Friends and Family Test

Last updated

The Friends and Family Test was introduced into the English NHS in 2013. It was a single question survey which asked patients whether they would recommend the NHS service they have received to friends and family who need similar treatment or care.

Contents

The friends and family question: “We would like you to think about your experience in the ward where you spent the most time during this stay. How likely are you to recommend our ward to friends and family if they needed similar care or treatment?

Patients could answer as “extremely likely”; “likely”; “neither likely nor unlikely”; “unlikely”; “extremely unlikely”; or “don’t know”.

The Prime Minister announced on 25 May 2012 that the Friends and Family Test would be introduced across the NHS from April 2013. [1] In October 2013 Francis Maude announced the Test would be extended across the NHS and other public services, including further education, Jobcentre Plus and the National Citizen Service. [2]

Publication of the first results in September 2013, based on small numbers of responses, brought complaints that the test was giving a false picture. [3] There were also complaints about the methodology on the grounds that it is susceptible to too many uncontrolled variables for the result to be meaningful. [4]

In November 2013 IWantGreatCare formed a partnership with the NHS Alliance to set up a service which allows patients to rate and review doctors, hospitals and GP practices, and provide the Friends and Family test which all GPs will be required to provide from December 2014. [5] By February 2015 it had grown into the biggest ever collection of patient opinion in any health service anywhere in the world. [6]

In July 2019 NHS England announced that the test would no longer be required in its present form. There would no longer be a mandatory question about whether the patient or service user would recommend the service from April 2020. [7]

It was suspended by NHS England for GP practices in March 2020 to free up GPs in the COVID-19 pandemic in England. They were told to resume from 1 April 2022. 1,593 GP practices submitted a total of 164,595 patient responses for July 2022. 87% were positive. [8]

Criticism

The test was criticised on a number of grounds. [9] [10] [11] In February 2014 Dr Neil Bacon, chief executive of iWantGreatCare, denounced the implementation of the test, in particular NHS England’s refusal to enforce standardisation of methodology to ensure the data could be trusted and truly competitive. [12] Research for the Care Quality Commission carried out by the Picker Institute in 2012 concluded that the test was “not appropriate for use in an NHS setting”. One of the aims of the test is said to be to help patients make informed choices about healthcare providers (though many patients are in no position to make such a choice) and providers are given a rating score on the NHS Choices website. However no explanation is provided about what this rating means. When tested on a group of undergraduate students none were able to accurately understand the meaning of the test headline score. [13]

In July 2014 it was announced that from April 2015 NHS trusts must collect free text comments from patients and collect demographic variables alongside the test data. From December 2014 the test was rolled out to GP practices, and from January 2015, to mental health and community services. [14] The number of responses collect by practices are small. In October 2015 5890 practices collected a total of 181,774 responses from patients - about one patient each day in each practice. Results for each practice can vary wildly from month to month, making the scores very unreliable. [15]

The Guardian published an account from a patient who had suffered a miscarriage and described the use of text messaging in respect of the test as "crass and inappropriate". [16]

Related Research Articles

General practice is the name given in various nations, such as the United Kingdom, India, Australia, New Zealand and South Africa to the services provided by general practitioners. In some nations, such as the US, similar services may be described as family medicine or primary care. The term Primary Care in the UK may also include services provided by community pharmacy, optometrist, dental surgery and community hearing care providers. The balance of care between primary care and secondary care - which usually refers to hospital based services - varies from place to place, and with time. In many countries there are initiatives to move services out of hospitals into the community, in the expectation that this will save money and be more convenient.

<span class="mw-page-title-main">Family medicine</span> Medical specialty

Family medicine is a medical specialty within primary care that provides continuing and comprehensive health care for the individual and family across all ages, genders, diseases, and parts of the body. The specialist, who is usually a primary care physician, is named a family physician. It is often referred to as general practice and a practitioner as a general practitioner. Historically, their role was once performed by any doctor with qualifications from a medical school and who works in the community. However, since the 1950s, family medicine / general practice has become a specialty in its own right, with specific training requirements tailored to each country. The names of the specialty emphasize its holistic nature and/or its roots in the family. It is based on knowledge of the patient in the context of the family and the community, focusing on disease prevention and health promotion. According to the World Organization of Family Doctors (WONCA), the aim of family medicine is "promoting personal, comprehensive and continuing care for the individual in the context of the family and the community". The issues of values underlying this practice are usually known as primary care ethics.

