Friends and Family Test 21/04/2017 Friends and Family Test Implementation Guidance – slides 2-6 Supporting information – slides 7-20 The materials – slides 21-24 Beverley Balin Patient Experience Manager

How to get started From 1 April 2015, all patients seen in any NHS service must be given the opportunity to respond to the Friends and Family Test. You must make sure the FFT is available for all patients in your area; how you do that locally is best decided locally with your teams using the guidance and information that follows. The materials you require are: paper response cards (to be given to all patients whether seen in the community or on a site), and posters and post boxes for where patients are seen on a hospital site. Response cards and posters are downloadable from the extranet. Post boxes are being delivered to each hospital site. If you want to order a more permanent box they can be ordered via Integra (code:WYB1223)

Printing the cards Click on the FFT response card icon – the response card icon will come up on the screen. The cards are generic and on pdf but the blue boxes are editable. Easy read version and a children’s version are also available (soon) In the blue edit box please type the name of the service (using the names on the list provided). If cards come back to Sedgemoor for data entry without the team/service/ward name they will not be attributable and will be wasted. Print as many as you will require. You can type the name and print directly from the extranet each time you need to print more (although you can save the template, it won’t save with the name typed).

Printing the posters Click on the FFT response card icon – the poster icon you selected will come up on the screen. Select to print in A4 or A3. Print enough so that patients can see them from different points of view. Laminate and put them on display. Ensure you have printed cards available in the department. Please remove any local feedback system e.g. comment books

Collecting the returns Encouraging patients to complete and put in the post box whilst they are still in the ward or department has proven to increase the number of responses (and helps to keep costs down). If patients want to post it back (or if it works better for your service to ask them to complete at home and then post back) then this is possible using the FFT Freepost address printed on the card. In this case, please give patients an addressed envelope. You will need to print some address labels for envelopes locally.

Returning FFT cards to Sedgemoor Cards collected locally should be returned to Sedgemoor using the internal courier. Please collate weekly, and return to: ‘Friends and Family Test’ Peninsula Community Health Sedgemoor Level 4 St Austell PL25 5AS Please ensure that you send the cards back weekly. Do not send a month’s worth back at the end of the month because the data entry needs to be done throughout the month. Cards collected in the last week of the month need to be sent promptly to Sedgemoor because the data needs to be entered before the end of the seventh working day of the following month.

The guidance states: “the opportunity to give feedback via the FFT should always be available” This means that there is never a ‘wrong’ time for patients to give their feedback. If they ask to do the FFT, they should be given the card or shown where to go online.

FFT Rollout Timetable 1 April 2013 Wards and Minor Injury Units 1 Jan 2015 Community Nursing, EIS, ACAH, Integrated Rehab, Specialist Falls, Neurology 1April 2015 All other services There will not be a national FFT CQUIN for 2015-2016 but it will be included in the NHS Contract It is a ‘must do’ across all patient groups in all services

Some fundamental principles The purpose of the FFT across the whole NHS is to create a culture where patients expect to be given the opportunity to feedback and NHS staff value and act upon patient needs and wishes. Patients have a right to participate in giving feedback to the NHS, and in considering their future care they have a right to see what others have said to help inform their choices and decisions. The FFT gives patients a voice and provides with the opportunity to feed back during or after their care and treatment. The FFT is not a traditional survey. It is a continuous feedback loop between patients and service providers.

When to give patients the FFT (not applicable to wards and MIUs) Local flexibility is permitted over the degree and frequency of promotion of the FFT, and at which ‘touch-points’ in a pathway this occurs. In planning this, service leads must ensure that they will hear from the full spectrum of their patient community, and in sufficient volumes so as to be useful improving the service locally. The opportunity to answer the FFT must always be available, but the question does not need to be directly put to people after every appointment. However, you might want to identify certain groups of patients, or certain parts of a pathway where a more proactive approach could be taken to identify any areas of concern specific to those groups.

FFT for Outpatients FFT applies to all patients being seen in outpatient clinics. For now, it is important to ensure that patients attending any PCH-led clinic are given the opportunity to respond to the FFT. PCH clinics are therapy or nurse-led. Where PCH hospitals host acute trust consultant clinics, we have no arrangement as yet with any of our neighbouring acute trust providers to implement the FFT for them. Eventually some arrangements will need to be made, but from 1st April, until further notice, do not proactively offer the FFT to these patients. If a patient requests a card however, they are entitled to have one, and if staff mark it RCHT or Derriford (or North Devon), we could forward it on from Sedgemooor.

