15 Steps Challenge

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We need you!

Mid and South Essex ICB wants to improve services for children, we are committed to listening and understanding patient needs, so that we can fairly commission the right services for the people across the area, ensuring that no community or group is left behind.

When we make commissioning decisions on behalf of our population, we will ensure that promoting equality is at the core of our values.

The 15 step challenge (details below) is part of that feedback to improve, change and better understand the needs and wants of our community.

We will seek your input, listen to you on a regular basis, ask for your experiences and feedback and continue to work alongside you to make sure local health and care services are the best they can be.

Your involvement is invaluable to us and there are lots of ways to participate in decision-making and have your say.

What is the 15 step challenge?

The challenge was developed following a mums frequent admission to hospital with her daughter and she explained she would know the care they would receive within 15 steps of entering the ward / clinic.

This is what a mum said at a workshop, she wasn’t a nurse or doctor, but she made an important point – "first impressions are important" Patients, families and carers quickly know whether they feel confidence and trust in the hospital or care service that they are using.

The Challenge is a simple way of making sure we listen to users of services and see things through their eyes so that we can improve. The 15 Steps Challenge toolkits are aimed at adults, but it’s important that children and young people have a say in how care areas could be improved too.

This toolkit has been written with and for children and young people to use in a 15 Steps Challenge so that their views and contributions are heard and valued. Thank you to all the staff, children, young people and families who have participated in its production, we hope you enjoy using it and importantly that it helps us continue to improve services in partnership with children, young people and families.

Young adults who are up to 25 years of age use adult services and they often have great insight on how we can make areas such as adult wards more welcoming to them. These resources, along with the other 15 Steps resources can help you to engage young adults in reviewing adult care environments so that we can continue to work with them to improve their care experiences.

Our team will be working together with families, utilising the challenge, looking at a wide range of services provided for our families. The challenge might be at a hospital ward, clinic, specialist service or commissioned service.



How do we challenge?

15 steps challenge has a number of toolkits aimed at a range of services and we will be utilising the children and young people toolkit, here is the breakdown of how the challenge works.

  • A member of staff in the hospital or health care service needs to help support the Challenge. This person is called the 15 Steps co-ordinator. The co-ordinator's role is to recruit and invite people to be in the 15 Steps Challenge team. The co-ordinator will arrange for the 15 Steps Challenge team to meet up, learn about the Challenge and then walk around the children and young people’s wards and health care areas.
  • There is extra information for the co-ordinator to help them with their role in section 6 and in the adult versions of the 15 Steps Challenge that can be downloaded from the https://www.england.nhs.uk/participation/resources/15-steps-challenge/
  • The co-ordinator will set a date to do the 15 Steps Challenge. On this date the 15 Steps Challenge team meet up – there should be a young person and a family member too, a senior leader from the hospital and a staff member from a different care area. Remember – this is about having fresh eyes and a young person’s perspective in the Challenge team.
  • We will use the poster and observation guides from this toolkit. The observation guides are not a checklist, they are there to help the team think about what they see during the walkaround.
  • The 15 Steps Challenge team walk around the children and young people’s wards and care areas
  • The team use the poster and the guides to help them notice things clearly. The guides focus on four areas that patients told us were important for their first impressions. These areas are also linked to the CQC standards for good quality healthcare. These four areas are
  1. Is it welcoming?
  2. Is it a safe place?
  3. Will it care for me?
  4. Is it well organised and calm?
  • There is a feedback survey to help note down things that are seen during the walk around. Don’t forget to include the good things as well as things that can be improved, noticing good practice is important, it helps the staff team celebrate and share good practice.
  • The group tells the co-ordinator what they have seen and noticed.
  • The 15 Steps co-ordinator will give the group’s feedback to staff teams so that they can make some changes and improvements.

The 15 Steps Challenge should be repeated after a few months to check that things are improving. It may take us time to get it right and we will be updating the interactive Map to show which services we visit

What matters to you?

Join our online community today.

We need you!

Mid and South Essex ICB wants to improve services for children, we are committed to listening and understanding patient needs, so that we can fairly commission the right services for the people across the area, ensuring that no community or group is left behind.

When we make commissioning decisions on behalf of our population, we will ensure that promoting equality is at the core of our values.

The 15 step challenge (details below) is part of that feedback to improve, change and better understand the needs and wants of our community.

We will seek your input, listen to you on a regular basis, ask for your experiences and feedback and continue to work alongside you to make sure local health and care services are the best they can be.

Your involvement is invaluable to us and there are lots of ways to participate in decision-making and have your say.

What is the 15 step challenge?

The challenge was developed following a mums frequent admission to hospital with her daughter and she explained she would know the care they would receive within 15 steps of entering the ward / clinic.

This is what a mum said at a workshop, she wasn’t a nurse or doctor, but she made an important point – "first impressions are important" Patients, families and carers quickly know whether they feel confidence and trust in the hospital or care service that they are using.

