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NHS Alliance rejects 'meaningless' friends and family test

The NHS Alliance has branded the Government’s flagship patient experience measure ‘useless and meaningless’ after it emerged a Department of Health commissioned report had advised against introducing the ‘friends and family test’ into the NHS last year.

The Prime Minister announced last week that the friends and family test will be rolled out to GP practices ‘as soon as possible’, but a statement from the NHS Alliance said that the test ‘won’t add anything new’ to currently available patient feedback tools.

The claim comes after the NHS Commissioning Board said last month that 12.5% of the quality premium payments given to CCGs will depend on the results of the test.

In a statement, the NHS Alliance - whose chair is Dr Mike Dixon - said: ‘In principle, as a patient-centred organisation which has long felt that patient perception and involvement should be taken more seriously, the NHS Alliance supports the need for a simple mechanism for patients to offer their experience of general practice.

‘However, the friends and family test is not the mechanism we need. It is vital to ensure that patients have the opportunity to explain why their experience was good or bad; otherwise the test will be both useless and meaningless.

‘There are already methods available to deliver feedback, and the friends and family test won’t add anything new, or tell patients what they want and need to know.’

The comments come as it emerged that a report, produced by the Picker Institute in June 2012, said a question about recommending services to friends and families was not suitable for NHS use.

The institute was commissioned by the CQC, on behalf of the DH, to test questions for the Government’s National Patient Survey.

Researchers tested how useful the question ‘How likely is it that you would recommend <this service> to a friend?’ was for NHS organisations.

They found that respondents ‘reacted badly to the concept of ‘recommendation’, particularly in the mental health setting, and a number of interviewees misunderstood what the question was asking’.

It cited academic evidence that showed the patient survey was an ‘unreliable measure of loyalty and, counterintuitively, that it is a less accurate predictor of actual recommendation behaviour than questions on satisfaction or “liking”’.

It concluded: ‘Given these issues and academic doubts about the quality and validity of the NPS we are unable to recommend it for use in surveys of NHS patients.

‘Furthermore, the evidence from our testing is that the question would be considered actively objectionable by a not inconsiderable proportion of survey recipients. We therefore conclude that the NPS is not appropriate for use in an NHS setting.’

Readers' comments (2)

  • The Net Promoter Score is a marketing tool not a measure of patient experience / outcomes. Applying such a measure to the healthcare service says more about the people that require it than it will express about what it purports to measure.

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  • Government pursues non-evidence based policy / intervention. Surprise, surprise!

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