Implementation and use of the Friends and Family Test as a tool for local service improvement in NHS general practice in England

Document type
Manacorda, Tommaso; Erens, Bob; Black, Nick
Policy Innovation Research Unit
Date of publication
3 April 2017
Health Services
Social welfare
Material type

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Since its announcement in 2012, the Friends and Family Test (FFT) has been rolled out across the English NHS, starting with inpatient, A&E and maternity settings in 2013. In July 2014, a review by NHS England (NHSE) on how the FFT was working noted that the value of the FFT as a tool for quality improvement outstrips its utility for performance management or for informing patient choice. These findings, along with pilot testing, informed the guidance set out for implementing the FFT in general practices (December 2014), mental health and community health services (January 2015), and dental practices, outpatient services and ambulance trusts (April 2015).

Positive effects of the FFT on staff morale were reported but several interviewees were frustrated that they could not act on the negative feedback that patients sometimes provided since it was generally anonymous. Overall the impact of the FFT on quality improvement was negligible and other tools (such as practice surveys and patient participation groups) were said to provide better patient feedback and be more helpful for quality improvement.

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