Friends and Family Test should ‘no longer be mandatory’

Over £12 million has been spent by NHS England on collecting feedback from patients for a test with a “questionable […]

30 January 2018

Over £12 million has been spent by NHS England on collecting feedback from patients for a test with a “questionable measure of performance”, experts say.

The Friends and Family Test was introduced in all acute hospitals in England in April 2013 to highlight both good and poor patient experiences. The main question is “How likely are you to recommend our service to friends and family if they needed similar care or treatment?” and respondents can rank their answer from “extremely likely” to “extremely unlikely.”


Glenn Robert, Professor of health care quality and innovation at King’s College London, said there was “widespread unease” about it among staff.

He argues in the BMJ that the Friends and Family Test should no longer be mandatory as it is used “purely a tool for national bodies to monitor them [hospitals]”.

According to NHS England, the FFT has seen more than 30 million pieces of feedback collected, with a further million added each month, which makes it the biggest source of patient opinion in the world.

Prof Robert and his colleagues’ claims that collecting and managing such large amount of data is complex and requiring substantial investments of time and other limited resources – over the past four years about £12million has been allocated centrally to support the test across England costing and around £1.5 million a year to maintain.


He goes on explain that “NHS England could free up the time and resources that providers currently spend on metrics that provide little insight for practitioners” and states the case for a compulsory friends and family test “lacks a strong rationale and scientific evidence”.

Dr Neil Churchill, NHS England’s Director for Patient Experience, said:

“More than half of NHS staff say they use this patient feedback to improve services to patients and in a recent survey 88 per cent of trusts said FFT was working well and 78 per cent said it had increased their emphasis on patient experience.”

There are presently no national CQUIN targets or financial incentives attached to the Friends and Family Feedback Test.


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