Table 2 Details of questions used in study

NHS Staff Survey

Good communication between managers and staff

Four questions with 5-point Likert-scale responses (ranging from “Strongly disagree” to “Strongly agree”):

• Senior managers here try to involve staff in important decisions.

• Communication between senior management and staff is effective.

• I know who the senior managers are here.

• Senior managers act on staff feedback.

% employees who agreed or strongly agreed with at least three of the four statements

Can contribute towards improvements

Three questions with 5-point Likert-scale responses (ranging from “Strongly disagree” to “Strongly agree”):

• There are frequent opportunities for me to show initiative in my role.

• I am able to make suggestions to improve the work of my team / department.

• I am able to make improvements happen in my area of work.

% employees who agreed or strongly agreed with at least two of the three statements

Fairness and effectiveness of incident reporting procedures

Seven questions with 5-point Likert-scale responses (ranging from “Strongly disagree” to “Strongly agree”):

• My organisation treats staff who are involved in an error, near miss or incident fairly.

• My organisation encourages us to report errors, near misses or incidents.

• My organisation treats reports of errors, near misses or incidents confidentially.

• My organisation blames or punishes people who are involved in errors, near misses or incidents.

• When errors, near misses or incidents are reported, my organisation takes action to ensure that they do not happen again.

• We are informed about errors, near misses and incidents that happen in the organisation.

• We are given feedback about changes made in response to reported errors, near misses and incidents.

Average scale score calculated for each individual (based on 1 = “Strongly disagree” to 5 = “Strongly agree”); these then averaged across all individuals in each organisation.

NHS Acute Inpatient Survey

Information about condition or treatment

A single question, with wording “While you were in the A&E Department, how much information about your condition or treatment was given to you?”

Responses “The right amount” (scored as 100), “Too much” or “Too little” (scored as 50), or “I was not given any information” (scored as 0)

Scores averaged across all respondents for the organisation

Involvement in decisions about care and treatment

A single question, with wording “Were you involved as much as you wanted to be in decisions about your care and treatment?”

Responses “Yes, definitely” (scored 100), “Yes, to some extent” (scored 50), or “No” (scored 0)

Scores averaged across all respondents for the organisation

Ability to talk about worries and fears

A single question, with wording “Did you find someone on the hospital staff to talk to about your worries and fears?”

Responses “Yes, definitely” (scored 100), “Yes, to some extent” (scored 50), or “No” (scored 0) (A fourth response option, “I had no worries or fears”, was ignored for this calculation)

Scores averaged across all valid respondents for the organisation

NHS Community Mental Health Service User Survey

Listening carefully

A single question, with wording “Did the person or people you saw listen carefully to you?” (N.B. before 2010 this question specifically referenced “your psychiatrist”, rather than “people or person you saw”)

Responses “Yes, definitely” (scored 100), “Yes, to some extent” (scored 50), or “No” (scored 0) (A fourth response option, “Don’t know/can’t remember”, was ignored for this calculation)

Scores averaged across all valid respondents for the organisation

Enough time to discuss needs and treatment

A single question, with wording “Were you given enough time to discuss your needs and treatment?”

Responses “Yes, definitely” (scored 100), “Yes, to some extent” (scored 50), or “No” (scored 0) (A fourth response option, “Don’t know/can’t remember”, was ignored for this calculation)

Scores averaged across all valid respondents for the organisation

Formal meetings to review ongoing care

A single question, with wording “In the last 12 months have you had a formal meeting with someone from NHS mental health services to discuss how your care is working?”

Responses “Yes” (scored 100) or “No” (scored 0) (A third response option, “Don’t know/can’t remember”, was ignored for this calculation)

Scores averaged across all respondents for the organisation

Treatment with respect and dignity

A single question, with wording “Did you feel that you were treated with respect and dignity by NHS mental health services?”

Responses “Yes, always” (scored 100), “Yes, sometimes” (scored 50), or “No” (scored 0)

Scores averaged across all respondents for the organisation