Intended for healthcare professionals

Rapid response to:


Friends and family test should no longer be mandatory

BMJ 2018; 360 doi: (Published 29 January 2018) Cite this as: BMJ 2018;360:k367

Rapid Response:

Re: Friends and family test should no longer be mandatory

The authors make strong argument for getting rid of the Friends and Family test. This is a problematic measure, potentially skewed by many. As a patient how do you know how much you can expect? Do you admit that you have accepted care that you wouldn't recommend to your nearest and dearest? What does that say about you as a parent if the care you are talking about was for your child? Would you recommend your friends and family go to a nearby, less specialised provider, with no experience of your specific condition, or travel many, many miles to another specialist provider, who you know little about anyway?

The Friends and Family test fails to get into the richness and potential of understanding actual experience and is an obstacle to meaningful and honest conversations between patients and staff. While ever it's reporting is mandated by higher authority, resources will be to drawn away from the creation of strategic experience focused work, as we continue to 'hit the target and miss the point'. Wider Patient Experience work will remain the 'nice to have', 'icing on the cake', 'soft and fluffy stuff' and the power of genuinely connecting with patients to drive improvement together will not be realised.

Providers should be held to account against their own patient experience strategies which should include an explanation of how experience is used for improvement in their organisation. Coulter (BMJ 2014;348:g2225) pointed out that, almost 4 years ago, we had been collecting data on patient experience data for over 10 years without systematically feeding this information into improvement. The Friends and Family test could be viewed as an unethical waste of precious time and resources, and providers who choose to think more deeply about Patient Experience should be encouraged to do so.

Competing interests: No competing interests

30 January 2018
Joanne L Minford
Paediatric Surgeon
Liverpool, UK