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'When I first heard about the family and friends test I was sceptical'

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Last week my new neighbour asked if I could recommend my GP practice.

Yes I did recommend it but the recommendation came with clarifications about which GP was good with children, which one listened and which was quick if you had something fairly straight forward. Not a simple “yes” or “no” answer.  

Currently the NHS is asking patients whether they would be happy for their friends and family to be treated by their service in a test which will be used to compare trusts’ performance. These so called net promoter scores are used in the independent sector to measure the quality of services in competitive industries.

When I first heard about the family and friends test I was sceptical. Is it possible to measuring satisfaction with healthcare in the same way as buying a tin of baked bean or getting my car serviced?  My scepticism was confirmed last week when research raised doubts about the “friends and family” test as a single indicator of patient experience.

The research published by the Picker Institute Europe and Care Quality Commission found that people didn’t understand what they were supposed to be recommending, and “some interviewees gave high scores despite describing very poor experiences to the interviewer”.

Researchers did find one question which worked well, in which patients were asked to score their overall experience of care from “0 (I had a very poor experience) to 10 (I had a very good experience)”.

It seems to me that NHS is continually searching for new ways of asking people about their experiences of healthcare. But why roll out a scheme like this and then do the research to find out if the right question is being asked?

Front line staff need to know how they are doing and if they are getting it right for the people in their care. Net promoter scores tick the box labeled consumerism but considerable time and effort goes into collecting this information and if we are asking the wrong questions the information is useless both to patients and staff.

  • Comments (2)

Readers' comments (2)

  • Anonymous

    The right question is 'Tell me if you were happy or unhappy with your experience, and please explain why' but that cannot be collated/compared in any simple way. The simpler questions, which collect answers easier to 'score' are usually preferred, but as you point out they are quite often either too simple, the wrong question, or the answer doesn't contain enough information to be very useful.

    Worse still, once collected answers have gone through the statistical analysis wringer, for some reason thay are then assumed to be meaningful in some way, even if the original question was fairly pointless !

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  • Anonymous

    my personal experience with filling in any survey questionnaires is that there are questions which may not be applicable to my situation, there may not be an option to give an alternative response, or there may be questions which I may not be in a position to answer or may not be in possession of the facts required. If these are online and an obligatory answer is required this makes it impossible to pass on to the next page or submit the questionnaire. A case in point was an RCN survey last week on the the increase of NMC fees! I felt I had wasted my time as I was unable to submit my form after completing it as there was one compulsory question I was unable to answer. As I felt it is an important issue I e-mailed the RCN and explained my position which I hope they will take note of but I doubt if I or others would always take the trouble to do this.

    The questionnaire will need to be very carefully thought out to illicit the maximum number of appropriate and useful answers and be well tried and tested.

    I also note that questionnaires are biased to what the organisation wishes to find out which is well and good but it does not always give the opportunity for those filling them out to give the information they find important to pass on.

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