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This project aims to get a better understanding of how NHS frontline staff use different types of patient feedback to improve health services and develop tools to help them make better use of this data.

Why this is important:

Patient experience is a key component of quality of care, and improving it is a priority for the NHS. There is much evidence about what matters to patients about their experience of care, yet the pace of change is slow and research demonstrates that there is still a long way to go to make change genuinely and consistently person-centred. Collecting data about patients' experiences is not enough; we need to use the data to improve care.

Many of the things that matter most to patients are about relationships with and behaviour of frontline staff.

Many of the things that matter most to patients are about relationships with and behaviour of frontline staff. Not enough is yet known about the best ways to support staff to use information about patient experience to improve care. There is some promising but limited evidence of approaches which have made a difference, such as facilitated feedback and discussion with ward staff of numerical survey findings, and use of limited personal stories to trigger change as part of an approach called 'experience-based co-design', in which staff and patients work together to improve care. We need to add to this evidence by improving our understanding of how frontline staff use different types of patient experience data for quality improvement; what motivates them to get involved in improvement; what helps or hinders; and what can be done to make patient experience data more convincing, credible and practically useful.


We plan to work with six frontline medical ward teams as case-studies, supporting them to plan how to use patient experience data for improvement and then observing what happens. We will start by analysing existing national survey data and conduct a new organisational survey of patient experience leads in all acute Trusts to create a national picture of how Trusts are performing on patient experience, and how they collect and use experience data.

From this we will select three high performing and three less well performing Trusts to work with us as case studies. Frontline medical ward teams (with patient members) from each site will join a 'learning community', with presentations from expert co-applicants from the Oxford Health Experiences Institute on the range and type of data available and what we know about how to use such data for improvement. Teams will then decide what topic to work on and design and implement their own interventions. We will observe and analyse what happens, using interviews, documentary analysis and on-site observation. We will also complete a baseline and follow-up survey of medical patients from each site. We will discuss emerging findings during the study with the frontline teams so they can adapt and improve what they do, and provide ongoing opportunities to discuss progress.

This project links closely with the patient experience theme on the National Institute for Health Research (NIHR) CLAHRC Oxford. 

How could this benefit patients?

We will produce a practical toolkit for NHS on strategies for making patient experience data more convincing, credible and useful for front line teams as well as how to involve patients & families in the process. We will share the guide online & through NHS England so other hospitals can learn from the results.


Download the resource book by clicking here.

Further information:

Full project title:

Understanding how frontline staff use patient experience data for service improvement - an exploratory case study evaluation and national survey.

Length of project:

Sept 15 – Nov 17




Health Services and Delivery Research (HS&DR) Programme

External collaborators:

  • Nuffield Department of Population Health: Ray Fitzpatrick, Crispin Jenkinson, Angela Coulter, Elizabeth Gibbons.
  • Picker Institute: Chris Graham, Jenny King
  • Said Business School: Sue Dopson
  • NHS England: Neil Churchill
  • Royal Berkshire NHS Foundation Trust: Melanie Gager
  • Kings College London: Jennifer Bostock.

> Technical summary