Advice about GP FFT for commissioners

Since 1 December 2014 GP practices have been required to implement the Friends and Family Test (FFT). We have implementation guidance for GPs.

From 1 April 2015, co-commissioning arrangements are available in England. References to ‘commissioners’ of GP services in this note can refer to NHS England or a clinical commissioning group (CCG) depending on local arrangements. Commissioners of GP services should agree how they are going to work together.

The FFT is a tool for patients to give feedback about their experience of services. A simple question asks how likely, on a scale ranging from: extremely likely to extremely unlikely, a person is to recommend the service to a friend or family member if they needed similar care or treatment. The question format includes the opportunity to provide more detail of the person’s experience through a free text comment box.

The real strength of the FFT lies in the follow up questions that can be attached to the initial question, and a rich source of patient feedback that can be used locally to highlight and address concerns much faster than more traditional survey methods. The results can be used by practices to track progress over time.

The FFT does not provide results that can be used to directly compare practices. The flexibilities in collection methodologies and variation in populations in different areas mean we are not comparing like with like.

There are no response rate targets or minimum response numbers for GP practices. However, we do publish each practice’s list size to put the number of responses collected into context.

It is our intention to be as flexible and inclusive as possible, while creating as low a burden as possible on practices and patients who wish to give feedback.

Requirements for GP practices

There are three key requirements of GP practices set out in the guidance:

  1. to make the opportunity to provide feedback through the FFT available to all patients at any time;
  2. to submit FFT data to the NHS England analytical team via the Calculating Quality Reporting Service (CQRS) each month; and
  3. publish the data locally.

Practices are allowed to use a collection methodology that suits their local circumstances. Patients do not need to be asked to answer the FFT question after every appointment or contact with the practice, but they should be made aware that the opportunity to provide feedback is available.

FFT data is submitted to our analytical team by the practice. Guidance on how to submit data is available. Local offices do not have access to the data for validation before publication. Once the data has been submitted by the practice it cannot be changed.

We publish the FFT data each month.

Role of commissioners

The focus for commissioners of GP services will be on influencing future behaviour in practices that are either not submitting data or submitting data that raises concerns.

Non-submission

Where data is not submitted, that will be reflected in the publication with the words: “no data”. Commissioners should contact practices that do not submit data to remind them that FFT is a contractual requirement. A standard letter has been produced which can be sent to GP practices that do not submit data.

If a practice fails to submit a second time, a further letter can be sent.

If a practice fails to submit for a third month, commissioners should consider issuing a breach of contract notice.

Concerns about data quality

Where the NHS England analytical team has concerns about the data (because the number of responses is significantly higher than we would expect) it will be published in italics. Commissioners may wish to contact practices where the number of responses is very low, or unfeasibly high to ask them to look at how the FFT is working, and to see if it could be improved.

Incorrect data submitted

The CQRS system does not allow practices to resubmit data once it has been submitted. Practices that realise they have submitted incorrect data, before the deadline for submitting data, can ask for their data to be removed by completing a simple proforma, In this case, the NHS England analytical team will replace the data with the words: ‘data submitted but not published due to issues with the data entry process’.

Non-responder – first reminder

Friends and Family Test

Since 1 December 2014, GP practices have been required to implement the Friends and Family Test (FFT), in line with the guidance published by NHS England in July 2014. In addition to the formal guidance, we have also published a shorter summary guidance.

It is a fundamental principle of the FFT that all NHS patients should have the opportunity to provide feedback about the services they receive. The FFT can provide practices with a rich source of patient views that can be used locally to highlight and address concerns much faster than more traditional survey methods.

We have tried to make the FFT process as flexible and inclusive as possible, while creating as low a burden as possible on practices and patients who wish to give feedback.

One of the key requirements of the FFT is that practices must submit their results to NHS England each month through the CQRS. NHS England has published guidance on what should be submitted and how. The FFT results for every practice in England are then published nationally on the NHS England website and on NHS Choices. We are not able to amend or add data after the deadline for submission.

I am concerned to note that NHS England did not receive FFT data from your practice [for last month].

If you need support or advice on how to implement FFT you can:

  • find advice, support materials, frequently asked questions, case studies etc on the NHS England website at the address above; or
  • e-mail the national FFT team: england.friendsandfamilytest@nhs.net

I would be grateful if you could ensure you submit data for next month at the appropriate time (any time between the end of the month and the twelfth working day of the following month).

Yours sincerely

Non-responder – second reminder

Dear

Friends and Family Test

As you will be aware, it is a contractual requirement to make the Friends and Family Test (FFT) available to your patients, and to submit data to NHS England. I am concerned to note that NHS England again did not receive FFT data from your practice [for months X and Y].

I do appreciate that implementation of the FFT is an additional burden at a time of increasing workload, but I can assure you that NHS England has sought to make the FFT process as simple and as low a burden as possible, while meeting the fundamental principle of the FFT that all NHS patients should have the opportunity to provide feedback about the services they receive.

One of the few key requirements of the FFT is that practices must submit data to NHS England each month through the CQRS. NHS England has published guidance on what should be submitted and how here.

If you need support or advice on how to implement FFT you have can:

I would be grateful if you could ensure you submit data for next month at the appropriate time (any time between the end of the month and the twelfth working day of the following month).

If you need any additional help or advice, or if you are not able to comply with the guidance for any reason, please use the contact e-mail address above.

Yours sincerely