News story

'Friends and family' test to expose poor care in NHS

New care test will be adopted by hospitals and GP surgeries in England, says Prime Minister.

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

Patient and staff satisfaction tests should be used across all NHS services to expose unacceptable standards of care, Prime Minister David Cameron urged today.

A new ‘friends and family’ test - where patients and staff are asked whether they would recommend the service to a loved one - will be introduced into every hospital in England from April 2013 and the Prime Minister wants that to go further, with GP surgeries, district nursing and community hospitals all adopting the measure.

The Prime Minister said that compassionate care must be everyone’s business and announced a new package of support for nurses, health care assistants and wider NHS staff.

Improving people’s experience of hospital and raising the standard of care is set to be a key priority for the Coalition in 2013, building on a NHS-wide drive to raise standards over the last year.

The announcement builds on the recently published ‘Compassion in Practice’  vision for nursing, midwives and care staff, which sets a blueprint for respectful and dignified care across the NHS.

New measures will include:

  • Patient satisfaction tests. From April 2013, ‘friends and family’ tests and patient-led inspections and will be introduced across all hospitals. The test will show hospitals what patients and staff care about most, and will be used to trigger improvements in services and performance.
  • Better training. Training and career development opportunities for health care assistants to progress through to fully-fledged nursing roles as part of  a new £13m innovation fund. And the Care Quality Commission will do a root and branch review of induction training for care staff to ensure that nobody can provide unsupervised help without an appropriate level of training. New minimum training standards for care staff will be published within weeks.
  • Understanding dementia. With 1 in 4 beds occupied by someone with dementia, understanding the condition is crucial. All NHS and social care staff, from porters to doctors, will have access to new training to make sure people know how to provide support for people with dementia. In addition, every NHS ward will have a ‘dementia champion’ and every NHS organisation a dementia nursing expert. A £50m incentive scheme will be available to improve dementia care in 2013/14.
  • More nursing rounds. Nine in ten hospitals have introduced hour by hour care rounds. We want to go further and detailed action plans for Compassion in Practice to be published in the spring will urge the remaining hospitals to do so within a year.
  • Better district nursing.** A new ‘vision for district nursing’ will be published so that commissioners of local services put a greater priority on their role in community care and look to strengthen these services, supporting patients to live independently at home and leave hospital quicker.

In addition, nurses and midwives at the beginning of their career will be given the opportunity to become ‘care makers’, a new initiative to use volunteer ambassadors in hospitals and homes to improve care. The initiative builds on the success of the London Olympics 2012 ‘Games Makers’.

Prime Minister David Cameron said:

A year ago, I said the whole approach to caring in this country needed to be reset.

Since then we have done a lot with more training and better support. And nurses are now checking on patients hour by hour in nine out of ten hospitals. We still have a long way to go to raise standards across the NHS and get rid of those cases of poor and completely unacceptable care that blight some hospitals and homes.

I want every hospital to give every patient the best possible care.

And I want to see patients given a real voice in deciding whether that care is good enough or not.

So from April, we will introduce a friends and family test and patient led inspections across all hospitals.

The test is a simple measure but crucially will show whether there is a basic standard of dignity, cleanliness and respect. And I want the NHS to go further, with GP surgeries, district nursing and community hospitals using the test to improve the care they provide as soon as possible.

We know what an incredible job nurses do - and how much we ask of them. So we’re giving nurses more support to deliver these changes but also help for all NHS staff, health care assistants and carers. Good quality care must be everyone’s business.

It is crucial that we continue to rebuild confidence in the quality of care in our country - and I hope this effort will help us to do that.

A recent survey showed 90 per cent of hospitals have now introduced nursing rounds, with more than half having implemented it in every ward. A new vision for nursing and care staff - “Compassion in Practice” - set out key priorities, the ‘6Cs’. This includes care, compassion, competence, communication, courage, and commitment.

Health Secretary Jeremy Hunt said:

Most of our NHS does a brilliant job looking after patients - but it is still true that in many places quality of care is not valued as highly as quality of treatment. The new friends and family test will shine a light on standards of care throughout the system and help expose the shocking examples of poor care that have been coming to light much earlier.

As part of implementing the vision, the Chief Nurse, Jane Cummings, and the Nursing and Care Quality Forum will ensure care rounds are in place across all hospitals.

The Chief Nursing Officer, Jane Cummings, said:

We all came into these roles because we wanted to make a difference to the people we care for. In the vast majority cases, the care that we provide is compassionate and highly skilled. But we need to seize this opportunity to make sure that in every setting across the country, care is excellent. This means patients are treated with compassion, respect and dignity as well as skill.

We need nurses and midwives across the country to help lead this change. The nursing and midwifery professions, backed by all parts of the NHS, must pull together and build the culture of compassion.

Feedback from patients is crucial to getting this right. The friends-and-family will be a key measure, highlighting the demanding, high quality work that NHS staff do day-in and day-out, by shining a light on excellent, as well as poor, care.

The Friends and Family test for patients has been piloted in Midlands and the East, with average scores increasing significantly since April 2012 (by 14 points on the 100 point scale used). A £50m incentive pot will be available for hospitals to support rollout of the Friends and Family test.

Hospitals can turn to a range of suppliers to support rollout of the Friends and Family test, with companies like IWantGreatCare and Patient Opinion deploying a variety of standardised approaches, from postcards to internet sites to Smartphones to collect the data.

Since the Prime Minister’s commitment to improve the standard of care, there have been several strands of work aimed at tackling the issue head on:

  • £100 million made available so that NHS nurses and midwives can use the latest devices and software to allow them to spend as much time with patients, not paperwork.
  • The nation’s top nurses launched a new drive to ensure values such as compassion and courage are at the heart of the NHS and the public health and care sectors.
  • £40 million to help Ward sisters, community team leaders, and other senior nurses gain the skills needed to lead their teams in providing compassionate care.  This will create a new generation of leaders that are able to ensure dignity and respect for patients prevails at all times.

Notes to editors

  • Support for nursing is one of the Prime Minister’s priorities. In January 2012, the Prime Minister set up a new Nursing and Care Quality Forum to identify and spread best nursing practice care across the NHS. The Chief Nursing Officer provides strong national leadership across England to enable this to happen. The forum is made up of independent experts who have reported regularly to the Prime Minister on progress and support the CNO.
  • About the Friends and Family Test. In the future, patients will be asked for their views on the care they receive in hospital. The Department of Health has published further details on the introduction of the new “Friends and Family Test”, which will see hospitals across the NHS in England report consistently, for the first time, on patient feedback and use their experiences to drive improvements in frontline care.
  • The introduction of the Friends and Family Test underlines the Government’s focus on patient experience and its drive to make sure the NHS provides the very best care patients deserve.
  • From April 2013, on every ward and in every A&E department, patients will be able to answer a simple question: whether they would want a friend or family member to be treated there in their hour of need. This will help hospitals to identify poor performance and encourage staff to make improvements where services do not live up to patients’ expectations. The answers will be made public so that everyone has a clear idea of which wards, A&E departments and hospitals are providing the best care.
  • Vision for compassionate care. In 2012, Jane Cummings, Chief Nursing Officer for England, and Viv Bennett, Director of Nursing for the Department of Health, have been talking to care givers up and down the country to start to understand what this vision should look like, and what values unite the profession.
  • The vision, Compassion in Practice, sets out the values and behaviours that have come up time and again - care, compassion, competence, communication, courage and commitment.

External site: Hospital ‘friends and family test’ announced

External site: Department of Health website - ‘Compassion in practice’

External site: Read about the Prime Minister’s Dementia Challenge

Published 4 January 2013