Friends and Family Test hits 50 million milestone

As the Friends and Family Test hits a major milestone, the Head of Insight and Feedback, explains why we should celebrate:

After five years of the Friends and Family Test (FFT) patient feedback tool being in used in NHS-funded healthcare, reaching 50 million pieces of feedback from patients is quite an achievement.

This is not to say that the NHS hadn’t been hearing from patients before the advent of the FFT – far from it: PALS, complaints, patient surveys and thank you cards have all been a feature of the dialogue between the NHS and the people it serves for decades.

That said, we hear from NHS teams that the FFT has done a great deal to increase the focus on listening to patients – whether that’s through the conversations happening in teams, conversations at board level or with patients themselves.

As it stands, the FFT is one of the largest collections of patient voice in the world.

To all staff that have contributed to this milestone, and to all those patients, service users and carers for all the feedback you have given, a big thank you. But it would be wrong of me to be pre-occupied by the size of this.

Feedback is more complex than 50 million ticked boxes. We know now that the act of giving feedback can be a hugely complex step for patients, depending on how well a person is, the timing of when they might give feedback, what they want to say, whether it reflects a good or bad experience, how continuous their relationship is with the doctors and nurses, and whether they want to be identifiable or not.

Given all that, not listening to what’s really being said – even if only said by one person – is to miss the point.

FFT, for us, is not a tick box exercise – it has been a game changer, particularly when staff have seen it as more than a data collection activity. Over the past five years we’ve seen great examples of how teams across the country have made real and impactful change by the simple and respectful act of listening to what their patients have told them and taking action.

Examples range from buying soft-closing bins for use on wards at night to overhauling patient fasting regimes prior to operations to reduce the time spent without food or drink.

In addition, the staff recognition awards that have sprung from  the celebratory and thankful comments about individuals and teams also points to the potential of the patient voice when it is intricately linked to how the NHS goes about things. We could do more of this. We should do more of this.

Though, to do that we realise that certain fundamentals need to be in place. We’re currently working with six integrated care areas to understand, in the new world of joined up healthcare systems, what these fundamentals are and how, from the offset of service design, through to service delivery and then service evaluation, the intelligence we can learn from patients will help us get it right for them sooner; will mean delivering a person centred health and care service; will mean better outcomes and better lives.

This is important for two reasons. Firstly, as is the case now, people who commission and run services need to know how well they are performing for patients but secondly, we also need to improve at the boundaries between care (such as physical and mental health) and integrated care systems are here to do that.

This requires new approaches and ICS pioneers are experimenting and learning by doing which will inform future practice. One example is a project focused on reducing frailty in old age, being run by the team at Frimley Health and Care.

In the meantime, we in the Insight and Feedback team at NHS England have also been listening. We know we have a job to do now to make FFT more effective to see what we can do to support local teams to listen and respond to patients, keeping the patient experience high on the agenda and to take it beyond 50 million ticked boxes.

We are starting by reviewing the questions, and reviewing the timing. We already have a bank of views from patients and staff across the NHS who have amassed five years’ experience of working with and responding to FFT. We also have research reports, evaluations and academic contributions. We are working with those who have said they’d like to help us in our bid to improve and evolve the FFT, as evolve it must.

You can find out more on our project page and, if you are a provider, commissioner or FFT supplier, you’ll find details there of how you can complete a survey to share with us your experience of using the FFT and help shape this national feedback tool for the future. We are listening.

Clare Enston

Clare Enston is NHS England’s Head of Insight and Feedback. Working alongside NHS Improvement, the Care Quality Commission and the Department of Health and Social Care, she leads on ensuring the views and experiences of patients and staff England are captured in order to drive improvements in patient experience and outcomes.

Clare’s team also explore new areas of insight not supported by the current national survey programme, along with developing thinking on insight and feedback approaches in the healthcare system.

Prior to joining NHS England in 2013, Clare worked in both the customer service and civil service sectors before moving into the work of NHS service improvement – latterly at Yorkshire & Humber Strategic Health Authority, where she had a regional role in health informatics.

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