NHS North Middlesex - Tailored Patient Experience Training with Results

Three years after Lord Darzi’s “High Quality Care for All” report, the challenge of delivering this ambitious vision continues to dominate the agenda of NHS Trusts throughout the country. North Middlesex University Hospital (NMUH) NHS Trust decided to address the challenge using a high-impact and innovative solution.

NMUH worked in partnership with Juice to launch their “Making the Difference” programme, comprising of a series of engaging training sessions delivered to all of the staff throughout the organization.

**Update on sustained behaviour change!**

Following the successful delivery of the training programme to over 2,100 of the trust’s staff between April 2010 and May 2011, an online survey was conducted with participants in July 2011. The Transfer of Training Evaluation Model (TOTEM) survey was designed to assess the transfer of learning beyond the “classroom” and the long-term effect on delegate behaviour. Despite the fact that some of the respondents were being asked to assess training that they had attended over a year previously The results indicated that 90% of respondents declared a change or transfer in learning, following the event, in their workplace behaviour.

The Challenge

Juice were asked to design and deliver a series of full-day training sessions which would be attended by all staff in order to equip them with the necessary skills and knowledge to deliver a first class experience for patients and their families.

Our Solution

A comprehensive phase of consultation helped ensure the key issues were identified and that the programme was designed to suit the Trust’s individual development needs. As a result, NMUH were clear that ‘traditional training’ would not produce the desired results.

The sessions designed by Juice therefore utilised a blend of live theatre, film clips, experiential activities and group discussions in order to give all staff a clear understanding of what makes an excellent customer experience and why it is so important to the success of the Trust.

Staff were encouraged to work together in a supportive environment to foster an understanding of how their own behaviour and attitude creates either a positive or negative customer experience through every interaction that they have, and powerful drama pieces were used to explore the meaning of “respect” in a diverse, multicultural community.

All participants were challenged to examine their own behaviours and commit to new, enhanced working relationships, both with colleagues and patients and to embrace their own personal responsibility in working together to achieve an excellent customer experience.


A total of 2,100 staff participated in the Making the Difference programme in two phases.

Pre and post course evaluations were completed ‘on the day’, and the feedback was extraordinarily positive (98% rated the event as highly enjoyable). Many delegates also sent unsolicited testimonials to express their thanks and describe the shift in their behaviour.

Examples of significant end of course self rating scores include; 

  • A significant shift of between 20-25% in skill and knowledge levels
  • 97% of delegates having a high understanding of the Trust’s Vision, Values and new Code of Conduct
  • 98% of staff having a high understanding of who their customers are; both internal and external
  • 99% having a high understanding of what an excellent customer experience looks and feels like, and why it is important to the success of NMUH
  • 99% having a high belief that delivering an excellent customer experience is everyone’s responsibility
  • 99% having a high ability to identify how they may need to adapt their own behavior to deliver an excellent customer experience
  • 99% having a high understanding of treating others with respect in a diverse, multicultural community
  • 99% having a high understanding of how every single interaction creates either a positive or negative customer experience
  • 99% will take action to improve internal working relationships in order to ensure an improved experience for both colleagues and patients and their families
  • 100% will employ the CARE principles in their interactions with patients and their families and their colleagues.

An online survey was offered to all participants in July 2011 following roll out from April 2010. This survey was designed to assess the transfer of learning beyond the “classroom” sometime following attendance using TOTEM (Transfer Of Training Evaluation Model). The results indicated that 90% of respondents declared a change or transfer in learning following the event in their workplace behaviour.

Key areas for assessment included:

  • Appreciating that customers include patients, relatives, staff, managers, colleagues
  • Viewing colleagues as customers specifically
  • Understanding how individual behaviour creates a positive or negative experience for their customers
  • Understanding how to diffuse situations professionally
  • Understanding how to challenge inappropriate colleagues behaviour
  • Paying attention to people’s emotional as well as physical needs
  • Working effectively with other teams or departments - being the perfect team player made a difference.

The findings from the 2010 staff survey also indicate that Making the Difference impacted on particular scores for those that attended the first phase.

  • The Trust compared most favorably with other acute Trusts in England on the percentage of staff receiving job-relevant training, learning or development
  • The Trust improved significantly from 2009 to 2010 on training in how to handle violence to staff/patients/service users
  • The percentage of staff experiencing physical violence from patients, relatives or the public was 7% compared to the national average of 8%
  • The Trust was significantly better than the Picker average on training in how to deliver a good patient/service user experience.

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