Testing Times For Improving NHS Patient Experience

Taking a Closer Look at the Latest Government Measure to Improve NHS service delivery

Rising demand for public services, changing population demographics and tightened budgets have transformed the environment in which the public sector operates. The need for a leaner, more efficient public sector means reform is high on the Coalition Government’s agenda. The introduction of the NHS Friends and Family Test earlier this year is the latest example of the increasing emphasis on making public services across the board more customer orientated.

All acute NHS Trusts are now required to ask both inpatients and Emergency Department patients one standard question known as the Friends and Family Test (FFT). The test asks: “How likely are you to recommend us to friends and family if they needed similar care or treatment?” It aims to encourage patient feedback, show patients that their views and experiences matter to the NHS, and improve patient care.

The idea behind the Friends and Family Test — that of providing a simple measure of patient satisfaction across all UK healthcare organisations — is a good one. It is right that healthcare provision should be designed around patients’ needs. Patient feedback provides a great basis to drive improvements. However, collecting robust, comparable data to even a simple question can be harder than it looks.

The government has set a target of a minimum 15% response rate, but this is not yet being achieved by all hospitals required to participate. Even where organisations are achieving the minimum percentage response rate, the actual numbers of patient responses remains very low in some cases. The Department of Health issued response numbers alongside scores earlier this month; however, the point of needing robust response levels was lost in some of the news headlines surrounding this first wave release of FFT scores.

To achieve measures that bear comparison across locations it is essential that, in addition to having a robust sample in every location, the method of measurement is identical too. However, the methodologies being used by different hospitals to conduct the Friends and Family Test vary widely. Methods in use for the test include paper surveys before patients have left the premises, kiosks which could be used by non-patients, issuing voting tokens for patients to post in a box, and more robust methods of collecting the data once the patient has reached home.

These factors mean the data currently being captured is not statistically robust in every case and therefore ‘league table’ style scoring comparing healthcare providers across the UK could be misleading.

While it is still early days for the Friends and Family Test, healthcare trusts striving for increased patient insight in order to improve their service can learn a lot from savvy private businesses, such as retailers and major hospitality brand owners, who are using technology to further exploit the talents of their workforce and build an emotional connection to customers.

Hospital Trusts are mandated to ask just one question. Retailers have learnt that asking the right series of questions allows them to understand how they are doing in looking after their customers across a range of elements that add up to the perfect customer experience. One question gives you a top line measure; the right set of questions allows you to understand how you are doing on the underlying drivers of great experience (why the patient feels and scores like they do) so you can focus your limited resources on making the improvements that will make the most difference to your patients or customers.

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