Friends and Family Test
The Friends and Family Test (FFT) is an important feedback tool that supports the fundamental principle that people who use NHS services should have the opportunity to provide feedback on their experience. Listening to the views of patients and staff helps identify what is working well, what can be improved and how.
The FFT asks people about their overall experience of services they have used and offers a range of responses. From April 2020, a new question about overall experience replaced the original FFT question about whether people would recommend the service they used to their friends and family. There were delays in some services implementing the new guidance in full due to the impact of the coronavirus on services. All organisations should now be implementing the new question and implementing FFT guidance.
The replacement question invites feedback on the overall experience of using the service. When combined with supplementary follow-up questions, the FFT provides a mechanism to highlight both good and poor patient experience. This kind of feedback is vital in transforming NHS services and supporting patient choice.
Patients who wish to provide feedback through FFT should get in touch with the relevant NHS organisation directly (for example, by contacting their NHS trust or GP practice). NHS England is unable to process FFT feedback directly from patients about their healthcare experience. For more information about how to give feedback or make a complaint about any aspect of NHS care, see feedback and complaints about NHS services (on this website).
See our section on Implementing FFT guidance for details of how the FFT works.
The feedback gathered through the FFT is being used in NHS organisations across the country to stimulate local improvement and empower staff to carry out the changes that make a real difference to patients and their care. You can see examples of this in our FFT case studies.
While the results are not statistically comparable against other organisations because of the various data collection methods, FFT provides a broad measure of patient experience that can be used alongside other data to inform service improvement and patient choice.
History of FFT
After being launched in April 2013, the FFT was rolled out in phases to most NHS-funded services in England over a two-year period, and now gives all patients, users of services, their carers and loved ones the opportunity to leave feedback on their care and treatment.
During 2018/19, we carried out a development project to improve the FFT and make it a more useful tool for driving service improvement. This resulted in a number of revisions to the way it works, set out in revised guidance for services, and these changes were effective from 1 April 2020, though implementation in some services was delayed due to pressures from the coronavirus response across the NHS,
By the end of 2019, the FFT had resulted in more than 75 million pieces of feedback. Data submission restarted from December 2020, following the pause during the response to COVID-19, and currently around 2 million pieces of feedback are submitted each month. This makes FFT the biggest source of patient opinion in the world. Scores so far have told us that at least nine out of ten patients respond positively on their experience. Patient comments also identify areas where improvements can be made so that providers can make care and treatment better for everyone.
Monthly results of the Friends and Family Test
The results of the FFT are published monthly. The FFT analysis tool is also updated monthly, this allows users to analyse their response data over time, assess the popularity of various response methods, review the distribution of response date at organisation and ward level across England, and revisit response data at organisational, site and ward level.
The National Quarterly Pulse Survey (previously Staff FFT)
From April 2014, all NHS trusts providing acute, community, ambulance and mental health services in England were required to implement the FFT for staff. The National Quarterly Pulse Survey (NQPS) has been implemented gradually from April 2021, replacing the Staff FFT. Guidance to support organisations administering the NQPS is published on the NQPS page.