This document summarizes the role of critical friends in providing feedback and oversight to nursing and healthcare initiatives at North Wales BCUHB. Critical friends are retired healthcare professionals who serve as observers, sounding boards, and trusted advisors. They aim to provide honest, constructive feedback from a different perspective to help improve care quality and patient experience. The roles and responsibilities of critical friends are described over three levels of involvement. Examples are given of how critical friends have accompanied teams performing ward audits and provided thematic analysis of their observations of care delivery. The benefits of critical friends versus public members are also delineated.

1. Angela Hopkins
Executive Director of Nursing &
Midwifery

2. This is me

3. North Wales

4. North Wales
• Beautiful rural
surroundings
•The population
increases during
summer months 4
million day trippers
from Northwest locality
(2013)

6. Today's Healthcare

7. • Caring
• Compassion
• Competence
• Commitment
• Confidence
• Courage
• Communication
• Comportment
“Culture - The sticky Middle”

8. BCUHB Volunteers

9. Role Models of the past

11. BCUHB Critical Friends

12. What is a Critical Friend
“ a trusted person who asks provocative
questions provides data to be examined
through another lens, offers critiques of
another persons work as a friend. A
critical friend takes time to fully
understand the context of the work
presented and the outcomes of that
work”.
Source Costa, A & Kallick, B 1993

13. Critical Friend Credentials
• Trust and respect
• Honest constructive feedback
• Ability to build relationships quickly
• Skilled observer and listener
• Provides a different perspective or view
• Retired Healthcare Professional
• Availability and support

14. What's the difference?

15. Power of Observation
“The most important practical lesson that
can be given to nurses is to teach them
what to observe: what symptoms
indicate improvement; what symptoms
indicate the reverse; which are of
importance…”.
Florence Nightingale 1866

16. Three levels
• Act as a reference group - contact via
email, post or telephone;
• Act as a reference/advisory group or
sounding board for reviewing nursing
and midwifery strategies;
• Act as an observer of care or fresh pair
of eyes within clinical environments
(core team of 8 CF).

17. The first year
• Getting to know you meetings;
• Role development;
• Governance arrangements;
• PDSA (Plan, Do, Study & Act) with 3 critical friends
accompanying Transforming Care team
members completing the monthly ward to
board audits:
– Observations of care;
– Gathering the patient experience;
– Feedback to the clinical team.

18. Critical Friends Versus
Public Member role
• Advisory or reference group for specific nursing
and midwifery strategic developments;
• Links to the successes of the past;
• Maintains local intelligence/knowledge;
• Fresh pair of eyes and ears;
• NHS Knowledge and ability to give constructive
feedback;
• Advocate for BCUHB.

19. Observations of Care

20. Thematic Analysis
I feel I am able
to give a
balanced and
informed
summary of the
data…
I feel I still have
and give
something back
to my
colleagues…
I was heartened
by the pride of
the nursing that
came across …
despite the
challenges

21. Engaging the public

22. Interview Panels

23. World Café

24. Critical Friend Feedback
Its reassuring so much
good work is going
on, on this ward …
Gosh how much
paperwork and
questions the
patients are asked
I enjoy the role and I
feel I am still
contributing to
patient care…

25. BCUHB Role Description
• Evidence of Professional NHS Development;
• Able to share views as an individual and or group
settings;
• Ability to provide constructive balanced feedback
and not allow personal agendas to influence the
role;
• Respect the views of others and treat others with
respect;
• Respect for individual and patient confidentiality;
• Approachable, with good communication skills;
• Able to demonstrate excellent Leadership Skills.

27. Resetting our direction

28. The Future
• Critical Friends and Volunteers will be an
integral part of improving;
• Critical Friends hold
us to account to deliver
high quality care;
• Further recruitment.

29. The NHS

30. Question for you?

31. I love my job because …

32. Thank you
Diolch