Recommendation 255

Real time results of patient feedback

Results and analysis of patient feedback including qualitative information need to be made available to all stakeholders in as near “real time” as possible, even if later adjustments have to be made.

Many local trusts are devising innovative ways to take this forward. Feedback from patients, carers and the public can be made on the quality of care through a range of technologies and channels including online, via bedside televisions, surveys and the friends and family test.

The NHS Constitution pledges that the NHS will encourage and welcome feedback on your health and care experiences and use this to improve services. Similarly, the Mandate states that NHS England will consider how to make it easier for patients and carers to give feedback and see reviews by other people so that timely, easy to review, feedback on NHS Services becomes the norm.

The friends and family test is currently in use in all acute inpatient services, A&E and in maternity. By December 2014 it will be rolled out to general practice, community and mental health services and the remainder of NHS services by the end of March 2015. The test asks all patients in acute inpatients and A&E if they would recommend the care they have just received to their friends and family if they needed similar care or treatment. The results are published for every ward and every A&E department and in real time – within a maximum of five weeks after the feedback was collected. From ward to board, staff and managers are able to look at the results of the friends and family test, see areas of strength and weakness and take appropriate action. Patients, the public and commissioners can see where scores or good and less good and use the results to hold services to account and commission for improvement.

A number of organisations already exist that enable patients, carers and the public to provide online feedback about their care. This includes, but is not limited to, Patient Opinion, NHS Choices, Good Care Guide and iWantGreatCare.

NHS England will make such comments accessible in a coherent and consistent way through NHS Choices and, from November 2013 will begin to bring together the most reliable and relevant data from national web services and act as a ‘front door’ to the best information on health and social care on the internet.

The government’s Information Strategy outlined that patient feedback and information on patient experience will be an even more important influence on shaping policy and the delivery and regulation of care services. Involving people in decisions about their health, care and services should be the norm, not the exception.

In the long term, electronic health and care records may prove to be a main vehicle for providing information on health and care outcomes and status, rating our experience of care, and leaving feedback and comment. Innovations linked to online records could enable us to record and share health comments and also prompt better conversations between us as patients or users of services and the professionals providing our care.


Results from the Friends and Family Test are published monthly in all acute inpatient services, Accident and Emergency and in maternity. In July NHS England published a Review of the Friends and Family Test and Guidance  to support rollout of the Friends and Family Test in other NHS settings. The review found that 85% of Trusts are using the Friends and Family Test to improve patient experience and 78% report that it has increased the emphasis placed on patient experience in their Trusts. The research undertaken amongst staff groups demonstrates that rapid feedback of scores and comments to ward managers and nurses results in a number of positive outcomes.

The first set of Friends and Family Test results from NHS staff were published in September. The Friends and Family Test was rolled out in general practice, community and mental health services by December 2014 and is on track to be rolled out in the remainder of NHS services as appropriate by March 2015.

So far more than 5 million Patient Friends and Family Test responses have been collected; 4.5 million responses have been collected from Accident and Emergency and inpatients, and more than 551,000 from maternity patients. The second Staff Friends and Family Test was run from July to September 2014 and more than 141,000 staff from 242 service providers submitted Staff Friends and Family Test responses.