Initial Climate Test Event

Climate tests are done to understand public opinion on a matter of interest. They help by providing actual insight into how the public feels about a subject rather than relying on gut feeling and intuition. The Bolton Care Record is a huge NHS led programme that may affect all the residents in Bolton.

An initial climate test should be done at the very beginning of a programme of work which is affecting change. This will provide a bench mark of understanding and help shape communications moving forward. Climate tests should be conducted frequently through any change programme of work to ensure that people understand the messages and are moving through the journey and ultimately changing behaviours.

At the very beginning of the programme we used the opportunity to understand what stakeholders thought and then used their thoughts to shape the programme.


Healthwatch and Bolton Community and Voluntary Services brought a group of 16 people together to share the vision of the care records and the aim of the partners. There were attendees from the following organisations:

  • BSURF (Bolton service user recovery forum)
  • BAND (Building a new direction)
  • Healthwatch
  • LGBT+ (Lesbian, Gay, Bisexual and Transgender)
  • Stroke Association
  • Age UK
  • Urban Outreach
  • Carers Trust
  • CVS
  • Asian Elders


Concerns and feedback raised included:

  1. What if the information gets into the wrong hands?
  2. How you going to stop it getting into the hands of insurance companies?
  3. How will you mitigate re discrimination
  4. What if a person presents at A&E with self-harming – they need access to clinicians with mental health experience.
  5. Consent issues –GPs can ask leading questions. Patient may not understand what they are consenting to.
  6. Are the current safeguarding measures in place actually working? If not this will just increase the risk and the issues?
  7. Patients need to feel involved and empowered
  8. Consent regarding historical data – how will this work?
  9. Crisis situation – permissions may be given but then will it be emphasised that consent can be withdrawn at any time.
  10. Consent procedures – will this be done in person and signed/dated/ Must not be done on phone.
  11. Training crucial for staff. Education crucial for patients.
  12. Is there scope to enable the patient to check the accuracy of their record
  13. What info will be put on to the patients record (trans patients v concerned)
  14. How will we reassure patients that they won’t be treated differently if they opt out?
  15. How can we guarantee that the data won’t be sold off in the future?


Recommendations to be considered:

  1. There needs to be free following information providing education about the process. What will happen to the patient’s information must be made very clear. There needs to be education on what the information is, who will see it and who can’t? As well as thorough understanding about how it’s accessed, where it’s stored and how a patient can opt in as well as out of the sharing process. Must be made clear that patients can object and won’t be penalised or discriminated against
  2. The programme should be referred to “The Bolton Care Record” – say’s what it is and had unanimous support.
  3. The benefits should be shared
  4. Lots of information and signposting to this information.

If you wish to be involved in the next climate test then please contact Healthwatch or CVS or alternatively email the programme direct at

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