice, improving safety, quality and productivity. I advised the government on integrated care as part of the NHS Future Forum, and supported NHS England to create the support and assessment framework for clinical commissioning groups (CCGs). I designed and led a new large scale change leadership programme for system leaders which was made available to every CCG.
  • At the Royal College of General Practitioners (RCGP) I led developments in policy, practice accreditation, quality awards and established the RCGP Centre for Commissioning. 
  • At NHS England I led the development of a new vision for primary care, playing a greater role at the heart of joined-up local systems, with an enhanced workforce, greater collaboration and expanded resource. I contributed to the NHS Five Year Forward View for the wider NHS, and I was the creator of the package of innovations, support and transformation in the General Practice Forward View. This delivered an annual £2.4bn increase in funding, plus an unprecedented £500m programme of improvement and transformation support. This policy work was informed by my belief that UK general practice is excellent but that it has been constrained internally and externally from delivering its full potential for patients and the public. [Read more about this.
  • Alongside my work developing vision and strategy for change, I established new approaches to providing targeted hands-on advice, consultancy and training for teams in GP practices and PCNs to adopt successful innovations. These included the 10 High Impact Actions to release time for care, and were supported by a national network of Forward View staff in CCGs and the expert Time for Care faculty of improvement advisors. This area of my work was informed by my belief that it is not sufficient to have a plan for what needs to change – frontline teams need support for how it will be changed. In primary care, this needs a complex and comprehensive model of change that draws on transformation practice, quality improvement and pragmatic leadership development. Just publishing a plan isn’t enough, and neither is just providing training. 
  • I regularly speak at regional, national and international conferences about integrated healthcare, the future of  primary care, change leadership and quality improvement, and have provided training for staff from over 15 countries. 


Outside my very fulfilling working life, I have helped establish two charities, and served on their boards, helping to grow their reach and impact. I have led volunteer teams of up to 150 people, and coached others to take up similar responsibilities. I still serve my local church as a volunteer, and coach leaders in churches as well as charities in the UK and South Africa. I am married to the amazing Emma Varnam, and we live the happiest of lives with our son and cat, enjoying the garden, walking and friends.

How can I help you?

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