A much talked about news story this week has been the significant drop in the number of Friends and Family Test (FFT) results submitted by GP practices.

Despite warnings about contracts being breached if there’s a failure to submit data, the response rate for the FFT from London practices fell to 57% in May, a drop of 13% on April’s results and the lowest of any English region. The South was the next lowest performing region, with 68% of practices submitting data, followed by the Midlands and East (70%) and then the North (72%).

The figures are hardly surprising, not least because the questions are poorly thought out. As one PM told us, “why would someone recommend this surgery to their friends and family when they’re in Scotland and we’re in Nottingham?”.

An alternative view

There’s no getting away from the fact that the struggling FFT has its enemies. But is it really all bad?

Nigel Sparrow, the Senior National GP Advisor and Responsible Officer at the Care Quality Commission, addressed the issue in number 16 of the CQC mythbuster series. He said: “I believe that it is important to emphasise that the value in the FFT lies in the free-text comments that are provided by patients. This provides practices with real-time feedback which can be actioned.

“FFT results in the form of the percentage of patients recommending a practice will be published transparently on the NHS England website and on NHS Choices. This data is not statistically comparable in the same way as the GP Patient Survey data. So please use FFT to inform lines of enquiry and judgements, while being mindful of its limitations as well as its benefits.”

“I would, however, encourage practices to look at their FFT results alongside other sources of data (such as the GPPS results) and to look at how their results change over time. By acting on the feedback provided by patients, the FFT results should of course improve.”

From the front line

A practice manager from a practice in Cumbria told us: “Yes, it has been poorly thought out and most probably created by suits who have never spent a working day getting to know the real general practice. At the moment it’s here to stay, we have to submit the data and take the time to do it. That’s why my GPs and I agreed to make the most of the opportunity and see how we could benefit.

“First of all, we used the good feedback to really boost morale within the practice. It’s amazing how a positive response perks people up. We were also interested to see how the positive feedback acted as a shop window for the practice. We’re in a small town but there’s plenty of new house building taking place at the moment and we found new residents were choosing us over other practices in the catchment area based on feedback, which clearly boosted our funding.

“Negative feedback also proved useful and on the back of what we read we introduced a telephone consultation service that has proved extremely popular with older residents who struggle to make it to the surgery and patients who are out at work all day. We’re glad we embraced FFT.”

Meanwhile, At the St Peter’s Medical Practice in Harrow, a common theme among FFT comments from patients was about the phone system being constantly engaged. The practice responded by putting in place a new telephone system with a menu of options, which is helping to route calls more quickly and the time patients have to wait to be dealt with. The practice has also improved its communications with patients via a newsletter and the leaflet to promote new services that patients were unaware of, such as the opportunity to request repeat prescriptions online.

Proof of the need for funding

Funding is never far from the top of any practice manager’s agenda and practices have been encouraged to use the Friends and Family Test results to ‘lobby’ CCGs and area teams to address funding and premises issues beyond their control.

The GPC guidance states that the second question that patients are asked, which is chosen by the practice, can be ‘tailored’ to local needs and to help generate evidence for fund lobbying.

Dr Mo Dewji, a practising GP in Milton Keynes, and NHS England national clinical lead for primary care, was quoted in the media as saying: “I wouldn’t see why, if this was a message that was coming up all the time, that I wouldn’t go to my local health authority, or CCG, or whichever may be, to say “look, I want to sit down and have this discussion, because every one of my responses, or a significant number of responses, is saying this, and it’s backed up by this bit of work we’ve done, and another bit of work.”

While the FFT isn’t great, it’s not all bad, and could possibly provide a nugget of information or opportunity that makes it worthwhile.

What are your views on the Friends and Family Test? Have you benefited from it at all or is it just another pointless NHS survey? Comment below or take your views to the story in Practice Index Forum here.