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The Friends and Family Test is not 'boosting my morale' - far from it

Dr Roger Neal writes

From Dr Roger Neal, Henlow, Bedforshire

Last November you published a story about the Friends and Family Test; its top line was: “’The Friends and Family Test (FFT) can provide staff with ‘morale boosting feedback’ as GPs are able to pick and choose the patients they ask to complete it, NHS England has said a few weeks before its launch’.

Other than yet another administrative burden I initially had no particular concerns about the FFT, that is until NHS Choices started using the data on their website for every prospective patient to see.

In May 2015 we had 21 FFT responses; 11 were ‘Extremely likely’ or ‘Likely’, four were ‘Neither Likely or Unlikely’, one ‘Unlikely’ and five responses were ‘Don’t knows’. There has recently been extensive new house building within our practice area and we also look after the families of a nearby forces base, mostly young and healthy but transient. Such patients therefore have limited experience of using our practice and are more likely to respond as ‘Don’t knows’ to such questioning.

The rub is that NHS Choices appears to be publishing the results on a monthly bases not accumulatively and more worryingly uses the ‘don’t knows’ within their calculation of recommendation as a negative response. For us this resulted in NHS Choices using our May data showing that only 52% (11/21 x 100) of patients would recommend our practice ie 48% wouldn’t. This is a grossly unfair simplification of the statistics. If you exclude the ‘don’t knows’ we would get 68% recommendation.

Our practice has no intention of manipulating this data as previous months’ responses are all far more favourable with no or few ‘don’t knows’ but perhaps others may think otherwise? My staff and I are failing to have our ‘morale boosted’ by the FFT. More FFS than FFT.

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Readers' comments (7)

  • To summarise what has been said:-

    A twenty five page Department Of Health publication on FFT guidance indicates that only the answer ‘extremely likely’ will result in a positive score or rating for the practice. Independent sources, and critics of the test and the way that it is scored believe that patients may respond differently if they knew that the response ‘likely’ does not count as a positive score for the practice and a neutral answer or a ‘don’t know’ will result in negative scores for the practice.

    This is divisive as you have discovered. Should you start advising patients of this when they complete the forms?

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  • if you don't play the game expect to be damaged.

    FFT is pointless, I'm shocked how much worse things have got since I left. I thought the stupidity would bottom out. I was wrong.

    GP's are hamstrung as too many do not understand they are under a full attack.
    In industry you realize how everyone recognizes their own value, and many (in marketing) are happy to over value themselves.

    GP's and medics in general continue to be modest and often are happy to sacrifice themselves for their patients. This is part of the problem.

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  • Can't you just forge them yourselves. I mean, Garbage Out deserves some Garbage In?

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  • A medical system that completely relies upon the subjective input of patients is never going to truly reflect the quality of that system. Objectivity against standards MUST be included.

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  • The whole test is pointless. Hopelessly biased... Hardly going to encourage a ' difficult' patient to fill in a FFT. And as for the rest... Hopelessly vague questions, the answers to which don't help improve patient care at all.

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  • However wrong, we cannot dodge or ignore the FFT. Hospital wards have been already been closed down on the basis of this test and no doubt the CQC will wish to act similarly with GP practices.

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  • Rog Neal

    Just been advised by NHSE that they will no longer be using dont knows in the published data.

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