<span class="mw-page-title-main">Monitor (NHS)</span>

Monitor was an executive non-departmental public body of the Department of Health, responsible between 2004 and 2016 for ensuring healthcare provision in NHS England was financially effective. It was the sector regulator for health services in England. Its chief executive was Ian Dalton and it was chaired by Dido Harding. Monitor was merged with the NHS Trust Development Authority to form NHS Improvement on 1 April 2016.

General medical services (GMS) is the range of healthcare that is provided by general practitioners as part of the National Health Service in the United Kingdom. The NHS specifies what GPs, as independent contractors, are expected to do and provides funding for this work through arrangements known as the General Medical Services Contract. Today, the GMS contract is a UK-wide arrangement with minor differences negotiated by each of the four UK health departments. In 2013 60% of practices had a GMS contract as their principle contract. The contract has sub-sections and not all are compulsory. The other forms of contract are the Personal Medical Services or Alternative Provider Medical Services contracts. They are designed to encourage practices to offer services over and above the standard contract. Alternative Provider Medical Services contracts, unlike the other contracts, can be awarded to anyone, not just GPs, don't specify standard essential services, and are time limited. A new contract is issued each year.

<span class="mw-page-title-main">NHS Wales</span> Publicly-funded healthcare system in Wales

NHS Wales is the publicly-funded healthcare system in Wales, and one of the four systems which make up the National Health Service in the United Kingdom.

<span class="mw-page-title-main">NHS Scotland</span> Publicly-funded healthcare system in Scotland

NHS Scotland, sometimes styled NHSScotland, is the publicly funded healthcare system in Scotland and one of the four systems that make up the National Health Service in the United Kingdom. It operates 14 territorial NHS boards across Scotland, 7 special non-geographic health boards, and NHS Health Scotland.

NHS 24 is Scotland's national telehealth and telecare organisation. This special health board runs a telephone advice and triage service that covers the out-of-hours period. The telephone service allows people who feel unwell or those caring for them to obtain health advice and information if it is not convenient or possible to wait until they can visit their general practitioner when the practice is next open. The advice line is not intended as a substitute for obtaining an emergency ambulance service via 999. The telehealth services provided by NHS Scotland fulfil some similar functions to NHS Direct Wales and the NHS 111 scheme in England.

<span class="mw-page-title-main">National Health Service (England)</span> Publicly-funded healthcare system in England

The National Health Service (NHS) is the publicly funded healthcare system in England, and one of the four National Health Service systems in the United Kingdom. It is the second largest single-payer healthcare system in the world after the Brazilian Sistema Único de Saúde. Primarily funded by the government from general taxation, and overseen by the Department of Health and Social Care, the NHS provides healthcare to all legal English residents and residents from other regions of the UK, with most services free at the point of use for most people. The NHS also conducts research through the National Institute for Health and Care Research (NIHR).

Healthcare in England is mainly provided by the National Health Service (NHS), a public body that provides healthcare to all permanent residents in England, that is free at the point of use. The body is one of four forming the UK National Health Service as health is a devolved matter, there are differences with the provisions for healthcare elsewhere in the United Kingdom, and in England it is overseen by NHS England. Though the public system dominates healthcare provision in England, private health care and a wide variety of alternative and complementary treatments are available for those willing and able to pay.

The Royal Wolverhampton NHS Trust runs New Cross Hospital and West Park Rehabilitation Hospital in Wolverhampton and Cannock Chase Hospital in Cannock.

IWantGreatCare is a service which allows NHS and private health care patients to rate individual GPs, hospital doctors and nursing staff on the care that they provide.

111 is a free-to-call single non-emergency number medical helpline operating in England, Scotland and parts of Wales. The 111 phone service has replaced the various non-geographic 0845 rate numbers and is part of each country's National Health Service: in England the service is known as NHS 111; in Scotland, NHS 24; and in Wales, 111.

<span class="mw-page-title-main">Clinical commissioning group</span>

Clinical commissioning groups (CCGs) were NHS organisations set up by the Health and Social Care Act 2012 to organise the delivery of NHS services in each of their local areas in England. On 1 July 2022 they were abolished and replaced by Integrated care systems as a result of the Health and Care Act 2022.