The Challenge is a simple way of making sure we listen to users of services and see things through their eyes so that we can improve. The 15 Steps Challenge toolkits are aimed at adults, but it’s important that children and young people have a say in how care areas could be improved too.

This toolkit has been written with and for children and young people to use in a 15 Steps Challenge so that their views and contributions are heard and valued. Thank you to all the staff, children, young people and families who have participated in its production, we hope you enjoy using it and importantly that it helps us continue to improve services in partnership with children, young people and families.

Young adults who are up to 25 years of age use adult services and they often have great insight on how we can make areas such as adult wards more welcoming to them. These resources, along with the other 15 Steps resources can help you to engage young adults in reviewing adult care environments so that we can continue to work with them to improve their care experiences.

Our team will be working together with families, utilising the challenge, looking at a wide range of services provided for our families. The challenge might be at a hospital ward, clinic, specialist service or commissioned service.



How do we challenge?

15 steps challenge has a number of toolkits aimed at a range of services and we will be utilising the children and young people toolkit, here is the breakdown of how the challenge works.

  • A member of staff in the hospital or health care service needs to help support the Challenge. This person is called the 15 Steps co-ordinator. The co-ordinator's role is to recruit and invite people to be in the 15 Steps Challenge team. The co-ordinator will arrange for the 15 Steps Challenge team to meet up, learn about the Challenge and then walk around the children and young people’s wards and health care areas.
  • There is extra information for the co-ordinator to help them with their role in section 6 and in the adult versions of the 15 Steps Challenge that can be downloaded from the https://www.england.nhs.uk/participation/resources/15-steps-challenge/
  • The co-ordinator will set a date to do the 15 Steps Challenge. On this date the 15 Steps Challenge team meet up – there should be a young person and a family member too, a senior leader from the hospital and a staff member from a different care area. Remember – this is about having fresh eyes and a young person’s perspective in the Challenge team.
  • We will use the poster and observation guides from this toolkit. The observation guides are not a checklist, they are there to help the team think about what they see during the walkaround.
  • The 15 Steps Challenge team walk around the children and young people’s wards and care areas
  • The team use the poster and the guides to help them notice things clearly. The guides focus on four areas that patients told us were important for their first impressions. These areas are also linked to the CQC standards for good quality healthcare. These four areas are
  1. Is it welcoming?
  2. Is it a safe place?
  3. Will it care for me?
  4. Is it well organised and calm?
  • There is a feedback survey to help note down things that are seen during the walk around. Don’t forget to include the good things as well as things that can be improved, noticing good practice is important, it helps the staff team celebrate and share good practice.
  • The group tells the co-ordinator what they have seen and noticed.
  • The 15 Steps co-ordinator will give the group’s feedback to staff teams so that they can make some changes and improvements.

The 15 Steps Challenge should be repeated after a few months to check that things are improving. It may take us time to get it right and we will be updating the interactive Map to show which services we visit

What matters to you?

Join our online community today.

  • 15 Step challenge now open - We have now launched! (TBC)

    Share 15 Step challenge now open - We have now launched! (TBC) on Facebook Share 15 Step challenge now open - We have now launched! (TBC) on Twitter Share 15 Step challenge now open - We have now launched! (TBC) on Linkedin Email 15 Step challenge now open - We have now launched! (TBC) link

    Welcome to the 15 Steps challenge!!


    We are looking for volunteers to help us!! We need you!

    The Challenge team are the key to the 15 Steps Challenge! It’s important that the team are a mixed group of people who can bring “fresh eyes” to exploring a healthcare service area. A group of young people or a mix of young people, family carers and staff from other services would all be examples of a good mix of 15 Steps Challenge team members. Aim to work with young people from different backgrounds and cultures, and make sure to include disabled people and others who can bring a different perspective. The team’s role is to spend time in a healthcare area and try to spot what is reassuring to young people and what could be improved to help them feel safer and confident about the treatment that they are receiving.



    Additional roles for young people

    Young people are a core part of the Challenge team, but they might also like to: • give the feedback to the health services/staff directly. • be the team’s “reporter”, by capturing everyone’s feedback. • award a certificate to services that have done really well. • write a blog or article about their experience of the 15 Steps Challenge for a staff newsletter.

    The 15 Steps Challenge team should:

    • Visit the health service areas unannounced – a surprise visit means that the Challenge team can see things how they really are.

    • Even before getting in to the main health care area, the team should notice the entrance area/reception areas – how do they feel? What information is available?

    • The team use all their senses – what does it smell like? What can be heard? Does it inspire confidence or worry? The team should focus on their first impressions.

    • After thinking this, the team focus more on the detail of what they are seeing. The observation guides can help with this.

    • The job of each member of the team is to think about how these first impressions and other details build up a picture of the health service – what does this information tell you about how young people are treated in this service?

    • The team discuss together the feedback that they would like to give back to the service. It is the role of the team to be honest, but also encouraging. Make sure the team give feedback on what could be improved but also what is working well.



    Contact our team or Transverse to join the challenge! ( add email )


Page last updated: 18 Nov 2025, 04:18 PM