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GPs can use Friends and Family Test to lobby for more funding

Practices could use the Friends and Family Test to ‘lobby’ CCGs and areas teams to address funding and premises issues beyond their control, NHS England’s FFT lead has said.

In an interview with Pulse ahead of today’s GP Friends and Family Test launch, NHS England national clinical lead for primary care Dr Mo Dewji advised that practices could use their findings to highlight issues beyond their control to their local area team.

The GPC said the second question that patients are asked, which is chosen by the practice, can be ‘tailored’ to local needs to help practices inform patients of the difficult circumstances facing GPs.

It is composed of at least two questions, and guidance states patients should have the opportunity to give feedback after every interaction, but GP leaders have described the idea of asking for feedback after home visits as ‘the ultimate low’.

The first question is dictated by NHS England and must ask if patients would recommend the practice to their friends and family. These results will be collected via CQRS and published monthly on NHS Choices  – with the first data to be published in March.

Practices must also have a second question – though they can have more than two – which is free text and is devised by the practice, there are no requirements to publish this question, though Dr Dewji said in the FFT pilots many practices did choose to share comments, with patient’s consent.

NHS England has previously said problems identified through the second question could save practices the time they spend on administering the test.

Responding to a question about whether the free text feedback would leave GPs more demoralised at being repeatedly told to address problems beyond their control, such as waiting times or premises, Dr Dewji said this could be used to their advantage.

Dr Dewji, who is still a practising GP in Milton Keynes, Buckinghamshire told Pulse his practice ‘already has an adult relationship with our local teams and CCGs’. He added: ‘I wouldn’t see why, if this was a message that was coming up all the time, that I wouldn’t go to my local health authority, or CCG, or whichever may be, to say “look, I want to sit down and have this discussion, because every one of my responses, or a significant number of responses, is saying this, and it’s backed up by this bit of work we’ve done, and another bit of work”.’

‘So I can see that happening, why not. This is a two way feedback.’

He added: ‘Remember the biggest advocate for a practice in the long run is the patient.’

GPC chair Dr Chaand Nagpaul told Pulse: ‘The simplistic banding of practices by the CQC was without context and it’s absolutely vital, for practices and patients, they deserve to understand context.

He added: ‘So I think the Friends and Family Test, the second question should be tailored for local circumstances and practices should be proactively putting out messages both to their area teams, and to patients about the factors that constrain their ability to provide optimal care. And we should be using that to lobby for the right changes for practices.’

Pulse revealed that there were no minimum targets for FFT responses, and that practices could pick patients who had more positive experiences at the practice to give feedback, with an NHS England spokesperson saying the feedback could provide a ‘morale boost’ for staff.

A recent Pulse survey asked practices what they intended to ask for their second question, of those that had decided the majority opted for patients to expand on why they would or wouldn’t recommend services.

Others intend to use it as an opportunity to engage the public on the NHS and its reforms, with several asking ‘Do you think the Coalition is running the NHS well?’

One asked: ‘Do you know that this practice gets the same amount of money for providing your medical care for a whole year as the walk-in centre gets for one appointment?’

A few GPs said they would ask ‘are you fed up with NHS surveys?’