Published: 27 September 2022

Staff consultation on trust in the HSE

Over 400 staff from all disciplines signed up to give their feedback on how we can build trust in the health service. This follows our extensive research in 2021 to understand what trust means to staff, to the public, and to patients and service users.

We heard feedback from staff through:

  • 16 workshop sessions
  • Engagement with our online research community of healthcare workers
  • A short online survey

Over the course of the workshops with staff, we identified the following 5 themes:

1. Learn and Listen

Listen to all stakeholders, including patients, staff and the wider public. Listen to and learn from feedback received and identify areas where learnings can be applied to develop a better service.

2. Culture

Create an attitude and atmosphere of trust, and demonstrate this through our behaviours. This is something to be developed over time, but staff identified a need to start this work now.

3. Communication

Build trust through positive and strong communications with the public, from the inside-out and top-down.

4. Technology & Process

Develop consistent and clear systems, processes and operations to build trust with the public. A key element of this involves investment in technology to allow for smoother, more consistent patient experiences.

5. Service Standards

Create consistent quality service through interactions and training while managing public expectations.

Action areas to build trust

We identified key priority actions under each of these themes and mapped them to the 4 categories from our earlier research on what builds trust. These categories are Public Good, Integrity, Respect and Competence.

There were so many strong suggestions from staff that are shaping our future priorities under this programme of work.

Public Good

You highlighted the need for better relationships with the media to promote positive stories. You suggested that we invest in communicating positive stories. You also highlighted the importance of including more staff advocates to drive solutions at ground level.


Some of the suggestions that emerged through our consultations included:

  • Do not hide mistakes
  • Do not try to avoid situations that might lead to a less than optimum outcome
  • Learn from mistakes quickly and implement learnings across HSE
  • Empathise, show compassion and listen to the patient before deciding on right actions
  • Try to agree to realistic timelines, options and outcomes at all stages


You suggested that the language we use in all our communications is in plain English. You highlighted the need for an updated process for using feedback to improve services. You also highlighted the need to develop and maintain a system of collecting learnings (for example, case studies) that staff can access.


Staff highlighted the development of the Regional Health Areas (RHAs) as an opportunity to improve the ways that we work. Some suggestions included:

  • Focus on consistency in interactions across the organisation
  • Build patient-centric systems to avoid failures (for example, operating hours and booking systems)
  • Focus on ease for users, not on ease for the organisation
  • Continuous performance appraisals sharing feedback on staff service quality with a focus on improvement

Other suggestions focused on the digitisation of healthcare. Suggestions included:

  • User experience improvements to the HSE website
  • A central repository of information and services for patients and staff
  • Invest in and implement digital health records for all patients and service users

Next steps

We listened and learned so much from these staff consultations about how we can build trust in the HSE. When updating the Trust and Confidence action plan, we will take what we learned from these staff consultations on board.

Some of these discussions confirmed that our existing actions were supported by staff, particularly:

  • The importance of being open and honest when things go wrong
  • Recognising the work of colleagues
  • Engaging with the media

We heard about the significant value of digital developments to help us to serve the public better. We will work to include actions that address digital concerns and issues to help us to earn public trust. There was also much discussion about how the new structures and RHAs could help to earn trust and recognition. We will take on board what we learned from our previous reform programmes.

Thank you to everyone who volunteered their time, thoughts and expertise to this work.