The NHS Friends and Family Test – can we help?

6 years ago, public confidence in the NHS was rocked by the scandal emerging from the conditions of care at Stafford Hospital – administered by Mid Staffordshire NHS foundation trust, and making ‘Mid-Staffs’ a near-daily invocation in the corridors of the Department of Health , NHS England, and GPs and hospitals across the country.

The investigations and inquiries into the scandal revealed some of the conditions at the hospital, and the resulting media attention prompted a period of national introspection regarding the NHS.

When the current government came to power in 2010, it launched the inquiry to end all inquiries (following four under the previous administration) into failings at the hospital. The ‘Francis Report’ (named after its chair, Robert Francis QC) took three years to publish, and apparently considered a million pages of evidence.

Central to the report’s findings was the question of openness and dialogue: The culture of the NHS needs to be one of constant improvement rather than complacency;  Staff must have a duty to report failings; and – most importantly for our purposes here, patients must be listened to.

This – and a government that has put ‘patient choice’ at the centre of its health narrative – laid the backdrop for the introduction of the ‘Friends and Family test’ in 2013: a standardised survey, carried out by all NHS trusts, and centred around one simple question: ‘Would you recommend this service to friends and family?’

Alongside this, we are also seeing a growing range of digital applications aimed at improving dialogue around patient experience – such as Patient Opinion and iWantGreatCare – creating more and more of an expectation that health services are subjected to the same online scrutiny we are used to for other products and services.

Fast-forward to the present day, and the NHS is rolling out the Friends and Family test in GP clinics from December 2014, and next year will expand to more services, such as mental health, ambulances and dentists. Administering these tests will be a challenge for England’s 200 Clinical Commissioning Groups – and one that we hope Citizen Space might be up to the task of meeting!

How to implement the Friends and Family Test using Citizen Space

Inspired by our friends at Stockport CCG, who asked us how they might be able to use Citizen Space to implement the Friends and Family Test in their area – here’s a guide to how we think CCGs could use Citizen Space to carry out their Friends and Family tests, with links to our Knowledge Base articles to help you:

1) Set up each GP surgery as a department on your Citizen Space hub
2) Set up the person responsible for FFT at each GP as department admin for their surgery.
3) Create a single FFT survey on your hub for one surgery, then clone this survey repeatedly and rename each one until you have one for each of your surgeries.
4) Move each survey into their relevant ‘department’ and make your the relevant department admin the owner of the survey – so they have access to the responses and can manage the survey.
5) They can then share the F&FT link with their patients, and patients’ friends and families for them to fill in on their smartphones, or better still, on a tablet at the surgery
6) You don’t need to be involved beyond this other than for technical support and have no need to look at responses.

This means:

  • All responses are held in one place
  • They can all be analysed from one place
  • The survey can be carried out either online or on a terminal or tablet at the surgery (as long as it is connected to the internet!)
  • Quick, accurate response gathering, with the ease of using Citizen Space online analysis and results tools for reporting
  • By putting each surgery in its own department, responses are only accessible to the admins in that surgery (and overall site admins for technical support)
  • Surgeries could be benchmarked against one another if you wish

The Friends and Family test has not been without criticism from within the healthcare community (this report from the Picker Institute sums up some of these, as well as positive points around the FFT), but we believe that if administered effectively – and captures the views of a large and diverse proportion of the patient body – it can be a really useful tool for boosting patient engagement with health services.

As always, we’re happy to help all our Citizen Space users with suggestions on using the tool – so if you’d like us to work with you to solve a consultation need, then drop a line to your account manager (Louise or Rowena), call us on 0845 638 1848 or email


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