<span class="mw-page-title-main">NHS England</span> Oversight body for the National Health Service in England

NHS England, officially the NHS Commissioning Board, is an executive non-departmental public body of the Department of Health and Social Care. It oversees the budget, planning, delivery and day-to-day operation of the commissioning side of the National Health Service in England as set out in the Health and Social Care Act 2012. It directly commissions NHS general practitioners, dentists, optometrists and some specialist services. The Secretary of State publishes annually a document known as the NHS mandate which specifies the objectives which the Board should seek to achieve. National Health Service Regulations are published each year to give legal force to the mandate.

Out-of-hours services are the arrangements to provide access to healthcare at times when General Practitioner surgeries are closed; in the United Kingdom this is normally between 6.30pm and 8am, at weekends, at Bank Holidays and sometimes if the practice is closed for educational sessions.

Healthcare in London, which consumes about a fifth of the NHS budget in England, is in many respects distinct from that in the rest of the United Kingdom, or England.

The Modality Partnership is a large GP partnership formed in 2009. Such large practices are often described as a "super partnership". According to the King's Fund in 2016 it was one of England’s largest super-practices. In 2018 it had about 400,000 patients and was thought to be the largest practice in England.

Healthcare in Devon was the responsibility of two clinical commissioning groups until July 2022, one covering Northern, Eastern and Western Devon, and one covering South Devon and Torbay. It was announced in November 2018 that the two were to merge.

Patient record access in the United Kingdom has developed most fully in respect of the GP record, because computerisation in that field is almost universal. British hospitals were slower to move into electronic records. From 1 April 2015 all GP practices in England have to provide online services to patients, including access to summary electronic medical records.

In 2005 the National Health Service (NHS) in the United Kingdom began deployment of electronic health record systems in NHS Trusts. The goal was to have all patients with a centralized electronic health record by 2010. Lorenzo patient record systems were adopted in a number of NHS trusts. While many hospitals acquired electronic patient records systems in this process, there was no national healthcare information exchange. Ultimately, the program was dismantled after a cost to the UK taxpayer was over $24 billion, and is considered one of the most expensive healthcare IT failures.

References

  1. ↑ "Introduction to the Friends and Family Test". NHS England. Retrieved 21 November 2013.
  2. ↑ "Press release Friends and Family Test extended across public services". Gov.uk. Retrieved 21 November 2013.
  3. ↑ "Nurses raise concern friends and family test is alarming patients". Nursing Times. 3 September 2013. Retrieved 21 November 2013.
  4. ↑ "The "Friends and Family Test" – lessons from the "Do you masturbate often?" question". Socialist Health Association. Archived from the original on 21 November 2013. Retrieved 21 November 2013.
  5. ↑ "NHS Alliance forms partnership with iWantGreatCare", national health executive, 22 November 2013, retrieved 22 November 2013
  6. ↑ Five million items of feedback for Friends and Family Test, OnMedica, 9 February 2015, retrieved 16 June 2015
  7. ↑ Controversial 'friends and family' question dropped, Health Service Journal, 22 July 2019, retrieved 26 August 2019
  8. ↑ "Restarted GP friends and family test 87% positive". Pulse. 9 September 2022. Retrieved 15 November 2022.
  9. ↑ Sizmur S, Graham C, Walsh J: Influence of patients’ age and sex and the mode of administration on results from the NHS Friends and Family Test of patient experience. J Health Serv Res Policy 2014. doi:10.1177/1355819614536887. Published online before print.
  10. ↑ Krol M, de Boer D, Rademakers J, Delnoij D: Overall scores as an alternative to global ratings in patient experience surveys; a comparison of four methods. BMC Health Serv Res 2013, 13:479.
  11. ↑ Benson T, Potts HWW (2014). A short generic patient experience measure: howRwe development and validation. BMC Health Services Research, 14, 499. doi:10.1186/s12913-014-0499-z
  12. ↑ "The friends and family test is much more than a target". Health Service Journal. 20 February 2014. Retrieved 15 March 2014.
  13. ↑ Are patients being heard? The friends and family test reviewed, Health Service Journal, 10 June 2014, retrieved 17 June 2014
  14. ↑ "Friends and family test changes announced". Health Service Journal. 21 July 2014. Retrieved 18 September 2014.
  15. ↑ Coulter, Angela (18 February 2016), "A mixed bag of poorly evaluated methods leaves patients frustrated, and doctors little wiser", BMJ, British Medical Journal, 352: i913, doi:10.1136/bmj.i913, PMID   26893467, S2CID   10218037 , retrieved 26 February 2016
  16. ↑ "A&E helped us through a miscarriage. Then we got a feedback text", The Guardian, 29 January 2015, retrieved 29 January 2015
This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.