A controversial patient feedback tool favoured by the government has been extended to community and mental health settings, but with a modified scoring system, after criticism that its use was “widely misunderstood” in hospitals.
The “friends and family test”, which asks patients how likely they would be to recommend a service to a relative, is being rolled out this month to settings including mental health wards and children’s services that provide care for those with conditions such as autism and eating disorders.
It is also being made available to patients accessing services in the community so they can score the quality of care they have received from healthcare workers including district nurses, health visitors and midwives.
“The real-time patient feedback it [the friends and family test] has generated is driving genuine improvements in care delivery”
The single-question tool was introduced across acute settings in England by the government in April 2013. It required all NHS-funded inpatient and accident and emergency services to ask patients if they would recommend the care they received to friends and family on a scale from “extremely likely ”to “extremely unlikely”.
It was later extended to NHS maternity services and was last month rolled out across the country’s 8,000 GP practices.
Tim Kelsey, NHS England’s director for patients and information, said: “The friends and family test was launched last year in A&E departments and inpatient wards in hospitals, and the real-time patient feedback it has generated is driving genuine improvements in care delivery.
“This improvement will only continue with the expansion of [the friends and family test] into mental and community services, as well as GP practices,” he said.
However, in its first year of use, concerns were raised about the way a trust’s overall singular score was calculated from the tool results, leading nursing directors to claim the presentation of the feedback was “misleading” and alarming patients.
The original version used a net promoter score calculation, a system widely used in business to measure customer loyalty, which presents the result as a single figure between -100 and +100.
The score was obtained by subtracting the proportion of respondents who would not recommend a ward or department from those who said they would be extremely likely to recommend it.
A major review by NHS England in July 2014 agreed the score was “widely misunderstood” by staff and the public, and recommended that changes should be made to how the test was implemented and presented.
NHS England agreed to introduce a replacement scoring system from October 2014, which presents results as the percentage of respondents that would recommend/wouldn’t recommend the service instead of a singular score. It also agreed to clearer publication of the trust’s results on the NHS Choices website.
Other changes, which are due to come into effect from 1 April 2015, include a requirement that trusts ask patients for comments alongside their answer to the single question rating their care experience.