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Friends and family test may save GPs time, says NHS England chief

Exclusive: The Friends and Family Test (FFT) may help GPs to save time, particulary as practices are ‘desperate’ to know how they can improve, NHS England’s lead for primary care has told Pulse.

Dr Mo Dewji said that the test, which is due to be rolled out across UK practices in December, would help GPs save time in the long-term by enabling them to improve their services.

He said: ‘It may feel like the FFT has increased workload, but actually most prac-/-tices are desperate to know how they can improve things. It doesn’t increase the workload all that much, because it’s improving the service.

‘If those improvements go on to make the service better, you can actually save time.’

Pulse reported earlier this week that GPs in England will be required to publish FFT data locally once a month as well as sending it to NHS England for publication on their website. NHS England is to reach a decision on where individual practices should publish their data within the next couple of months.

A six-month pilot of the scheme, involving 31 practices in Bedfordshire CCG in November 2013. was a ‘big success’, according to a report published by NHS England. Practices gathered FTT data using a variety of collection methods, including paper feedback forms and digital questionnaires hosted on a tablet device. Information was fed back to the CCG on a weekly or monthly basis.

Dr Dewji said that the practices who had piloted FFT ‘had not indicated that it is a burden’. However, he conceded that FTT could ‘theroretically’ add to the administrative burden on some GP practices, especially in the early stages.

He said: ‘I do appreciate that theoretically this could be seen as a resource issue in terms of work. But I suspect a lot of the early collection will actually be administrative and then the clincians can come along later. For some it, the administration systems are already available, and this is an extension of that.

‘I’m not sure at present, from the pilots, that it’s going to create a huge amount more work. It’s something we’ll need to review and keep an eye on, but at present it doesn’t appear to be.’

The finer details of how practices should collect FFT data has yet to be ironed out. NHS England has said that it will consult with the GPC, area teams and individual practices to work out the best method during the first months of the roll-out. In the meantime, practices have been encouraged to be ‘flexible’ in their approach to collecting FFT data.  

Research by the Picker Institute Europe found that practices using different collection methods (in combination with demographic factors like patient age and sex) could result in FFT being an unreliable performance measure.

While it has acknowledged the increased risk associated with using different data collection systems, NHS England say that using a variety of methods may encourage more patients to participate in the FFT when it is first rolled out.

Dr Dewji shrugged off suggestions that data collection processes should be standardised across all practices. He said: ‘It would be easy for us to streamline for the sake of it, but we might not pick the right way. However the information is collected, the information from the free text question will always be there, so there won’t be a loss of funds or resources for the sake of it.’  

Dr Dewji said there was ‘no reason’ to think that FTT data would be skewed by a disproportionately high number of responses from patients with chronic conditions, or that doctors could become the victim of Trip Advisor-style ‘revenge reviews’ from patients unhappy with their clinical decisions.

He said: ‘This doesn’t mean that FTT is going to become a method of putting down GPs. There’s always going to be a query that comes along that GPs don’t feel is totally reflective of what happened, but then again that’s no different to when we look at other reviews.

‘We may feel as if it doesn’t feel right, and we may worry about it – but that’s how we feel about any new change. There’s no evidence from the work that happened with the pilot sites or the GP Patient Survey to suggest that this is an issue.

‘There’s an awful lot of evidence that patients who come with one view initially, over time as they get educated, they get far more responsive. If patients engage with us on a regular basis, then they start to be more engaged with their own health.

‘Practices have always engaged with patients in different ways. This isn’t new, it’s just a way of collecting more information.’

Meanwhile, there are no plans to abandon the current GP Patient Survey, which is administered by Ipsos Mori and currently collects data from around 1m patients a year, he said.

Back in 2012, when the FFT was announced, fellow GPC negotiator Dr Peter Holden said it was ‘trite trouble’, and would not reflect reality of good GP practice because GPs have to tell patients ‘things they don’t want to hear’.

The test has also been criticised by CCG leaders who feared it could be misused to ‘beat up’ NHS staff.