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15 Steps Challenge

15 Steps mother daughter website.JPG
"I can tell what kind of care my daughter is going to get within 15 steps of walking on to a ward"
quote from parent that sparked the Challenge


What is the 15 Steps Challenge?

The 15 Steps Challenge is a series of toolkits which are part of the resources available for the Productive Care workstream. They have been co-produced with patients, service users, carers, relatives, volunteers, staff, governors and senior leaders, to help look at care in a variety of settings through the eyes of patients and service users, to help capture what good quality care looks, sounds and feels like.

There are five toolkits that make up the 15 Steps Challenge:

  • The 15 Steps Challenge for acute services
  • The 15 Steps Challenge for mental health inpatient care
  • The 15 Steps Challenge for children and young people’s inpatient services – this document should be used alongside the adult inpatient toolkits but is designed specifically for use by children and young people
  • The 15 Steps Challenge for community services
  • The 15 Steps Challenge for clinic and outpatient settings

Each toolkit provides a series of questions and prompts to guide patients, service users, carers and NHS staff through their first impressions of a care setting.

The Challenge toolkits help to gain an understanding of how patients and service users feel about the care provided and what gives them confidence. It can also help organisations to understand and identify the key components of high quality care that are important to patients, services users and carers from their first contact with a care setting.

The purpose of the 15 Steps Challenge is:

  • to help staff, patients, service users and others to work together to identify improvements that can enhance the patient or service user experience
  • to provide a way of understanding patients’ and service users' first impressions more clearly
  • a method for creating positive improvements and dialogue about the quality of care.
Implementing the 15 Steps Challenge

Nottingham University Hospitals NHS Trust rolled out the 15 Steps Challenge to all 80 of its wards on the same day! Find out how the Trust prepared and rolled out the Challenge in its acute wards.

How can I get started?

The download for toolkit and resources are free for use within NHS England. To access them you will need to be logged in.

To start using the 15 Steps Challenge download a copy of the toolkit you require along with the accompanying resources by visiting our 15 Steps resource page. This will provide you with everything you need to know about the 15 Steps Challenge for your particular care setting and step by step guidance on how you can get started.

The 15 Steps Challenge for acute services

The following resources provide you with everything you need to know about the 15 Steps Challenge for acute services and step by step guidance on how you can get started.

  • The 15 Steps Challenge toolkit
  • The 15 Steps Challenge - what to look out for
  • 15 Steps Challenge Appendix 2 - Ward notice for staff and patients
  • 15 Steps Challenge Appendix 3 - Action Plan template
  • 15 Steps Challenge Walkaround feedback template
  • Briefing note for senior leaders - 15 Steps Challenge
  • Patient engagement briefing note - 15 Steps Challenge
  • Slide set 1 Background and summary - 15 Steps Challenge
  • Slide set 2 Strategic alignment - 15 Steps Challenge
  • Slide set 3 Getting prepared - 15 Steps Challenge
  • Slide set 4 The walkaround day - 15 Steps Challenge
  • Slide set 5 Action planning - 15 Steps Challenge
  • Volunteer agreement template 
Download these resources: NHS England only or Non NHS

The 15 Steps Challenge for mental health inpatient care 

The following resources provide you with everything you need to know about the 15 Steps Challenge for mental inpatient care and step by step guidance on how you can get started.
  • The 15 Steps Challenge for mental health inpatient care toolkit - what to look out for
  • 15 Steps Challenge for mental health inpatient care - what to look out for
  • 15 Steps Challenge for mental health inpatient care Appendix 1 - Template for a poster for staff and service users
  • 15 Steps Challenge for mental health inpatient care Appendix 2 - Supporting notes for secure settings
  • 15 Steps Challenge for mental health inpatient care Appendix 3 - Supporting notes for children's and young people's settings
  • 15 Steps Challenge for mental health inpatient care feedback template
  • 15 Steps Challenge for mental health inpatient care Action Plan template
  • Briefing note for senior leaders for mental health inpatient care
  • Briefing note for service user engagement leads for mental health inpatient care
  • Slide set 1 Background and summary - 15 Steps Challenge for mental health inpatient care
  • Slide set 2 Strategic alignment - The 15 Steps Challenge for mental health inpatient care
  • Slide set 3 Getting prepared - The 15 Steps Challenge for mental health inpatient care
  • Slide set 4 The walkaround day - The 15 Steps Challenge for mental health inpatient care
  • Slide set 5 Action planning - The Steps Challenge for mental health inpatient care
  • Volunteer agreement template  
Download these resources: NHS England only or Non NHS

The 15 Steps Challenge for children and young people’s inpatient services

The Children and young people’s version of the 15 Steps Challenge is designed to be used alongside the adult inpatient versions of the Challenge. The adult versions will give full guidance on setting up and implementing the Challenge. This resource has been developed with young people and is designed specifically to support and involve young people in the 15 Steps Challenge process.

The following resources provide you with the 15 Steps Challenge for children and young people’s inpatient services toolkit, a useful poster and templates that can help with the 15 Steps Challenge.
  • 15 Steps Challenge for children and young people’s inpatient services toolkit
  • Poster – a visual resource for children and young people
  • Observation guides
  • Feedback sheet
  • Certificate
Download these resources: NHS England only

The 15 Steps Challenge for community services

The following resources provide you with everything you need to know about the 15 Steps Challenge for community services and step by step guidance on how you can get started.
  • The 15 Steps Challenge for community services toolkit
  • The 15 Steps Challenge for community services Appendix 1 – Leaflet for patients or carers to photocopy or print
  • The 15 Steps Challenge for community services Appendix 2 – Telephone prompts template
  • The 15 Steps Challenge for community services Appendix 3 – One page summary guide for conversations with patients
  • The 15 Steps Challenge for community services Appendix 4 – Feedback template
  • The 15 Steps Challenge for community services Appendix 5 – Action Plan template
  • Briefing note - 15 Steps Challenge for community services
  • Slide set 1 Starting off on the right foot - The 15 Steps Challenge for community services
  • Volunteer agreement template  
Download these resources: NHS England only or Non NHS.

The 15 Steps Challenge for clinic and outpatient settings

The following resources provide you with everything you need to know about the 15 Steps Challenge for clinic and outpatient settings and step by step guidance on how you can get started.
  • 15 Steps Challenge for clinic and outpatient settings toolkit
  • Observation guides
  • Feedback template
  • Action Plan template
  • Slide set – a step by step guide presentation
Download these resources: NHS England only

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