The roll-out of the Friends and Family Test to all NHS services should be welcomed by those working in the community.
Anything that recognises standards of care given in GP surgeries, community hospitals and people’s homes matter just as much as that delivered on an acute hospital ward should be applauded. All too often initiatives and media reports focus on nurses working on wards, and never mention that such work is equally essential in other environments. So bravo that the community is being given equal billing.
But patient satisfaction scores are only one part of the story. In a world where TripAdvisor rankings, Amazon stars and Google ratings guide our every decision, it is important not to get sidetracked by the figures.
Knowing whether someone would recommend their district nurse is valuable feedback for that individual nurse and his or her manager. However, knowing why – or why not – is the most important part of the puzzle.
And the results from practice nurses in a GP surgery or district nursing team is going to tell a different story to those scores on a busy ward of a large teaching hospital or even a district general hospital.
Patients with long-term conditions will see the same district nurse over and over again. In some parts of the country there will be no other nurse available to change their dressings or administer their medication.
I suspect the results of the tests will be different in the community, where relationships are often much longer term and more personal than in the acute sector.
Patients may not feel comfortable criticising someone who comes into their home every day to provide what they consider “a favour” rather more than a service – someone whom they see as a friend.
Alternatively, spending more time with a patient could expose greater flaws or personality “clashes”.
Rolling out the test will tell an interesting tale, and it’s one we’ll be keen to follow at Nursing Times. But it should be analysed with an understanding of the nuances between caring for patients on a ward and caring for them in their own home.
Compassionate care offered by community nurses often takes on a different look when administered in a ward – the way people want to be looked after varies depending on where they are and how comfortable they feel.
Nursing should be careful not to get caught up in a drive to set such standards that it devises a seventh C – consistency. Doing the same thing in every situation is not always the right thing to do. For in the case of nursing, what makes nurses unique is their ability to tailor the care depending on the situation and the patient in front of them. And long may that continue.