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The Friends and Family Test (FFT) is set to mark its second anniversary by rolling out to millions more patients when it is implemented from April 1 in NHS dental practices, ambulance services, patient transport, day-case and outpatient services.

Launched less than two years ago in April 2013, FFT has already allowed more than five million patients to give invaluable feedback on their experiences of care and treatment in services throughout the NHS.

It has quickly grown into the biggest ever collection of patient opinion in any health service anywhere in the world and gives staff the ability to react promptly and make swift and lasting improvements to care provided.

Tim Kelsey, NHS England’s National Director for Patients and Information, said: “This latest extension of the Friends and Family Test is a remarkable achievement. In just two years we have reached a point where we are gathering patients’ views right across the NHS.

“It is enabling us to take prompt action to improve services in line with what patients want, and to highlight where things are going well.”

He added: “Not only has the FFT been a step forward in terms of transparency and openness, but it has been a real game changer in terms of the NHS getting better at listening to patients and acting on what they say. Real public participation is leading to the design of better services.”

One of the new areas that FFT – first announced by the Prime Minister in January 2012 -will be extended to from next month includes asking children and young people under 18 what they think of the care they have received.

Birmingham Children’s Hospital was the first children’s hospital to adopt the Friends and Family questionnaire for children and young people, having originally been involved in a 2012 pilot scheme.

Young people are now taking part in FFT in all the hospital’s in-patient areas, day services and its Emergency Department (ED), as well as mental health services. The hospital is also looking at how it can extend FFT to out-patient departments too.

Janette Vyse, the hospital’s Patient Experience Lead Nurse said: “By reacting to the feedback we have received from children and young people we have made numerous improvements. These have included buying new DVD games chosen by them for use on the wards, introducing activity books and games to occupy young people while they are going through diagnostic tests in the Emergency Department, introducing silent bins so children are not kept awake at night and carrying out a review of the food they receive.”

The FFT was first introduced two years ago to A&E and inpatient services and has since been rolled out to GPs, maternity, mental health and community services and to NHS staff.

Examples of improvements to services prompted by feedback from FFT include:

  • Buckinghamshire Healthcare NHS Trust – installed wi-fi around the site so that patients could entertain themselves and stay in contact with their family and friends via social media; extended visiting hours for patients’ partners; bought a special chair to ensure stroke victims with poor upper body tone can still use the showers; bought reclining chairs for the comfort of relatives who need to stay overnight with a very sick patient; took on more staff with expertise in breast-feeding to help new mothers with initial difficulties; added details of the daily ward routine to patient information packs so that inpatients know what to expect; and created posters showing patients what the different uniforms on the wards mean so that they can more easily identify staff.
  • A GP practice in Wessex that took part in an FFT pilot last year responded to patient feedback about there not being enough appointments by extending evening surgeries, creating an extra 1300 slots per year. They also used it as an opportunity to remind patients about the high number of lost appointments caused by patients failing to turn up (28 doctor appointments and 23 nurse appointments in one month alone).
  • Leicestershire Partnership NHS Trust listened to a suggestion from a visually impaired patient who used their community services and told them that tinted drinking glasses would be much easier to see. The Trust now plans to order only tinted glasses as replacements are needed.
  • In Cumbria, the Clinical Commissioning Group and local health trusts found that the FFT helped them to improve services for children and young people. Feedback told them that children using A&E felt vulnerable because of the presence of “adults who are drunk and keep shouting” so they are reviewing their waiting area layouts to try to create areas where young patients feel safer and more comfortable. Children also told them about particular areas of the hospitals where the staff seemed less child-friendly and the trusts have provided training to help those staff improve their interactions with younger patients.
  • At Hillingdon Hospital in London, patients staying in hospital said noise on the wards at night kept them awake. The management launched a “Comfort at night” campaign among staff which resulted in wards having lights out or dimmed at night, extra pillows and blankets being readily available, the purchase of silent-closing waste bins, ensuring that staff wear quiet shoes and explaining to patients beforehand if they are likely to be awakened in the night for medication or checks.

Other examples of improvements include responding to patient comments about food quality, ward temperatures, waiting times and making appointments.

Most FFT feedback, however, has been overwhelmingly positive across healthcare organisations and many report that the initiative has provided an unexpected boost to staff morale and created many more opportunities to give well deserved pats on the back to individual staff who have demonstrated excellent patient care.