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Our Care Opinion journey from single service to Trust wide subscription

Update from Royal Devon University Healthcare NHS Foundation Trust

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About: Northern Devon Healthcare NHS Trust

picture of Lisa Townsend

My name is Lisa Townsend and I am the Patient Experience and Involvement Lead at Northern Devon Healthcare NHS Trust.  I have a passion for patient care and joined the Patient Experience team in December 2019.

I was introduced to Care Opinion when I first started in my role. Our Trust had a basic registration and I was asked to respond to feedback that arrived. Up until this point I had very little knowledge of the system and I quickly found it was a valuable tool. It was exciting to be able to interact with anonymous feedback and use the stories to implement change. However, it was frustrating to not have access to all of the reporting and tools that the advanced subscription had to offer.

We decided to trial the advanced subscription as a test of change using one or two departments. We felt this would enable us to use the 'plan-do-study-act' cycle to get the most out of the advanced subscription and also to enable our team to prepare a business case to roll out Trust wide after the pilot.

My first stop:

Was to talk to our neighbouring Trust, Royal Cornwall Hospitals NHS Trust. Their Patient Experience team and Jess in particular were very helpful, sharing their training materials and discussing their journey with me. They gave me many helpful tips and have been a source of help throughout the process.

My second stop:

Was to ask for involvement from our Non-Executive Directors (NEDs) and also our communications team. The Patient Experience Matron and I did this informally by requesting 15 minutes with the NEDs before their official meeting started. We arrived during their coffee and chat time armed with a short selection of slides and feedback and bucket loads of enthusiasm. Thinking back to the moment makes me smile but we certainly got them interested. From the very start I set up a weekly digest of stories (with their agreement), that was delivered by email on a weekly basis. This ensured they were informed of all CO stories during the trial. I was aware that they were listening to the feedback as I would often receive an email asking for more information about a particular story.

We had also been talking to services throughout our hospital and by this point I knew that the Cancer Services team were keen to be involved in the trial. We found that recruiting a team that is interested and keen makes it much easier when implementing a test of change and the staff engagement was fundamental to our project being a success. Twenty five of the cancer services staff were asked to be Care Opinion responders and signed up for membership.  In April 2020 we launched our twelve month trial; however this was right around the same time that the Covid-19 pandemic arrived in the UK.

The turning point:

Feedback was slow for the first couple of months, however the Cancer Services team, along with the hospital and the rest of the world were very focused on the adjustments to Covid-19. Then in July 2020 we received this story: 'Admin issues & long drive for Coronavirus test' from a patient relating to the pandemic. It was a well written heartfelt story and spoke about their marvellous treatment but also reported how they had  their treatment changed from chemotherapy to radiotherapy at a neighbouring Trust and had been subjected to a 98 mile journey solely to use a swabbing service, leaving them exhausted.

We've made a change response

Our 'Living with and beyond' Cancer Lead responded to this story and by working with our Covid Communication Cell was able to implement a change within two days, not just for our Trust but County wide! We were able to report the change we had made to the patient who used the 'like' button. We also were able to showcase this reciprocal change at a higher level, demonstrating the power of feedback via Care Opinion. I look back and see this story as the turning point of the Care Opinion trial. It demonstrated how service users could use the platform to not only praise staff but to suggest ways of improvement. Furthermore, we could make a real time change that was an important morale booster during this challenging time.

We used the Cancer Service trial to prepare a business case to roll out the advanced subscription Trust wide. By the end of the trial their data had accumulated to allow us to produce some interesting reports and visualisations demonstrating changes we had planned and made following feedback. Our communication team included the stories as regular part of their internal and social media campaigns. 

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By this point, news of the trial had been spreading throughout the Trust and we had departments that were getting in touch asking for the same level of subscription as Cancer Services. This was when we arranged for James Munro, Care Opinion CEO and the rest of the team to put on a webinar aimed at service leaders and managers throughout our Trust. This was a success and shortly afterward our business case was approved; we are currently rolling out training and a supporting package to all services to ensure that the patient voice can be heard via Care Opinion at every level.

We currently have 192 responders spread throughout our Trust and the team is still growing. Our Associate Directors of Nursing and senior team regularly respond to feedback and encourage teams without a responder to sign up. We have recently started to use the reporting data in monthly directorate governance meetings, not just to look at where we are actively listening and planning changes but also to improve staff morale. The response has been favourable.

Favourite Care Opinion feature:

My favourite new addition to the tools is the 'Invitation link', which we are using to simplify the process for departments to see their real time feedback at the touch of a button. Invitation links also allow us to turn the links into QR codes, making it easier and more accessible for patients to tell their story direct from their smart phones.


My goal for the next twelve months is to raise awareness at community groups and supporting organisations, in the hope that we can reach out to authors for co-production and co-design service development opportunities. Indeed, we are already collecting a repository of names and contact details of authors that have consented to be contacted for this purpose. The Care Opinion team continue to support and encourage me on our journey and I see Care Opinion as a valuable tool for developing our services in the future.

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