Both Sides Now is different from other patient feedback mechanisms because it takes into account both patient and staff experiences. Hearing both perspectives on particular issues facilitates better understanding – this enables the Trust to more effectively address areas of concern, with full staff buy-in to implementing the solutions identified.
‘The aim is not simply to gather patient feedback, but to enable it to lead to improvements and to generate a return on investment, because getting to the detail behind negative feedback enables it to be addressed in a specific and effective way.’ (Project lead)
Both Sides Now also aims to generate innovative approaches to service improvement in response to the feedback, not only involving staff but looking much more widely at changes that could potentially benefit many patients across the NHS. For example, having identified an issue with noise at night on wards keeping patients awake, not only have ward managers in the Trust issued ear plugs to patients, but the Both Sides Now team is in talks with the manufacturers of heart monitor machines to explore the possibility of reducing the level of noise that these machines emit.
The Both Sides Now approach also aims to benefit staff, by making them feel confident and proud to deliver a high quality of patient experience:
‘I really want staff, including doctors, nurses and other health professionals, who got into the NHS because they have a vocation for it, I want them to see and feel a significant change in the way that patient experience is understood. I want disillusioned people to be rediscovering their vocation and having a real sense of partnership with patients.’ (Project lead)
The project leads aim for Both Sides Now to become a social enterprise, and hope to continue to spread the Both Sides Now methodology and ethos to other NHS trusts, social care trusts and CCGs.
The project team credit their success to date to a number of factors. Principally, the Both Sides Now methodology is extremely appealing to staff, because it values their opinions as well as those of patients, and it has the power to help generate appropriate solutions to problems. This is evidenced by staff feedback to the project team and the action plans that have been put in place following the workshops.
The use of stories captured on video is compelling and easy to engage people with. The enthusiasm of the Both Sides Now team and their belief in the potential of the project to transform organisational culture around patient engagement are also key to Both Sides Now’s success.
- User needs and experiences Encourage patients to be succinct in their stories for a more impactful video. Allow patients to talk about what they want to talk about – it’s their story.
- People and culture Listening to the voices of staff as well as those of patients is key to bringing staff on board - the project is not simply about staff having to take criticism from patients.
- Processes and systems Detailed project plans helps to keep things on track and clarify responsibilities.
- Initiating and sustaining Demonstrate passion and belief in what you are doing – this can help to generate buy-in from others and spread the approach.
- Get high profile support for the project. Include patient experience in C-QUINs to ensure that it is a high priority area for the organisation.
Clinician and non-clinical staff throughout one of the trusts report feeling more empowered to support patients with challenging needs. For example, a security guard found a patient who was distressed and suicidal in the basement of the hospital, and he was able help him to move into the main hospital building, as a result of feeling confident about his ability to show a more caring approach to patients. The security guard got a ‘heroes award’ for the approach he displayed. The project leads are confident that this is one indication of the culture change that Both Sides Now has brought about.
In one trust, systems and procedures are now being challenged where they do not serve the best interests of patients. For example, there was an incident in which a patient with learning disabilities became very distressed overnight because staff had not allowed his mother to stay with him, because it was not hospital procedure. The story has raised the issue of staff being able to challenge systems which do not help patients, and this will be raised with the Board when they view the film.
One trust regularly shows a discovery interview video at Board meetings since implementing the Both Sides Now approach, and this has already made a real impact on members:
‘they were stunned into silence.’ (Spread partner).
Since the introduction of Both Sides Now, non-executive directors have started visiting wards to explore the issues raised.
One trust introduced a training course for nurses called In Your Shoes, in response to an issue raised around both patients and staff feeling that they lose their identity during a patient encounter. For example, patients reported a loss of identity when their cultural needs were not met; while staff reported a loss of professional identity when they found themselves unable to meet a patient’s needs.
In response to an issue identified by patients and staff around lack of coordination between different agencies, Manchester Mental Health and Social Care Trust has appointed a police representative to the Trust’s Shadow Council of Governors.
Anecdotal staff feedback from across all three trusts shows that staff have responded extremely positively to Both Sides Now. In contrast to feedback from tick-box surveys – which typically just tells them if patients are unhappy with something - Both Sides Now allows staff to understand why there is a problem and what they could do to resolve it. Staff are encouraged to empathise with patients and early indications suggest that they are therefore more likely to change their behaviour. For example, in one trust discussions about communication at a Both Sides Now workshop enabled clinicians to learn from each other about ways to improve their communication with patients and their relatives. It is unlikely that this discussion would have taken place without Both Sides Now.
At one trust, there has been an increase in Net Promoter Scores since the introduction of BSN, and a reduction in complaints.
- Visit Website