The new-look Friends and Family Test’s challenge to services

The Director for Experience, Participation and Equalities at NHS England discusses today’s published changes to the Friends and Family Test (FFT) policy from next April:

I’m extending a challenge to you today in terms of how we maximise this opportunity of changes to the feedback tool for patients across most NHS services.

After five years of using it, many of you – healthcare professionals, commissioners and patient representatives – shared your thoughts on how it could work better and yield greater insight for improving services. Since last year, you’ve shared your thinking with us through the FFT Development Project and persuaded us that policy changes will help you get more from this tool.

Many of the 1,300 stakeholders we heard from expressed firm support for the FFT and told us how it was making a difference by helping services to focus on incremental, continuous improvements on both large and small issues identified by patients and service users. It was clear that gathering feedback is worth the effort and that it has become embedded in delivering services.

The biggest policy change we’re making is new wording for the standard FFT question to focus it on experience and make it easier to understand. Instead of asking people whether they would recommend the service to their friends and family, we will be asking them to tell us about their overall experience of using the service. Coupled with a follow up question chosen locally, we believe it will give providers a richer seam of information to mine, revealing what’s working well and what can be improved.

We’re also giving providers more flexibility over when they prompt feedback. Instead of particular service having to meet strict requirements to do so at fixed times, they can now tailor it to what their service users want. Maternity is one example: women told us they should be able to give feedback any time and not just at four fixed points during months of interaction with services, so we’ve acted on that.

We’re putting less emphasis on collecting big numbers of responses and more on listening to what the feedback’s saying and showing patients you’ve got the message, so they feel that giving feedback is worthwhile.

So, we’ve listened to YOUR feedback and we’ve acted on it by changing some of the requirements and being less prescriptive about others, giving greater flexibility to put you more in control. But currently, it’s just a document, a piece of guidance, and unless its revisions are embraced and fully exploited, it will make no real difference.

That will happen only if those of you who deliver and commission services really grasp the opportunities that the revisions offer. You have six months to prepare for the new ways of working and your decisions could be transformative.

We’ve always said that the Friends and Family Test isn’t a ‘test’ for patients and service users; it’s about putting all of US, in the NHS, to the test in terms of whether the patient experience we deliver is good enough, in the patient’s eyes.

My challenge to you is to rethink how you currently deliver the FFT, taking more ownership of the design of your systems to collect feedback, being more creative and more actively determined to get something valuable from it.

In particular, consider:

  • How will you use the greater flexibility to add value by tailoring the FFT to the needs of specific service users and your local communities?
  • What can you do differently to involve more patients and service users in those decisions?
  • Can you do more to promote opportunities to give feedback whenever someone wants to?
  • How will you give staff who deliver the services more input on how feedback is collected and involve them in co-designing any follow-on questions?
  • Is there more you can do to show people that you are paying attention to their feedback and that patient insight is making services better for everyone?

We’ve worked hard together to shape the new guidance. My colleagues in the Insight and Feedback team are getting out to as many of you as possible to talk about the changes and how you might make the most of the flexibilities. Please ensure it makes a difference out there in hospitals, community services and primary care practices, for you and for everyone who gives and receives NHS healthcare.

When you do, please also remember to tell us about it so that we can share your amazing ideas – through case studies, webinars and more – to help others to use patient insight to deliver the best NHS we possibly can, for everyone.

This is not just about a tick in a box. We need to commit to using the FFT as an opportunity to start a conversation to involve patients more in their care and to learn something about what really works for them.

Dr Neil Churchill

Neil is Director for People and Communities at NHS England, having joined the NHS after a 25-year career in the voluntary sector. His work includes understanding people’s experiences of the NHS, involving people and communities in decision-making and leading change to improve the quality and equality of care. He has a particular focus on strengthening partnerships with unpaid carers, volunteers and the voluntary sector.

Neil has previously been a non-executive director for the NHS in the South of England, is a member of the Strategy Board for the Beryl Institute and Chair of Care for the Carers in East Sussex. He is himself an unpaid carer. Neil tweets as @neilgchurchill

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