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Friends and Family test set to expand across all NHS services


Today NHS England took the next step towards expanding the Friends and Family Test (FFT) to all NHS services.

The roll out of the FFT will mean every patient will have the opportunity to provide feedback on the services they have received, enabling the public to make better informed choices about the services they use. It also means providers will be able to design care services based on the feedback and around the needs of patients.

As it sets out to expand FFT, we have published a comprehensive guide for use by hospital trusts and the providers of NHS funded services, helping them to implement FFT most effectively for both patients and staff. This includes advice on how to make the FFT more inclusive, allowing people of all ages and from all parts of our community to provide feedback.

The new guidance - which is interactive and contains advice, videos, supporting materials and case studies - has been compiled after an in-depth review of the FFT in A&E and inpatient services since it was introduced in April 2013. As a result of the review, we intend to make the test easier for the public to understand and to gather more personal comments from patients. The review found that the FFT - which has gathered more than three million pieces of feedback since its introduction - had made a positive impact on the NHS, with 78 per cent of trusts saying it had increased the emphasis on patient experience in their trust.

The FFT was also seen to have an important role on driving local service improvements, as well as boosting staff morale when positive comments are received. The review also found the net promoter score was not easily understood, and as a result, the FFT will create a more transparent presentation of the data, which both patients and staff will find easier to understand and use.

Tim Kelsey, NHS England's National Director for Patients and Information, was keen to praise the FFT and its impact on our organisation. "The key aim in setting up the Friends and Family Test was for the results to be transparently published and available to inform patient decisions and choice."

"The FFT has already gathered more responses than any other feedback exercise ever undertaken. The huge numbers of responses that have already been received, many of which reflect the positive experience of patients, provide a key source of information to inform the decisions and choices patients make about their care."

"We are already seeing many examples of the ways in which the valuable free text comments are being used to make improvements to the experiences of patients in our hospitals and communities. As we roll out FFT to the whole of the NHS its value will be further strengthened. I hope that this will create a culture where patients expect to be given the opportunity to give feedback, and NHS staff value and act upon patients' needs and wishes."

"By April 2015, we will have introduced the FFT to millions of patients across thousands of providers of NHS funded services including GP and dental practices, ambulance, mental health and community services, as well as out-patients. We are going to continue to look at what the FFT data tells us and how we can continue to improve the way it is collected and used. This will include work to examine how we can make FFT more comparable to further increase its future usefulness in helping patients make informed choices."

"This reinforces our commitment to transparency, driving up standards and listening to the voice of patients from all backgrounds and communities in our society."

Health Secretary Jeremy Hunt said:  "We want the NHS to be the most transparent healthcare system anywhere in the world, and the Friends and Family Test is both making it easier for patients to have a say about their care and helping hospitals improve standards. More than three million people have provided feedback already, and expanding the test to all NHS services will help improve patient experiences right across the NHS."

Improvements made to services as a result of NHS staff acting on FFT feedback are wide and varied, ranging from hospitals ensuring patients do not feel isolated, to improving the food they receive.

Other examples of the improvements made to services include:

  • The University Hospitals Coventry and Warwickshire Trust received FFT maternity feedback raising issues over the new birth centre's discharge process and visiting times for partners. As a result staff worked to speed up the discharge process for mothers and changed visiting times so partners can stay on the ward at night.
  • The Mid Staffs NHS Foundation Trust bought in soft-closing bins in response to patients saying noisy bins were keeping them awake at night.
  • ยท A patient who uses a wheelchair told Hull and East Yorkshire Hospitals NHS Trust the mirrors in the bathroom were too high. As a result full length mirrors were installed.

From 1st December 2014, the FFT will be rolled out to GP practices, and from 1st January 2015, to mental health and community services. It will further be extended from 1st April 2015 to NHS dental practices and patient transport services as well, covering acute hospitals outpatients and day cases.

To see the guidance in full, go to: http://www.england.nhs.uk/ourwork/pe/fft/fft-guidance/

Background Information:

The Friends and Family Test was launched on 1st April 2013 in A&E and inpatient services across the country. The FFT was introduced to maternity services in October 2013, capturing feedback from women at four key stages of their pregnancy. Since its launch, more than 3 million pieces of FFT feedback have been gathered. The new guidance uses evidence gained from a review undertaken by NHS England which looked at the experience of FFT being implemented for the first six months in A&E and in-patients.  This was supplemented with learning from two phases of testing by organisations implementing FFT within and across a variety of NHS settings.

FFT will now be mandated to include an additional free text question where patients give the reasons for their response - as this provides the feedback which is so crucial to staff in being able to improve services. The other main change is that we will be moving to a more transparent system of scoring which will be simpler for people to understand. This will be introduced in the autumn following user testing of different options.

Staff can react in real time to the feedback they receive on services, and this has led to numerous improvements in services at hospitals. These have included:  hospitals ensuring patients do not feel isolated, better communication with patients and improving hospital food.

The NHS Friends and Family Test focuses on collecting data in real time, or as close to real time is as is possible, so results can be acted upon quickly with a minimum of time-lag from collection to publication of the results. This allows staff to act quickly on the results and importantly to assess whether these actions have made a real difference to the patient experience.

It is important to focus on the purpose of The NHS Friends and Family Test - to improve patient experience. It acts as a catalyst to ask 'why? - why have patients awarded us this score?' and 'what can we do to improve the patent experience?' Trusts are collecting hundreds of pieces of detailed feedback from patients every day and it is this insight that is enabling Trusts to make positive changes.

The FFT data is published monthly on the NHS Choices website and NHS England statistics page.