The 15 steps challenge

Would you like to help make improvements to our patients, families and carers' experiences of our community healthcare services?

If so, you might like to get involved in our 15 steps challenge. Anyone who is a member here can get involved.

Membership is free and open to patients and members of the public aged 16 years or over. To become a member visit our membership page.

What is the 15 steps challenge?

The 15 steps challenge is an activity involving a team of members, staff and our board members who visit a different healthcare service here each month to see the care given from a patient's point of view. The visits identify what is working well and what could be done differently to improve the experience for our patients, carers and families coming to the service in the future.

Why is it called the 15 steps challenge?

The name comes from a mother who regularly visited a hospital with her daughter who said:


"I can tell what kind of care my daughter is going to get within 15 steps of walking on to a ward".


In response to this quote, a national project was developed (by the NHS Institute for Innovation and Improvement) to gain a better understanding of and make improvements to the patient experience in hospitals. We have made some changes to the national project so we can use this approach in our community services.

What happens on a visit?

Supported and guided by the project co-ordinator before, during and after each visit, a small group of members and staff walk around the service as if they are a patient visiting the service for the first time.

Team members note down their first impressions of what they see, hear, smell, feel and think. The team may also observe the clinicians at work and talk to patients and their relatives or carers about the care they have received.


Every service is different but there are always four key questions we consider on each visit:

  • Is it welcoming?
  • Is it safe?
  • Is it caring?
  • Is it well organised and calm?

Working together the visit team then discuss their findings and feedback suggested areas for improvements to service teams and senior leaders in the organisation, who are supported to make the changes by a deadline.

Depending on the type of improvements, the visit team may revisit the service a year later to make sure the changes have been made.

What is the time commitment?

You can be involved in as many or as few visits are you want.

Before the visit you will receive one or two emails from the project co-ordinator but there is no need to prepare in advance as everything is explained on the day of the visit.

The visit itself will take 2 ½ hours. Visits take place on weekday mornings or afternoons and we always make sure the visit takes place near to where you live, work or study to save your travel time.

About one week after the visit you will receive a copy of the report and invited to make any changes to make sure your views have been heard and understood clearly.

Why would I get involved?

We are committed to working with our patients and members to ensure our services are designed, delivered and evaluated together. Being involved in the 15 Steps Challenge is one of the ways you can influence and shape our healthcare services.

Here is what a couple of our members have said about what their involvement has meant to them:



“As a member here I always enjoy assisting whenever possible and being part of a “15 Steps” team has a special place in my heart as we are assessing the environment to ensure that patients experience the best possible results from their visit. It’s good to know that I have helped in a small way to maintain the usual high standards.” Melvin Gamp

“I joined CLCH in 2013 as a volunteer and also a member. I soon found myself being asked to take part in the 15 Steps Challenge involving visiting some of nursing homes and community hospitals. I have thoroughly enjoyed being involved in the challenge and would recommend anyone who has an interest in healthcare and the time to make a difference in their local community to sign up and support this. It has been so satisfying and rewarding.” Anthea de Barton Watson

How do I get involved?

If you are interested in getting involved, we would love to hear from you. Please contact Susan Blackwell, our 15 Steps Project Co-ordinator by email or by telephone on 020 7798 1453.