Real‑time feedback loops – what they are, where we are, and what’s next
A real‑time feedback loop is a way of listening to patients as care is being delivered, responding quickly, and crucially, feeding back what has changed as a result. Unlike annual or one‑off surveys, real‑time feedback provides regular, ongoing insights that allow teams to make small but meaningful improvements in‑the‑moment, as well as capture stories of great care which demonstrate our values of listening, caring and improving in practice.
As Jason Nicol, Head of Wellbeing, Culture and Development, explains:
“Real‑time feedback is about shortening the distance between listening and acting. It also enables areas to understand the quality of care provide over time and to choose to act on areas that matter to patient and the staff group. When people take the time to tell us about their experience, we owe it to them to respond quickly and visibly, including celebrating examples of great care.”
Where we are now – learning from our test ward in ARI
Over recent months, one specific ward in ARI has been a key testing site for real‑time feedback. Patient comments gathered at the bedside have helped teams understand what matters most to people during their stay and where changes make a tangible difference.
Patients consistently spoke about kindness, teamwork and feeling listened to, for example:
“Everyone is always polite, friendly. The kindness of some of the nurses is outstanding. If I am feeling down, they offer to chat – they are making me feel at home.”
“They all seem to work very well together and help one another out when needed. You really get a sense of them learning and supporting each other.”
Real‑time feedback has also highlighted where improvements were needed, helping the ward act quickly. In relation to communication and planning, patients said:
“I’ve been kept informed at every stage. They tell me what they’re doing and why – I can’t fault them.”
and where things were less clear:
“Sometimes as a patient you hear different things from different people and it’s hard to know what the care plan is.”
Importantly, feedback wasn’t just collected – it was acted on. Ward‑level actions included changes to noise management, clearer communication around procedures, and reinforcing medication counselling, with teams reporting back on what had changed.
Plans for 2026/27
Building on the learning from the initial ward, the focus for 2026/27 is to embed real‑time feedback more consistently across 10 wards so that listening, acting and feeding back becomes routine. It is then our intention to expand this by a further 10 wards in 2027/28.
This will include:
- Clearer and simpler routes for real‑time feedback in clinical areas
- Support for teams and managers to interpret feedback and close the loop
- Stronger links between real‑time feedback, iMatter actions and wider culture and wellbeing work
- More visible “you said – we did” communication back to patients and staff
- Measurement of impact over time on both patient and staff experience as a result of undertaking this process.
Get involved
If you’re interested in learning more about real‑time feedback, supporting its use in your area, or taking part in future testing, please get in touch via gram.realtimefeedbackloops@nhs.scot