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FRIENDS & FAMILY TEST
The Friends & Family Test: challenges and opportunities
Andrew MacPherson, managing director of The Strategic Projects Team, originally part of NHS Midlands & East and now hosted by the Greater East Midlands CSU, has had a major role in the development and then implementation of the Friends & Family Test. Ahead of the next stage of the roll-out, he spoke to NHE.
Q)
How have you been involved in the FFT?
I cut my teeth in sectors having to ‘up their game’ in terms of their customer service as they faced economic challenge and increased consumer expectation. This scenario is not unlike the NHS, which I joined formally in 2009, to set up The Strategic Projects Team. In 2012, while pursuing a broader agenda for sustainable service excellence, I (along with co- creator Dr Stephen Dunn) designed, launched and delivered the NHS Friends and Family Test (FFT), initially in the Midlands and East region.
FFT was introduced nationally after prime minister David Cameron recognised its significance in 2012 and announced its roll- out across the NHS. We were then engaged by the Department of Health and latterly NHS England to manage the roll-out of FFT in A&E, acute inpatient and maternity services across the country and initiate the guidance for other pathways.
Q) How has the FFT been received?
It has not been without its challenges. It’s fantastic when the government of a country gets behind something like this, but inevitably it introduces a new dynamic to something we always saw as a ‘ground-up’ movement. The perception of FFT will inevitably continue to swing between that of a traditional ‘performance’ metric and our original intention: that of a culture change driver.
Q) And how do you feel FFT is making a real difference to patient care?
It’s certainly making a positive difference to 56 | national health executive Sep/Oct 14
patient care in terms of provider behaviours. Like any embryonic transition, those behaviours will vary and that more traditional interpretation of ‘yet another performance metric’ to pillory, can be quite counter to FFT’s positive change agenda.
FFT is about much more than just ‘the score’. The headline score generates an appetite for asking ‘why’ a patient gave their answer, creating a wealth of insight available from ‘ward to board’. The true success of FFT is that it has enabled providers to make changes to their services, and has directly improved patient experience through celebrating success and trapping shortcomings. It has the potential to deliver a true cultural change by putting the patient’s overall experience openly at the centre of care.
platforms, and this is where real empowerment can lie.
“The NHS Friends and Family Test is the largest patient experience programme in the world…We have, however, so far only ‘scratched the surface’.”
In the Midlands and East 2012-13 roll-out, data was published in a much shorter window and was made available simultaneously to CEOs, clinicians, caterers – everyone involved in the patient journey.
I am sure that’s an aspiration for the national transparency and insight agenda, but the original FFT vision will not be complete until it happens.
Q) It sounds like there is a lot of
scope for it to be rolled out further?
By progressively empowering every provider or commissioner employee to see the ‘near real time’ impact of their day-to-day contribution (or that of their organisation) to each patient’s overall care, it should represent a revolution in patient experience
Q) Are there any changes you would make to the FFT?
There are still, inevitably, gaps. FFT’s status as a ‘national statistic’ is impressive, but again the necessary rigid control is sometimes counter to the ‘near real time’ concept of shared data for all at any time. The latter is being achieved depending upon the sophistication of local
I have recently completed a series of FFT workshops with over 1,000 GPs and practice managers. It’s an environment of mixed response, although it’s no different to our experience when rolling out to acute care across the country. There are people seizing the opportunity, reeling from it, and rejecting the initiative.
The principles of FFT insight present a huge opportunity for all public services, if they remain true to the objective of customer/ provider empowerment. That empowerment resonates with the ‘Collective Leadership’ research by, for example, the King’s Fund. What you are (potentially) seeing in the NHS is exactly the same change that retail, transport, utilities and some professional services went through in the 90s; becoming increasingly customer-centric; recognising the productivity opportunity through employee satisfaction and
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