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Patient feedback coming to a council near you

12 June, 2013

I’ve written before about the NHS “Friends and Family Test”, and joked that this could be coming to a council near you sometime soon. Well it seems this could be closer than I thought.

The NHS Friends and Family Test is a version of the Net Promoter Score, commonly used in customer satisfaction analysis across the private sector. You’ll have been asked numerous times when buying televisions, holidays or mobile phones: “would you recommend this product/service to your family and friends?”, with a 10-point answer scale and a box to fill in. I was even asked it recently when buying a doughnut…

In the NHS version, patients are now being asked: “if they needed similar treatment, would you recommend this ward/A&E department to your family and friends?”.


Since 1 April, it’s been mandatory for all acute trusts to ask this question of all of their inpatients, and everyone who goes through A&E. And there are plans to roll it out to the whole of the rest of the NHS by 2015: maternity services in October, day surgery patients in April, community and mental health service users during 2014, and patients of GPs, dentists and all other services at some stage too.

There are parallel proposals to roll out a version of the test to all NHS staff too: asking them whether they’d recommend their Trust as a place to work; and whether they’d recommend it to their own family as a place to be treated.

Ambitious plans indeed. And very much at the heart of current reforms: not least, because they’re seen as a key part of the response to the Francis inquiry.

Indeed, NHS England counts as its two most important priorities: having satisfied patients, and motivated positive staff. CQC are talking about the patient and staff Friends and Family Test scores as key indicators of organisational health and patient safety. And this year’s CQIN links all of this directly to financial rewards for Trusts who score well.

The scheme has its detractors as well as its promoters. Critics say it’s expensive, superficial, not statistically comparable, inappropriate as a measure of a public healthcare system, and potentially offensive to some patients. The debate will continue, no doubt.

But encouragingly, we’re detecting a change in tone from the new gang of civil servants who are running this in NHS England. Less talk of national comparisons and league tables; and more talk about using the Friends and Family test to drive local improvement – in individual trusts and individual wards.

There are stories already emerging about rapid, real-time reaction to the Friends and Family Test, and rapid improvements as a result. And lots of parallel developments going on around collecting patient experience metrics in other ways – including some really interesting work around so-called “sentiment analysis” of twitter feeds and other social media.

It will be interesting to see how quickly – and how effectively – all this can be put into practice. And particularly interesting for LGC readers as it appears there are conversations going on at the highest level between NHS England and the Department of Health about how to implement this across the whole of social care as well. Significantly more challenging, I expect. So watch this space.

Daniel Ratchford
Chief Executive

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