RFL Comparison Case Study: 2020-2021

Customer Overview


Royal Free London NHS Foundation Trust 

London, England 

  • High-performing clinical and teaching hospital.
  • 1,770 beds across three sites: Barnet Hospital, Chase Farm Hospital, and Royal Free Hospital. 
  • 16 hospitals, and 29 clinics with 100+ clinical departments. 
  • 1.6 million patient admissions annually.


The Royal Free London NHS Foundation Trust engaged clinical and non-clinical staff at the beginning of the COVID-19 pandemic to take a pulse on the value of the support services and communication efforts. The Trust utilized staff feedback and data from the first COVID-19 debrief to prepare for the inevitable second surge of COVID-19. Through data analysis and goShadow support, key learnings are integrated into new ways of providing patient care and staff support--psychologically, emotionally, and operationally. The goShadow team partnered with The Royal Free London NHS Foundation Trust again at the beginning of 2021 to learn from both teams and individuals after the second surge.

NHS Foundation Trust COVID-19 Challenge 2020 vs. 2021

Over the course of the past year and a half, Royal Free London Foundation Trust, one of England’s high-performing clinical and teaching hospitals, has been confronted with similar obstacles as every healthcare organization worldwide. COVID-19 has infected 195+ million people globally and taken the lives of 4+ million people. The COVID-19 pandemic began as an unexpected, and unprecedented event that was taking a noticeable toll on frontline workers. As a result, the Trust engaged the goShadow team to determine “What Matters” most to their employees. The Trust identified what went wrong, what went well, and what could have been improved from the first surge of COVID-19. The 2020 COVID-19 debrief and survey were utilized to gather feedback from employees in preparation for the second surge. The challenge in the 2021 employee debrief was to determine how to incorporate key learnings from the COVID-19 pandemic into the culture, patient care, and new working style. The key learnings were not solely focused on COVID-19 but how to improve the organization, support, communication, redeployment, and patient and family care to successfully move forward in a new normal.

What Matters? Insights

Royal Free London Foundation Trust utilized employee surveying to get to the root of “What Matters” most to employees. The urgency of determining how the needs of the community shifted due to COVID-19 was evident during the 2020 survey and debrief due to the need to prepare for the second surge. Senior leadership gained key insights through heightened data analysis and various data visualization methods.

Gaining insights from the real words of employees was invaluable to senior leadership. The analysis of data during the first COVID-19 debrief revealed three main categories of open-ended responses: communication, safety, support. These categories were used to gain deeper insights and analysis in both the 2020 and 2021 surveys. 

The 2020 COVID-19 debrief laid the foundation to create new programs, maintain existing services, and understand the desires and pain points of employees. 1,000+ employees completed the survey which consisted of 3 scaled satisfaction questions, 12 open-ended questions, and 3 multiple response questions. The separation of the second COVID-19 debrief into two surveys disseminated to individuals and teams provided invaluable  data on their unique experiences. A combination of ordinal and open-ended questions were provided for any team that desired to debrief together. This approach  differed from the first COVID-19 debrief and was used to understand the team experiences as a unit.

Sentiment analysis played a key role in interpreting the “What Matters” insights. Sentiment analysis is a method of data analysis used to understand the social context of data. goShadow analysts meticulously read through each response and categorize the responses into the sections of communication, support, and safety. Each category is divided into subcategories that specifically align with the open-ended response. The categories are then split by sentiment (positive or negative) and theme.

Leadership & Value gained 2020 vs. 2021

Senior leadership engaged employees to understand the successes and barriers through their eyes. Demographic information was collected in both surveys to examine which bands, roles, and departments were represented. The demographic data from the first COVID-19 debrief was instrumental in developing a more robust outreach plan to obtain feedback from all roles in the Trust. 

Consistent emotional support, teamwork, and visibility of leadership were identified as successes in the 2020 COVID-19 debrief. Recruitment and management of staff, standardized redeployment training periods, and addressing the psychological and emotional toll of the COVID-19 pandemic were identified by employees as opportunities for improvement. Senior leadership utilized this feedback to maintain and improve existing programs while also creating new support opportunities for the second surge of the pandemic. 

Employees identified increased distribution and guidance regarding PPE, strong teamwork, flexible work accommodations, and policies and procedures from the first wave of COVID-19 preparing staff for the second surge as successes in the 2021 Individual COVID-19 debrief. Adequate IT support, proper equipment (ventilators, pumps, consumables), and adequate staffing were identified as areas for improvement. Overall employees felt that the Trust was significantly more prepared during the second surge of COVID-19. The 2021 team and individual surveys were focused on the key learnings and next steps senior leadership can take away. The Royal Free London NHS Foundation Trust intentionally sought to hear the voice’s of all community members by asking “What Matters to You” these four words shifted the mindset of the COVID-19 experience from a tragedy to an opportunity to reflect, grow, and become stronger individually and as an organization.

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