Ask, Listen, Do

Written by Mary Busk, Family Carer Adviser, NHS EnglandDate 18 Jun 2018

Making conversations count for children, young people and adults with a learning disability, autism or both and their families in education, health and social care. 

How much do we really know about feedback, concerns and complaints? There are laws and policies for what should be done, but are they peripheral in organisations or central to learning and person centred planning? Are feedback, concerns and complaints underpinning how services and organisations listen to and frame their commissioning and service delivery? Do they work for all groups of people and their families?

Everyone has the right to receive good quality education, care and support, and the right to say how they feel about the quality of care and support they get. Ask, Listen, Do started from a realisation that feedback, concerns and complaints systems (and safeguarding and access to justice) do not seem to work as well as they should across education, health and social care for children and adults with a learning disability, autism or both and their families.  

That reflects in part their journey through many complex systems in education, health and care and the many barriers and difficulties they face. The systems and processes are also very complicated. There is also not a good enough understanding about how to listen to families or children, young people and adults, and the reasonable adjustments needed to do that. People and their families are often not included or do not feel that feedback and other systems work for them and do not take part in them.  

We must also acknowledge a perception that sometimes families can be seen as difficult and challenging which can get in the way of organisational listening, learning and reflection. The findings from qualitative and early findings from quantitative (survey) work we have done are summarised below.

 listening and taking concerns of service users properly is very important and vital to making improvements.

We are now working with national partners, including the Local Government and Social Care Ombudsman, Parliamentary and Health Services Ombudsman, Directors of Adult Social Services, Local Government Association, Care Quality Commission, , Department for Education and others, along with families and people themselves to help all organisations make it easier for people and their families, children and adults, to give feedback, raise a concern and make a complaint and to know that it will make a difference through an Ask, Listen, Do approach.

 feedback, concerns and complaints should all be taken seriously and feed into the cycle.

National partners have agreed with our analysis of the problems and have committed themselves and their organisations to the Ask, Listen, Do principles:


  • The organisation asks people about their experiences and makes it easy for people to do this.
  • The organisation makes sure that the person, their family or advocate know how to give feedback, raise a concern or make a complaint
  • People feel able to speak up when they have feedback, a concern or complaint
  • Everyone knows when a concern or complaint is a safeguarding or a criminal issue, and what must happen


  • The organisation really listens to what has been said and is not defensive
  • The organisation and staff have the skills to listen to and understand what it feels like for the person


  • The organisation does something positive about it in good time and tells the person what they are doing to put it right
  • The organisation learns from the feedback, concern or complaint and changes things so the service can improve
  • The organisation improves its services by working with the people that use them, listening to and learning from people’s experiences

We are seeking to influence and change organisational behaviours and approaches through these principles, our own work and the work of the national partners in education, health and social care.

One example already is that NHS Improvement will include Ask, Listen, Do in their new learning disability standards which is to be issued soon.  Another example is that the Department for Education commissioned Whole School SEND to work with families and NHS England to coproduce a guide to help make conversations about their children and young people count for all families in all schools.

We are also producing top tips for families to help empower them in understanding and dealing with these complex systems, and training and other resources to support organisations.

Please get in touch if you would like to know more, or if we would like to make your own commitment to these principles and this work.