Patient experience, Public health

The friends and family test won’t deliver the revolution we need, argues Chris Mimnagh

Chris MimnaghWe need a revolution. Right now the NHS is at a turning point and, as commentators have pointed out post Francis report, we are now forced to look with fresh eyes.

The emperor has no clothes; performance measures alone do not guarantee great care. They may indicate it, but do not guarantee it. The friends and family test (FFT) is a way of ‘outing’ patient experience beyond metrics, a soft measure which, according to experts, correlates with great care.

But what happens when the FFT shows things are not as good as they could or should be?

Will our staff be required to go the extra mile? Will we mandate smiles, greetings and corporate mantras to give the impression of enhanced service? Probably, but that won’t be revolutionary enough.

Neil Bacon, a champion of FFT, has a website which uses patient feedback to hold the mirror to hospitals and soon, primary care.

Useful though this resource may be, it ignores the voice of staff – frontline, support, engaged and disengaged – who have joined the NHS and are part of the equation that delivers great care.

Lessons from Mid Staffs tell us that whistleblowers do badly in the NHS and that we need a duty of candour when things go wrong. While that is laudable and right, it again misses the fact that the NHS should be able to use staff experience before things go wrong to prevent errors – to raise issues before problems arise.

Outside of corporate communications activities, Listening Into Action initiatives and staff briefs, we need to make the drive, commitment, concerns and solutions which all NHS staff have, transparent. Transparent to the NHS as a whole, their management and the entire population.

How could we do this?

Let’s set up It’s not compulsory, but if you work for the NHS, have a problem, a solution, something to say, then let’s hear it.

I recall a staff intranet site which had ‘people pages’ for all staff members, on which people could note practical details such as past jobs etc, with a space for a photo and statement. One health care assistant who worked on the cancer unit had her photo with the caption, “I love my job so much – I’d do it even if I wasn’t paid.” I know now that if I ended up on her unit I would get great care, but I also know that she would be able to suggest ways it could be better and alert us all if things were not right.

I know people will say we can’t and that bellyachers and disaffected troublemakers will populate the pages. Maybe, but those same people are caring for your friends and family right now – unheard, unseen and needing a voice.

It’s a revolution, but we need it now.

Chris Mimnagh is a GP and director of strategy and innovation at Aintree University Hospital NHS Foundation Trust

About NHSConfed .

The NHS Confederation is the membership body for the full range of organisations that commission and provide NHS services. We are the only body to bring together and speak on behalf of the whole NHS. We have offices in England, Wales (the Welsh NHS Confederation) and Northern Ireland (Northern Ireland Confederation for Health and Social Care) and provide a subscription service for NHS organisations in Scotland.


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