Viewpoint: Dr Kailash Chand: The friends and family test is a political gimmick

Every GP practice in England will have to provide monthly data on the Friends and Family Test (FFT) from January next year, writes BMA deputy chairman Dr Kailash Chand.

Dr Kailash Chand: concern over Friends and Family test (Photo: Michele Jones)
Dr Kailash Chand: concern over Friends and Family test (Photo: Michele Jones)

The FFT proposes that every patient will be able to give feedback on the quality of their care after undergoing treatment. This NHS England idea appears more of a political gimmick rather than a clinically meaningful mandate for general practice.

I am not opposed to feedback from patients and their families. However, the FFT is based on a model developed to test satisfaction with consumer products. My objection is whether friends and family are proper judges of general practice in all its complexity.

It’s difficult to see what value this new proposal adds

Primary care isn’t Facebook, and healthcare isn’t a commodity like eating in a restaurant. And we must make sure that we don’t confuse issues around general practice such as shortages of doctors and nurses, with the care that patients get from the staff that look after them.

The national GP patient survey already includes a question on whether you would recommend a GP practice to someone who has just moved into the area. About a million people a year respond to this question—a sample size big enough to flag up major concerns at practice level and to provide reasonably solid results at CCG level. It’s difficult to see what value this new proposal adds.

There is no published clinical trial demonstrating its validity

Consider the question: ‘How likely are you to recommend our GP surgery to friends and family if they needed similar care or treatment?’

Does anyone really think this will improve patient care? There is no published clinical trial demonstrating its validity, nor is there evidence of its efficacy in raising the quality of services. The lack of any improvement in NHS patients’ experiences is not down to a lack of data. NHS trusts and GPs already have more data than they can handle and they don’t need more meaningless or misleading figures.

General practice can deliver, but in my view this burdensome data collection will only serve to generate league tables based on customer satisfaction, rather than waiting times and clinical outcomes

I am as committed as anyone else to providing quality care to our patients, but the FFT is simplistic, lacks authenticity, and will lead to distortions of families’ and friends’ perception of hospitality, rather than clinical services, rendered to patients. What is required is to empower patients by changing the culture throughout NHS organisations and developing a more collaborative working relationship with service users. If NHS England really wants to give patients the best care, they should introduce better quality measures, and ensure that general practice is adequately resourced (more GPs,more funding) so that we can match up to the high levels of expectations that friends and family have.

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