interviews

FFT must not create bureaucratic burdens for GPs

Dr Maureen Baker, chair of the Royal College of General Practitioners (RCGP), explains that the introduction of FFT to GP surgeries must be ‘workable’ and ‘flexible’.

Providing feedback to GP teams can improve the care they deliver to patients, according to the Royal College of General Practitioners (RCGP), with many surgeries already actively encouraging patients to raise concerns if they feel that the care and services they have received are below their expectations.

NHE was told that when the FFT becomes a contractual requirement for GP practices from 1 December 2014, it will provide another opportunity for patients to raise their concerns.

Dr Maureen Baker, who became chair of the RCGP in 2013, told us: “The GP-patient relationship is unique in the NHS and GPs remain the most trusted healthcare professionals in the UK, with the vast majority of patients reporting positive experiences after visiting their GP.

“However, there is always room for improvement and it is important that all patient feedback – whether positive or negative  – is taken very seriously.”

She added that at a time when GPs are facing intense financial and workforce pressures, it is essential that implementation of the FFT is as “workable” and “flexible” for GPs as possible.

Reducing bureaucratic burdens?

Earlier this year an NHS England Review of the FFT stated that the collection of FFT data at GP and outpatient services will increase the volume of data collection to an industrial scale, “such that issues of sustainability may need to be considered, i.e. what can be done within the cost boundary and with the limited resources available to the service”.

It added that there is a trade-off that needs to be made between ensuring the qualitative feedback is listened to and creating an unsustainable industry around its usage.

Dr Baker said the RCGP has been in discussions with NHS England and other stakeholders to work out how to maximise the benefits of the FFT in terms of improving services for patients without creating any further, unnecessary bureaucratic burdens.

However, she noted: “What is really needed to improve patient care across the entire health service is more investment in general practice. We are calling for 11% of the overall NHS budget by 2017 so that we can offer shorter waiting times for appointments, as well as more flexible opening hours and better continuity of care for our patients in their communities.”

The RCGP appears to have mollified its criticism of the FFT. Last year, in response to the ‘Improving general practice – a call to action’ consultation, Professor Nigel Mathers, honorary secretary of council at the RCGP, wrote: “We would caution against placing undue emphasis on the FFT. In our view, this will fail to provide as meaningful a measure of patient experience as the GP Patient Survey, not least as it risks making overly simplistic – and therefore misleading – comparisons between different GP providers.

“Moreover, the FFT will inevitably impose an additional administrative burden on practices, and will duplicate feedback already received through the Patient Survey.”

This view has been reiterated by BMA chair Dr Kailash Chand who has said he doubts anyone really believes the introduction of FFT to GP practices will improve patient care. The move “appears more of a political gimmick rather than a clinically meaningful mandate for general practice,” he has been quoted as saying.

Dr Chand stated that effective patient engagement will be crucial to developing improved models of care, but the FFT data collection may lead to the generation of league tables based on customer satisfaction rather than clinical outcomes.

Prof Mathers added that in order to ensure the roll-out of the FFT  is as effective as possible, the RCGP would urge NHS England firstly to ensure that the ‘comparability’ issue is addressed and explained (see page 51), and secondly to minimise the additional bureaucracy faced by practices in implementing the test.

He added at the time: “We recognise that patient choice of provider is one means of empowering patients and driving quality improvements. However, we feel that, in order to improve patient outcomes and deliver cost-effective care, it will be more important to focus on new forms of choice that are based on the principles of prevention, shared-decision making, improved sharing of patient information, and the provision of more care in the community.”

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