Health Service Focus

28.09.14

FFT can provide ‘important’ feedback for GPs

Source: National Health Executive September/October 2014

Dr Mo Dewji, NHS England’s national clinical lead for primary care, explains what the roll-out of the Friends and Family Test will mean for GPs. David Stevenson reports.

From 1 December 2014, it will be a contractual requirement that all GP practices implement the NHS Friends and Family Test (FFT).

Since the introduction of the FFT in April 2013, more than three million individual pieces of feedback have been collected on patients’ experiences of inpatient, A&E and maternity services.

NHS England hopes that rolling out FFT to GP practices will provide doctors with regular near real-time feedback direct from their patients, which can help them understand their areas of strength and weakness, while driving improvements to patient care.

The FFT is much faster than traditional survey methods, which often take months to produce results.

Dr Mo Dewji, NHS England’s national clinical lead for primary care, told NHE: “FFT will be implemented across the NHS, including community, mental health, ambulance and dental services, by April 2015, giving patients a consistent and powerful means to provide feedback wherever they access NHS-funded care or treatment.

“When combined with supplementary follow-up questions, the FFT question provides a mechanism to highlight both good and poor patient experience.

“The free text responses are a rich source of information that allow practices to consider the comments being made by patients in detail and identify actions that can be taken to improve patients’ experience much more quickly.”

Asked what the introduction of the FFT will mean for GPs on the frontline, NHE was told that NHS England has sought to make the FFT as “low burden” and “flexible” for practices as possible. For example, NHS England is keen to see practices gain feedback from as many patients as possible – but it is not setting a target response rate.

Mandatory minimums

Dr Dewji said: “The guidance, which has been agreed with the BMA’s General Practitioners Committee, is clear that practices do not need to ask patients to complete the FFT questionnaire at every appointment, but should make the opportunity available for those who do want to provide feedback.”

However, there are a small number of mandatory requirements. For instance, practices must:

  • Provide an opportunity for people who use the practice to give anonymous feedback through the FFT;
  • Use the standard wording of the FFT question and the responses;
  • Include at least one follow-up question that allows the opportunity to provide free text comment;
  • Submit data to NHS England each month. NHS England will publish guidance on how this will work in due course; and
  • Publish results locally.

Pilot success

NHE was told that a six-month pilot of the scheme, involving 31 practices in Bedfordshire CCG in November 2013, was a big success.

Dr Dewji stated that the response from these pathfinder providers was very positive. For example, patients were more eager to participate than initially envisaged.

“Some pathfinders reported that the FFT helped to improve patient and staff relationships generally, by providing a further opportunity for staff and patients to have a conversation about healthcare,” he said.

“In some cases, participation in the FFT prompted patients to take further participatory action: some patients went on to join focus groups, support groups and patient representative groups. We will publish a report with more detailed comments, setting out lessons learnt, shortly.”

Asked what support GPs will receive to implement FFT, NHE was told that the guidance published in July includes contact details for queries. At the same time, there are events being organised across the country where practices can find out more about how to implement FFT.

Practices will be responsible for their own data collection arrangements. NHS England will start to collect the monthly data from GP practices from the end of January 2015, and will start to publish monthly data after three months have been collected. This is to give the new system time to bed in and to deal with any issues that arise.

Dr Dewji added that NHS England is very clear that FFT does not provide results that can be used to “directly compare practices” because the “flexibilities in collection methodologies and variation in populations in different areas mean we are not comparing like with like”.

He added that there are other robust mechanisms for that, such as the national GP Patient Survey and outcomes measures, but, for each practice, it can help mark progress over time.

“Service providers are already collecting hundreds of detailed feedback comments from patients every day, and the experience to date has shown that many of the problems identified through the feedback can be easily resolved,” said Dr Dewji.

“Equally, the very many positive comments received through the FFT are important for raising and maintaining the morale of hard-working staff.”

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