Feedback from patients has become increasingly important in the provision of health care and the management of health services in many countries in the last 30 years. Government policy in England and the published research literature from different countries have focused more on the collection than on the use of patient feedback. There are significant gaps in the research literature relating to the ways in which patient feedback is used in the management of health services. The purpose of this research is to examine how feedback from patients is (or is not) used in the management of hospitals in the National Health Service in England. This thesis contains the results of a qualitative study of the use of patient feedback in two purposively selected NHS foundation trusts in England. Data were collected through interviews with managers, from government and Trust documents and websites, and through the observation of meetings. The findings show that qualitative feedback about patients’ subjective experience of their illness and services is used by managers to engage with and motivate staff, but that the quantified results of surveys are used to establish criteria and standards for service improvement. Although compliments and commendations by patients are used to praise staff they are not used to help set explicit standards for service improvement. Boards of directors sometimes use feedback from patients to help set strategies for quality improvement, but appear not subsequently to use that feedback explicitly to monitor the implementation of these strategies or assure the quality of services. The thesis fills gaps in the published literature by demonstrating that, although patient feedback is used in a variety of ways in the management of staff and in the development of strategies to improve the quality of services, managers in general and boards of directors in particular do not always use that feedback systematically to assure and improve the standards of service for patients.