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Friends and family test shows large variety in care quality

People would not recommend 36 wards for treatment

Adrian O'Dowd

Tuesday, 30 July 2013

Large variety in standards of care between different hospitals in England has been revealed in the first results published today of the NHS Friends and Family Test.

Data from the ratings test, introduced in April, covers the three months of April to June and is gathered from a survey that asks patients whether they would recommend A&E and inpatient wards to their friends and family based on their own experience.

The survey covers around 4,500 NHS wards and 144 A&E services.

The test is meant to give patients a chance to give real time feedback to hospitals and to decide for themselves whether their care is good enough or not, prompting hospitals to take action, if necessary, to improve.

It is anticipated that the test will be extended to maternity services later this year, to GP practices, community services and mental health services by the end of 2014 and to all parts of the NHS by 2015.

There were wide variations in numbers of respondents, which affected overall scores, but from the new data, in June, 36 wards out of 4,500 across the country scored an overall negative figure, down from 66 in April.

Over the first three months, more than 400,000 NHS patients completed the survey and specialist hospitals tended to have higher scores for inpatient services.

All 157 acute NHS trusts submitted in-patient data as well as independent sector providers, and A&E data came from all 144 providers of relevant A&E services.

The test’s scores range between +100 and -100. A&E service scores ranged from 100 to minus 13, with the top 10 trusts landing between 100 and 79. The scores for inpatients ranged from 100 to 43.

NHS regulator the Care Quality Commission will use the data as part of its new surveillance system when assessing risks at hospitals.

The figures are not comprehensive given that the England-wide response rate for both inpatient and A&E surveys was only 13.1%.

Tim Kelsey, NHS England’s national director for patients and information, said: “At the heart of Robert Francis’s report into the tragedy at Stafford hospital was one basic message: to ensure the NHS delivers high quality care for all, we need transparency of the patient and carer experience. It is the absence of this transparency that often allows poor care to go undetected.

“Friends and Family Test is a major step forward for patients and for the quality of their care. Direct patient and citizen feedback is vital to improving the services the NHS provides. Trusts can concentrate their focus on improvement with this information.

“From this first publication, we can see a significant and real variation in the quality of customer service across the NHS. There are home truths here and everyone will expect those trusts who have large numbers of their patients choosing not to recommend their services to respond as quickly as possible.”

Mr Kelsey warned that the data should be handled carefully because low response rates could have a dramatically disproportionate impact on scores.

Health secretary Jeremy Hunt said: “Today marks an historic moment in the NHS. This simple survey will give us the information we need to celebrate the best in our NHS and root out poor care.”

Dr Mark Porter, chair of BMA Council, said new ways of making the feedback process even more effective should be encouraged.

However he also warned: “It is important that any assessment of the NHS’ performance is based on a holistic assessment that allows us to fully capture patient feedback and takes into account the issues affecting particular services.

"Simplistic rating systems or questions often fail to provide the context in which care might be being delivered, for example the impact on certain services as a result of the government’s competition agenda or budget cuts."

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