What is the POSITIVE study?

POSITIVE (Using Positive Feedback Provided By Service Users In Health Service Improvement) was a study running from November 2021 to September 2022, which has inspired a larger programme of work. It was led by Stefan Rennick-Egglestone, in partnership with Care Opinion and Nottinghamshire Healthcare NHS Foundation Trust.

The initial aim of POSITIVE was to understand how feedback collected from former NHS patients and service users can be used to help improve services that are currently on offer. The focus was on feedback presenting positive experiences of using services. The rationale for this is that there is more to learn from experiences that have gone well than from experiences that have gone badly. 


What did POSITIVE involve?

The study involved five tasks:

  1. conduct a review of existing research into the impact on healthcare staff and services of receiving positive feedback from patients
  2. develop heuristics for identifying positive feedback in two databases: Care Opinion and the NHS Friends and Family Test
  3. collect at least 200 examples of positive feedback from these two databases
  4. analyse the characteristics of these 200 examples to provide an understanding of what positive feedback involves
  5. run a workshop with NHS stakeholders to understand how our findings might inform health service work


We published a systematic scoping review here, which mapped map all available empirical evidence for how positive patient feedback creates change in healthcare settings. This implemented (with some modifications) a prospectively-published protocol available here.  A paper describing our analysis of 200 items of positive feedback has been submitted for publication. 

Further information

For further information on POSITIVE, please contact Stefan Rennick-Egglestone through stefan.egglestone@nottingham.ac.uk