Between 2013 and 2015 the Friends and Family Test (FFT) has been rolled out across parts of the NHS. It consists of a single question asking whether the patient would recommend the service they just received to their friends and family. Answers are recorded on a 5-point scale from “extremely likely” to “extremely unlikely”. This is followed by an open-ended question asking why the patient gave the particular response. Although originally intended to support patients in choosing the “best performing” services, the guidance from NHS England (NHSE) was subsequently modified to say that feedback from the FFT, in particular from the open-ended responses, should be used to identify and address quality issues.
Our study aimed to investigate how the FFT was implemented in general practice, and whether it contributed to improving the quality of services provided. We carried out semi-structured qualitative interviews with staff from a purposively selected sample of 42 general practices distributed throughout the four NHS regions in England. We also interviewed staff from the four NHSE regional teams, as well as from two innovative practice organisations and from the Royal College of General Practitioners. Within each practice, the target was to complete three interviews: one with a clinician, one with the practice manager (or another administrator) and one with a representative of the practice’s Patient Participation Group (PPG). One hundred and thirty-four individuals were interviewed for this study.