Utilize employee feedback during COVID-19 to understand the value of services and programs.

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. 
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The Royal Free London NHS Foundation Trust engaged clinical and non-clinical staff across all sites to take a pulse on what COVID-19 support services and communication efforts were the most valuable. The Trust’s goal was to determine which services and programs should be continued and how to best communicate with teams in preparing for a second COVID-19 wave:


Provide senior leadership with clear employee identified improvement opportunities and next steps regarding the best way to progress.

1,000+ employees completed the survey consisting of demographic questions, 3 scaled satisfaction questions, 12 open-ended questions, and 3 multiple response questions.

Several statistical correlations and analysis were performed to decipher the factors affecting employee satisfaction on a daily basis.

Responses were categorized into three overarching themes of support, communication, and safety. Subthemes were carefully developed by thoroughly examining all responses.

NHS Foundation Trust’s COVID-19 Challenge 


Royal Free London NHS Foundation Trust, one of England’s high-performing clinical Trusts, faced the same challenge that all major healthcare organizations have been confronted with in 2020. COVID-19 has infected 93.2+ million people worldwide, taking the lives of 1.9+ million people. Royal Free realized early that the COVID-19 pandemic was taking a visible toll on those at the frontlines and saw this as an opportunity to engage goShadow to design a digital survey to discover  “What Matters” most to employees during the first wave of COVID-19. 

In May 2020, an initial employee survey was disseminated to deep dive into the Trust’s COVID-19 response. At this time PPE, equipment, and testing kits were in limited supply resulting in early feedback from employees expressing dissatisfaction. Senior Leadership understood the importance of employee feedback and that times of crisis call for human connection and knowing what matters most. The Trust identified a need to understand what was working well for employees and discover the pebbles in their shoes  to create sustainable and scalable change. The Trust resolved to take a system-wide snapshot across all sites to examine programs, morale, and support staff needed.


The standard of care delivery and employee needs had shifted worldwide in a matter of weeks. The demand for supplies, PPE, and support was high. Maintaining positive morale was increasingly difficult in a time of crisis. The unpredictability of COVID-19 left the Trust making important decisions to the best of their ability, regardless of information available to them.  
Overall I felt really proud to be a part of this Trust in the crisis. I felt that strong and clear leadership, communication and support was available and necessary changes were made quickly and responsively. While it is very easy to criticise, and things were not, and could not be, perfect, in general they were done very well under the circumstances.

What Matters? Insights

Royal Free London NHS Foundation Trust needed to get to the root of what mattered to staff right now. goShadow co-created action oriented questions consisting of demographic information, 3 scaled satisfaction questions, 12 open-ended questions, and 3 multi-response questions to understand the specific experiences of Trust employees. Heightened data analysis was utilized to glean important details from employee feedback. The goShadow team utilized various forms of data visualization by categorizing all open-ended responses into the three main categories revealed through analysis: communication, safety, and support. Meaningful quotes from Trust employees system-wide were provided to Senior Leadership to show the human story behind the data. 

Themed employee responses to being asked, "What could be improved?" in regards to the COVID-19 response.


Deeper insights were provided to Senior Leadership through correlational statistical analysis. The correlation was essential in determining the key factors affecting employee satisfaction through examining the likert scale questions in combination with the use of keywords such as support, senior leadership, communications, email, food, PPE, and freenet.  

Employee responses were broken up into the three themes of communication, safety, and support. Sub-themes provide more detail to what makes up these categories.


Benefits Achieved and Value Created

Senior Leadership sought out the voices of their employees, wanting to share in their success and barriers. Demographic information extracted from the survey was utilized by Senior Leadership to create a strategic plan to reach more people in future “What Matters” surveys and overall communications. Employees identified regular emotional support, teamwork, and visibility of leadership as successes, indicating that the Trust can continue to foster related programs and responsibilities in a second COVID-19 wave. Employees identified recruitment and management of staff,  standardized training periods (particularly indicated by those redeployed), and addressing the psychological and emotional toll of COVID-19 as opportunities to improve in preparation for a second wave.


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