Experience
Experience Insight
Nottinghamshire Healthcare carries out a Patient and Carer Experience (PACE) survey across all its services to gather feedback from patients, families and carers. Care Opinion, an independent online feedback site, is also used to gather feedback. Between 1st June 2024 and 31st May 2025, 5,961 PACE Surveys were returned and 751 Care Opinion stories posted, totalling 6,712 pieces of feedback. This was an 8% increase on the previous 12 months of that feedback, 8% (531) is from family or carers.
The Mental Health Care Group account for 50% of the feedback received, Community Health Care Group at 43% and Forensic Care Group Services accounts for 7%.
Across the Trust, 30% of teams, 3 teams out of every 10, received no feedback via PACE or Care Opinion in the last 12 months.
Patient and Carer Experience (PACE)
Between 1st June 2024 and 31st May 2025, feedback via the SMS (text message) PACE survey increased by 28% to 2,783 returns. SMS accounts for 47% of the PACE returns received, followed by 43% via paper forms and 10% via the online survey.
Across all services, 72% of patients/carers reported their overall experience of the service as being excellent, and 16% reported it as good.
In response to the 'what could be improved' question, 6% (76) of comments were rated as being highly critical and 48% (652) as fairly critical . In response to the 'what was good' question, 10% (354) comments were rated as being highly complementary and 63% (2233) rated as fairly complimentary.
In relation to 'what could be improved', feedback focussed on:
- provision of services (14%)
- care received (10%)
- communication (10%)
In relation to 'what was good', feedback focussed on:
- staff (18%),
- attitude of staff (18%)
- care received (15%)
Care Opinion
Of the 751 Care Opinion stories posted in the 12-month period, 35% (263) were posted via the Care Opinion website, 32% (242) were posted via a kiosk link, 31% (234) were posted via a Care Opinion Story form and 2% (12) were submitted via telephone to Care Opinion's Freephone number, demonstrating the range of routes that patients and carers use to provide feedback.
- 82% (616) of the Care Opinion stories were wholly positive
- 4.8% (36) minimally critical
- 8.2% (62) mildly critical
- 4% (33) moderately critical and
- 0.5% (4) strongly critical
The main themes for positive feedback were around staff, in particular the helpfulness, support and advice provided. The more critical feedback focussed on communication issues, with some patients and carers also critical about information, equipment and support.
At Rampton Hospital, the patient's digital portal (Made Purple) gives patients the opportunity to leave feedback via Care Opinion. This online feedback mechanism was paused in March 2025 due to concerns on the approach to moderation and supporting patients to use community meetings, and other feedback mechanisms alongside Care Opinion, consistently. The IEV team is currently working with the leadership team at Rampton to develop a clearer feedback pathway, and to refresh the approach to moderation for high secure settings.
Service Improvements based on Patient and Carer Feedback
Staff teams are encouraged to report what has changed because of listening to patient and carer feedback. Plus, for those changes to be feedback to patients and carers the impact of their feedback by utilising 'you said, together we did' materials. Below are some examples of changes made because of feedback.
Clayfields House Secure Unit - Young people asked for clearer information about what to expect before arriving and how to ask for help. In response, the unit co-produced a short, animated video with current patients, detailing what to expect and explaining the support available.
Post-Covid Service - Patients raised concerns about long waits for an externally provided Symptom Management group. The team created an in-house Symptom Management Group tailored to patient needs, including shorter sessions with breaks, and a new nutrition session. Feedback showed that peer support was a highly valued element of the sessions, so Peer Support Volunteers are now helping co-produce and lead a dedicated Post-Covid Peer Support Group.
Virtual Ward Service - Patients fed back to the team that they found the text messaging system for submitting clinical observations complicated and confusing. The team worked with developers from SystmOne to utilise Communications Annexe, which now feeds data directly into medical records for the team to review. As a result of this change, approximately 250 patients are now using this improved system.
Adult Speech and Language Therapy (SLT) - The service had discontinued LOUD Groups (a support group for people with Parkinson's Disease) to reduce waiting times for the service. Feedback after the groups stopped highlighted how valuable patients found the groups. It has now been agreed that the groups will be resumed for a new cohort of clients as a block of sessions. Patients will be informed that it is a time-limited support group at the outset.
The Health Shop (Nottingham Recovery Network) - The Health Shop (part of Nottingham Recovery Network) supports women facing severe multiple disadvantages, including homelessness, sex work, substance use, and domestic abuse, by offering Long-Acting Reversible Contraception (LARC). Originally, only the first injection was provided, with follow-up expected via GP surgeries. However, feedback showed that many women felt more comfortable with Health Shop staff and were unlikely to access mainstream services. In response, a dedicated women's health clinic was set up at Victoria Health Centre, where patients are supported by Health Shop staff and seen immediately by specialists with no referral needed. The service is commissioned by Nottingham City Council and thanks to positive outcomes and feedback, additional funding has been secured to continue this vital service.
ACORN Offender Personality Disorder Service (HMP Whatton) - feedback received from patients that they would like to have sessions outside and more access to fresh air. As a result, the service hosted a 5km walk on the field for enrichment and plan to have further outdoor enrichment activities.
Children's Speech and Language Therapy - The Children's Speech and Language Therapy (SLT) Service gathered feedback through surveys and focus groups with parents, supported by a Patient Experience Volunteer. Parents asked for clearer information on waiting times, early advice and signposting while waiting and an easier online way to contact the service. In response, the service introduced drop-in sessions, included estimated wait times and helpful links in acknowledgement letters and an online referral form via the Trust website, which has led to an increase in referrals to the service.
CAMHS Inpatient wards - All CAMHS inpatient wards took part in an NHS England Quality Improvement project focused on psychotropic medication for young people. Feedback from parents and carers showed a need for clearer information on:
- How medications are prescribed
- What off-label use means and how it's applied
- Who to speak to about medications and when (e.g. CPA meetings, pharmacist calls)
- Where to find reliable information
- In response to the feedback, a CAMHS junior doctor is developing a leaflet covering these topics, to be shared when a young person is admitted. Young people and families will be involved in co-producing the leaflet to ensure it meets their needs.
Patient and Carer stories at the Trust Board Meetings
The bi-monthly Trust Executive Board includes a patient or a carer attending the meeting to share their experiences of using and being involved with our services. The Board can ask questions and hear directly from service users what their experience of the Trust was like, and areas for change or improvement. There is often learning from the experiences shared and this section summarises actions taken as a result to improve the service.
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