The Friends and Family Test Review 2014

The Friends and Family Test was fully reviewed between November 2013 and March 2014, after the first six months of data collection in the A&E and inpatient settings.

This work drove a number of key decisions about how the FFT would operate as it was rolled out for implementation across further areas of the NHS. It contained a number of recommendations designed to promote the effectiveness and value of the FFT for the NHS, and for the public.

The review influenced the subsequent national FFT guidance, providing an evidence base for changes from the initial model and information about its impact, as well as providing good practice for broader implementation.

Published in July 2014, it also also recommended a move away from the Net Promoter Score (NPS) and the introduction of a simpler scoring system in order to increase the relevance of the FFT data for NHS staff, patients and members of the public.

As a result of these findings, FFT results are presented as a percentage of respondents who would or would not recommend the service to their family and friends.

This change was introduced for Staff FFT results from 25 September 2014 and for patient FFT settings from October 2014.

The review report was based on two main sources of evidence:

  1. Large-scale qualitative research with NHS staff, stakeholders, patients and the public, conducted independently by Ipsos MORI.
  2. Quantitative analysis of existing FFT data conducted by NHS England analysts and peer reviewed by the Office for National Statistics.

The FFT Review report

There are three appendices which are available on request to  These cover details of the quantitative research, the qualitative strand and the review of FFT suppressions.