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

I read this and had to double check whether I had written this myself without realising it! This articulates my sentiments exactly! My Trust was one of the early implementers of FFT and initially I was intrigued; I saw this as another tool and another metric to help us triangulate our Patient Experience intelligence........

My dismay came quite quickly with the push from national CQUINs, CCG quality monitoring and regulators key lines of enquiry focusing in on response rates and not the incredible data behind patients responses. As a leader for patient experience this pushed us back years; all our energy had been on seeking, acknowledging and acting on our patients feedback, recognising the importance of listening to their voices yet the achievement measures were focused on how many replied. I struggled particularly with medical colleagues who when presented with their local level data challenging its statistical relevance and were at times dismissive.

Real time feedback has its place but we need a variety of tools and metrics, we actually need greater energy put into how we triangulate across all our data sets.....patient experience is absolutely teeming with data; the perfect example of being data rich but information poor. Who for example is able to extrapolate themes and trends across FFT (immediate reaction), National surveys (time to digest & ponder & reported some 5 months later......), complaints (by their nature have been considered in detail and not taken lightly), Healthwatch type data which is sought out, walkrounds and Golden Hour feedback (in the moment), social media, Care Opinion, listening & engagement events.....etc, etc? We are not comparing apples with apples.....

The fear that Trusts will not seek feedback is in truth insulting to those of us for whom it is the essence of our roles, for those staff who use their feedback to make a difference, to those services who use co-design and patient voices to evaluate and redesign.

Those who know me have described me as a patient experience 'purist'....I absolutely get the need for drawing themes and trends, for understanding the bigger picture and yes the statistical relevance especially when we are looking at service redesign and improvements; but it all comes down to the fact that if my mum is receiving NHS care then her individual experience matters, not whether it was not the norm or the majority of patients had a different experience, it's about what happened to my mum.

Experience is personal, it is rooted in perceptions, assumptions and expectations and is both relational & functional; there are simply too many variables. Our FFT has given us some powerful data but we could use the resources (& not just the money) in so many better and different ways to gather our patients feedback.....and we need to be trusted to do that.

Competing interests: No competing interests

30 January 2018
Jennie Negus
Deputy Chief Nurse - Patient Experience