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Having just facilitated a workshop in the NHS on corporate resilience in times of challenge, this model that Helen outlines seems perfect in the context of sustaining resilience - the need to be a healthy organisation by constantly re-thinking purpose and process. But there needs to be a coathook. Improving quality doesn't really do it for me, simply because I think the workforce element of improving quality is often forgotten. So, I'd like to see the coathook as improving wellbeing and performance through a constant process of rethinking, but orientated towards commitment, trust and engagement, as when these are achieved, quality exists and is made even better, and encouraging innovation (however defined) is a key element of commitment, trust and engagement as it provokes challenges, and challenge is a strong feature of commitment and engagement.