'Staff don’t need another stick to be beaten with'
We all love a listing. Many a weekend away now starts with a click on TripAdvisor to pick the hottest hotels and the coolest cafes.
But transfer this idea to the NHS, as the Friends and Family Test has done, and I am not sure it gives a full picture of how well a department or trust can meet the patient’s needs. In fact, many argue scoring hospitals in this way has proved counterproductive.
Originally, net promoter scores (the basis for the Friends and Family Tests) were introduced to measure the success of private sector services. It was deemed useful to compare the customer service of, say, one high street bank with another. But there are all sorts of variable factors involved in a visit to, say, an accident and emergency department - how unwell the patient feels, how busy the department is, whether there has been a major incident and so on.
I am not saying these variables should not be measured. Far from it - they can be a useful indicator. But we should remember those who score the trusts are self-selecting and so can skew the figures.
This week, Yeovil District Hospital claimed its Friends and Family Test results (see page 2) had been misrepresented by the quintile method adopted by NHS Choices, which takes out the lower 20% of trusts and categorises them as being among the worst in the country. Even though - as in the case of Yeovil - 95% of its respondents would recommend the trust to friends and family.
The data is also flawed because it does not take into account the volume or percentage of respondents. Many trusts surveyed under 5% of patients and gained a higher ranking than those who provided scores with a greater proportion (and volume) of responses. So some of the numbers are not robust behind the rankings. Some trusts have nearly 400, while some don’t even manage 100. It seems the latter doesn’t give enough of a statistically sound base to draw conclusions from or comparisons with. And yet NHS Choices is.
Trusts are used to being measured against targets and filtering out the findings to help them improve performance. However, this test has been given such a high profile by the prime minister that the public have been encouraged to put a huge amount of faith in it.
The test has some merit. However, without a commentary, the results can be misleading to the public and demoralising to staff.
What NHS staff don’t need is another stick to be beaten with.
If NHS England wants to publish these test results, it should do so responsibly, with respect for those hardworking staff and hospitals whose reputations could be ruined by the data.
Jenni Middleton, editor
email@example.com. Follow me on Twitter @nursingtimesed
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