Press release

Friends and Family Test extended across public services

Francis Maude has announced the extension of the Friends and Family Test across the NHS and other public services.

This was published under the 2010 to 2015 Conservative and Liberal Democrat coalition government


Francis Maude today (1 October 2013) announced the extension of the Friends and Family Test (FFT) across the NHS and other public services, including further education, Jobcentre Plus and the National Citizen Service (NCS).

The simple test – answering the question “Would you recommend this service to your friends and family?” – will be extended to all NHS services in England, including mental health services, community nursing, and outpatient appointments by the end of March 2015. The test will also be used to assess Jobcentre Plus services (learning from which will be incorporated into the next phase of the Work Programme), further education courses and all service providers of government’s flagship youth scheme National Citizen Service.

This comes as the test is today rolled out to every maternity service in England, meaning that all new mothers will be asked if they would recommend their service to their friends and family. With over 700,000 births a year in England, this will be a fundamental change to the way the NHS listens to patients and will help parents-to-be make choices over the care they receive throughout pregnancy.

Announcing the extensions, Minister for the Cabinet Office Francis Maude said:

We know that transparency delivers better public services. It drives up standards, informs choice and holds providers to account. This extension of the Friends and Family Test will put more power in the hands of the public, allowing them to give clear and honest feedback on the services that hard-working families use every day.

Transparency is an idea whose time has come. Later this month, the UK will be hosting the Open Government Partnership summit which will bring together world leaders who want to push reforms harder and faster, and encourage civil society to hold their feet to the fire and generate inspirational new ideas.

Health Secretary Jeremy Hunt said:

In its first 4 months alone, over half a million patients have had their say through the Friends and Family Test. If their local service doesn’t listen to them, patients can vote with their feet and go elsewhere.

We’ve seen how services like Walsall Hospital have made huge improvements by listening to patients. Making the Friends and Family Test apply to all parts of the NHS will make those improvements go further and faster.

The NHS is embracing the need for more patient feedback – these are the seeds of lasting culture change. Patients will be given unparalleled opportunities to hold health services to account and choose their care as the Friends and Family Test is rolled out across the NHS.

The test, which has been available in A&E and inpatient hospital wards since April 2013, allows hospital trusts to gain real time feedback on their services, down to ward level, and increases the transparency of NHS data to improve choice for patients and so drive up quality. The scale of the roll out and volume of feedback is the largest ever in the NHS: existing national surveys, such as the National Inpatient Survey 2012, collected the views of 64,500 patients, whereas in the first 4 months alone in just 2 areas (A&E and inpatients), the Friends and Family Test has collected the views of more than half a million patients.

Notes to editors

  1. The Friends and Family Test (FFT) is a survey which asks patients whether they would recommend the NHS service they have received to friends and family who need similar treatment or care. It also provides the opportunity for general feedback. The aggregate results are then published online, allowing service users to make comparisons between different providers, and hence driving up patient choice.

  2. Following the Prime Minister’s announcement in January 2012, the FFT was initially introduced for providers of NHS funded acute services for inpatients (including independent sector organisations that provide acute NHS services) and patients discharged from A&E (type 1 & 2) from April 2013.

  3. Across the NHS, patient involvement in and feedback on services has increased steadily over the past 12 months. The first year of patient-led inspections, where teams of patients inspect their hospital, has seen over 5,000 patients inspect more than 4,000 wards, with more than 400 of these inspections covering mental health services. From April to July, over half a million (596,587) patients have given their views through the FFT.

  4. Guidance for the existing Health Friends and Family Test and other information is available from NHS England. In further education, the test will feature prominently in the Learner Satisfaction Survey from 2014/15. It will be available to all further education learners. For Jobcentre Plus, the test will be included in a customer satisfaction survey run by an independent social research agency. For NCS, the test will be included in the on-going evaluation of the programme and will be independently administered by NCS Trust. The government is committed to ensuring the FFT is conducted by an independent provider where possible.

  5. The government will also look into how the test can be incorporated to maximum effect across other public services.

Case studies of changes implemented in the NHS as a result of FFT

5 Boroughs Partnership Trust, Cheshire

Patient feedback can lead to real and lasting change. For example, after listening to patients on a low-secure ward where patients often stay for a long time, 5 Boroughs Partnership patients told staff that they would feel more comfortable and at home if they could choose their bedding. Staff listened and took patients to choose their bedding within a budget, so that they could feel more at ease. In their adolescent ward, young patients said that they would like to spend more time outside off the ward. There is now an “off the ward” activity every day.

Walsall Manor Hospital

We know that patient feedback can be used to make huge improvements in care. In the 2010 National Patient Survey, Walsall Manor Hospital scored in the bottom 20% on more than half the questions asked. They then introduced the FFT and now ask every patient, very simply, how likely they are to recommend Walsall Manor to their friends or family and to name one thing they could do to improve their stay.

From TV remote controls, to warmer rooms to staff shortages, patient feedback led to fast corrective action, including focusing more resources in wards that were under pressure. A year ago, their own patient satisfaction scores averaged 65. Today, they’re up to 75%.

In that same period, C.Diff infections are down 80%, pressure ulcers are down 30% and falls down 20%. Not all of this is because of patient feedback, but it is thanks to a new culture of patient-centred ambition – as Richard Kirby, the Chief Executive says, “it’s changed the nature of the discussion”.

Published 1 October 2013
Last updated 1 October 2013 + show all updates
  1. Added link to relevant policy
  2. First published.