Measuring response rates (or not)? For inpatients and MIU attendees, all patients must continue to be given the question after discharge or attendance. Response rates for these groups will continue to be measured and reported until we are informed otherwise. For all other services, response rates will not be measured or reported. However, 3 important points here are: All patients must ‘know’ that they can give feedback via the FFT if they wish (so how will you ensure this?). The opportunity to feed back must always be available to them. You will be asked to demonstrate what actions you have taken locally in response to feedback so you will need to generate sufficient feedback to act on.

Some changes to national guidance (Applicable to all areas including wards and MIUs) From 1 January the FFT is now scored as a % (the old Net Promoter Score methodology which gave a score ranging from -100 to +100 has been discontinued). All patients must now be included, including children and young people and others who might require more accessible methods. A children and young person’s version of the FFT, and an Easy Read version can be used, or they can be helped to answer. A note about token collection systems – PCH has never used this method because we would not have been able to capture qualitative comments. However those organisations that have used them must now stop – from 1 April 2015, they are no longer permitted in any location.

Can parents, carers, staff or volunteers help to complete the response? Yes Wherever possible, the FFT feedback should be collected from the patient. In some cases, patients may wish to give feedback but need help to do so e.g. due to their age, disability or health condition. In these circumstances, help from a parent, carer, volunteer or a member of staff can be given. Any support given to a service user who lacks capacity in answering the FFT questions, must comply with the five key principles of the Mental Capacity Act 2005. Parents or carers may also want to provide their own feedback. They can do so.

Can family members and people in paid support roles be asked the FFT? Yes Family members, carers, and people in paid support roles can provide valuable insights, and can give their views. People in paid support roles should have an understanding of the care or treatment received but must not have been involved in providing the care or treatment for which feedback is being sought. Where feedback is being given by someone who is not the patient, it should represent the persons own views of the care or treatment received and should not be given on behalf of the patient i.e. the person should not try to guess or make assumptions about what the patient thought about their care or treatment.

The FFT in sensitive situations Patients who want to give feedback through the FFT should always be able to. However, there may be times when it is neither appropriate nor possible to proactively seek feedback via the FFT. Clinical discretion can be applied where it is felt that the patient is not physically and/or mentally well enough to participate or in situations where asking it may cause distress or have an adverse impact on the patient’s care or treatment. Judgement should be used on a case-by-case basis – not a blanket exclusion. At the same time, assumptions should not be made about certain patient groups not wishing or not being able to respond to the FFT. NB: Consideration should be given to other means of seeking feedback from people who are not asked the FFT question.

Where will the results be published? The FFT results are published monthly on the NHS England website and the NHS Choices website. Results are also published locally on PCH website, and in hospitals ward/department public areas on Patient Feedback Display Boards. These boards must be kept up to date. Patient comments can be used provided the patient did not tick the ‘opt out’ box on the response card. This is part of the NHS commitment to be open and transparent and give patients in-depth information about health services.

How are the results used? The scores and the patient comments should be used at service level to improve services and demonstrate you respond to feedback. Aggregated PCH FFT scores (and response rates for wards and MIUs) are reported monthly in the Quality Dashboard. Individual ward/department/service scores are reported quarterly in the Patient Experience Board Report together with examples of positive and negative comments and actions taken in response to negative feedback. These reports also feed through to NHS Kernow who use the results to monitor our contract and inform their commissioning decisions. Patients and members of the public can use the results to see how their local services are performing and to inform choices.

Are the FFT results comparable? Not very. The FFT is not intended to be a statistical measure to compare different organisations. The primary purpose of the FFT is to ensure that organisations obtain regular and timely feedback from patients, take ownership of the results and act on the feedback. The data may be used to track improvements over time within an organisation where collection methods and local demographics are stable.

Any questions? Bev Balin Patient Experience Manager beverley.balin@pch-cic.nhs.uk Tel: 07768 558450 I am happy to attend any team meetings to help you plan your FFT approach with your team. Sara Reid FFT Administrator Patient Experience Team PCH HQ, Sedgemoor sara.reid@pch-cic.nhs.uk Tel: 01726 627567

FFT Card This card is editable. Please type the service name and location in the 2 blue boxes and then print however many you want. Its important to type the correct service name as per the service list provided online.

Poster for wards

Poster for Clinics

Poster for MIUs