Post by Deborah Udy Okusaga Akanne (@deborah_udy_okusaga)
NHS INTERVIEW MASTERCLASS — WEEK 2, DAY 5
The NHS Interview Station That Decides Your Band — And That Nobody Is Preparing You For.
Four days into this masterclass and I want to start today with something that has been sitting in my DMs all week.
Multiple doctors, physiotherapists, and AHPs have messaged me saying the same thing in different words:
I feel like I am preparing for the wrong interview.
They are preparing for clinical questions. They are preparing for values questions. They are preparing for leadership questions.
And then they sit in front of the panel and the conversation takes a turn they did not expect — and they realise, too late, that there was an entire station they never knew existed.
It is called the service improvement and innovation station.
And in 2026, it is the station that most directly determines whether you receive a Band 5 offer, a Band 6 offer, or no offer at all.
Here is why it exists — and why it is now weighted as heavily as it is.
NHS England's IMPACT programme — launched in 2023 — is the NHS's national framework for embedding continuous improvement thinking across every clinical service in England. It is not a pilot. It is not a regional initiative.
It is a mandated strategic commitment that every NHS Trust is now expected to deliver against — and that every clinical hire at Band 6 and above is expected to actively contribute to.
The IMPACT programme is built on three principles: understanding the current state, having a clear picture of the desired state, and using structured improvement methodology to close the gap. This is the NHS's formal adoption of the Model for Improvement — the framework developed by the Institute for Healthcare Improvement — which uses the PDSA cycle as its core improvement tool.
What this means for your interview is specific and urgent.
NHS interview panels at Band 6 and above are now explicitly assessing whether candidates understand improvement methodology — not just whether they have participated in an audit.
The difference is significant:
Audit identifies the gap between current practice and a defined standard. It describes. It measures. It compares.
Improvement methodology closes the gap. It tests a change. It measures the impact. It adapts and iterates. It produces a sustained improvement in clinical outcomes or service delivery.
A candidate who describes audit participation is describing clinical governance compliance. A candidate who describes a structured improvement project using PDSA methodology is demonstrating the thinking that NHS Trusts are now specifically hiring for.
The question that surfaces this distinction is usually framed as: Tell us about a time you identified an opportunity to improve a clinical service and what you did about it.
Or: Describe your experience of quality improvement methodology.
Or at senior level: How would you approach improving a service area that was underperforming against its clinical targets?
Most candidates answer with an audit story. The panel is looking for an improvement story. They are not the same thing — and the scoring matrix reflects that distinction explicitly.
Today I am giving you everything you need to answer this station at the level it is being assessed.
📩 The service improvement station is one of the specific stations I prepare every client for — because it requires structured thinking that is completely different from clinical scenario preparation.
If your interview is approaching and you do not have a PDSA-structured improvement story ready — DM me "NHS" today.
This station is deciding offers right now.
Post 2 arrives at 9:00 AM — and it covers the PDSA cycle in the specific language NHS interview panels score against.
Not the textbook version. The interview version — with the exact phrases that signal to the panel that you understand improvement at the level they are hiring for.
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