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Happy staff=happy patients: How the SPEaC app came to be

25 June 2018

Anne Frampton, Consultant in Emergency Medicine, and Andrew Hollowood, Clinical Chair, both at University Hospitals Bristol NHS Foundation Trust, describe the development of the SPEaC Happy App. This blog is part of the Bristol Firsts series, celebrating Bristol-based innovations in the NHS’s 70th year. If you have an idea for a Bristol Firsts blog, get in touch with Zoe Trinder-Widdess on

“How are you feeling today?” – asking questions like this can make the difference to anyone’s day, whether you work in the NHS or not. Back in 2015, we already knew that happy staff=happy patients. So we looked for a way for staff to feedback, in real-time, what was great about their day job, but also niggles and frustrations that were getting in the way.

Our answer to this was the SPEaC Happy App (also known as simply the Happy App). It’s a real-time staff feedback mechanism that we first piloted at University Hospitals Bristol NHS Trust. From the outset we worked with a team of NIHR CLAHRC West researchers who helped us understand what made staff tick and how we could get the most out of this new tool.

We were bowled over by the response. Uptake was fantastic, and within a few months our pilot in two areas of the trust had grown to tens of areas, and by Christmas 2016 almost all the trust was able to use the app to feedback.

The app uses emoji style icons to ask staff “how are you feeling today?”. They select a mood, leave a comment and then local leaders act as moderators responding to the feedback, picking up and resolving issues.

Staff were involved with the design and implementation from the outset. We held workshops with staff to identify the app’s key features, including that it was anonymous, easy to use, readily accessible and was responded to, so that staff were assured that their voice was being heard. Staff were involved in “culture” weeks to promote engagement with the app.

We developed close working relationships with front-line staff and executive directors to ensure engagement and buy-in from floor to board. We also developed the site in line with feedback and requests from local teams and trusts. This included upgrading the dashboard and reporting tools, flexibility to embed bespoke initiatives through locally designed categories, and features like positive incident reporting and staff surveys.

We developed the app so that each organisation can customise the common structure to create their own bespoke version. This meant there was enough commonality to enable analysis across the system, whilst recognising the needs of individual organisations.

We worked with HR and other execs at a partner organisation to develop the board-level analysis dashboard. This provides the in-depth analysis that allows the app to influence decisions at a senior level, as well as providing local team feedback.

Through an evaluation with NIHR CLAHRC West, we identified that it helped staff in different ways. For individuals it gave them a voice, as a key feature was anonymity. It flattened hierarchies and ensured that everyone had their say. Staff often identified quick wins which, when fixed, boosted morale and supported improved patient care. For local leaders it gave them an opportunity to own issues, and from a trust point of view it has supported recruitment and retention in several areas.

More than 50 per cent of the comments uploaded to the app were positive, with staff especially feeding back on team working, often with suggestions for improvements.

Since 2016 we have gone from strength to strength. Supported by Health Education England (HEE), we have been able to roll out this innovation to other local trusts, as well as some further afield. We’ve had interest from places like Belfast, Kilmarnock and even Adelaide.

Our vision is to enable all staff to provide honest anonymous feedback about their day and know that they will be listened to.

Happy staff=happy patients: How the SPEaC app came to be
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