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Friends and Family Test should provide ‘morale boosting feedback’, NHS says before launch

Exclusive: 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.

Practices will not have to ‘proactively’ ask patients for feedback using the FFT but will be allowed to seek feedback from ‘specific patients’ if they want to when the test is rolled out across UK practices in just a few weeks, NHS England told Pulse.

In fact one of the strengths of the test was that ‘there is nothing to stop a practice seeking positive feedback’ which can help give staff a morale boost, a spokesperson said.

But GP leaders have described the rule as an ‘ultimate low’ for the NHS, with GPs having to ‘sink to the point’ where they have to actively canvas patients to give good feedback.

From next month, the controversial test will ask patients whether they would recommend NHS services to friends and family. Patients can answer the question anonymously on a five-point scale, with responses ranging from ‘extremely likely’ to ‘extremely unlikely’, according to guidance published in July.

NHS England has said that GPs are required to provide the means to complete FTT to all those who wish to do so and to feed response data back to NHS England on a monthly basis –  information that will be published online for patients to view.

However, data from a second mandatory question that calls for a ‘free text’ response need not be fed back to NHS England nor published online – even though NHS England told Pulse this element of the test represents the ‘real strength’ of FTT.

The NHS England spokesperson told Pulse: ‘It is important to be clear that the purpose of the FFT is not to conduct an official assessment or performance measure of services.

‘The fundamental principal of the FFT is that all patients should be allowed to provide feedback on their NHS funded care or treatment that can be used to identify the opportunity to make improvements. The requirement is to make the opportunity to use FFT available to all patients.

‘Practices are allowed to proactively seek feedback from specific patients if they want to, and there is nothing to stop a practice seeking positive feedback – in fact, it is one of the strengths of the FFT that it has been seen to provide staff with morale boosting feedback which reinforces that most of the time they are giving great care that is appreciated.’

In the original guidance, NHS England said ‘patients do not need to be asked to respond to the FFT question after every interaction, but they should be made aware that the opportunity is available to those that want to provide feedback through the FFT at any time.’

And speaking to Pulse this week, it confirmed that the practice does not have to ‘proactively ask patients to provide feedback, but the opportunity should be available to any patient that wants to.’ It wanted GPs to have flexibility ‘to do what works for them and their patients’, but leaflets at home visits and on repeat prescriptions would be a ‘positive action,’ as well as posters in the waiting room.

In addition, with no minimum data submission requirement for FTT, GPs will not be penalised for low return rates.

Terry Morgan, NHS England’s FFT GP Workstream Lead, said: ‘The great majority of GPs have indicated they are ready to do the FFT from 1 December and we will be giving extra support to those who are less confident, via our regional teams, in the next few weeks.’

‘We have tried to ensure FFT is as easy and flexible as possible for GPs to implement. It goes without saying that we trust doctors to be professional and to get the best they can from this feedback tool. There is nothing for anyone to gain by trying to manipulate the system and we don’t expect that to happen.’

But Peter Swinyard, chair of the Family Doctor Association, told Pulse that encouraging doctors to actively canvass patients for good feedback was ‘the ultimate in low’.

He said: ‘I don’t want to come to the end of my career with an FFT score of “bloody awful”, so we get a better score on the friends and family test, which the Government seems to think is important.’

‘Of course FFT is not a valuable metric. I can get a brilliant score very easily: I simply give everybody exactly what they want, and forget about what they might need. That is not good medicine, and it will do people no good in the long run, but it will keep my FFT scores very good.’

Dr Bob Morley, medical secretary of Birmingham LMC said the test was a ‘political gimmick’ but that GPs should use it ‘to obtain the best possible feedback’.

He said: ‘The more feedback in total practices get, the higher the patient satisfaction rating is likely to be. We know that GPs have higher satisfaction and trust than any other parts of NHS and public sector. It should reinforce the extremely high esteem in which the majority of GP practices are held by their patients, despite the currently difficult circumstances they have to work under.’

He added that he expected the CQC to use the results of the test as part of GP inspections.

He said: ‘I don’t see it as a bad thing, the CQC using these scores. They already use NHS Choices, for example, which self-selects a very small number of very dissatisifed patients. I’m far more comfortable with the idea of the CQC using the results of the FFT rather than something like NHS Choices.