Recommendation F254: Access for public and patient comments
From Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry, published 6 February 2013.
Recommendation
While there are likely to be many different gateways offered through which patient and public comments can be made, to avoid confusion, it would be helpful for there to be consistency across the country in methods of access, and for the output to be published in a manner allowing fair and informed comparison between organisations.
In brief (written by this site)
In September 2024, the Department of Health and Social Care and NHS England reported that the Friends and Family Test gives patients and carers the opportunity to leave feedback across most health services, but noted that "the FFT is not intended to provide data that can be used to compare different organisations" (DHSC and NHS England, Feb 2026). Earlier, in May 2024, the Thirlwall Inquiry legal team found that the extent to which national consistency in feedback access had been achieved remained unclear (The Thirlwall Inquiry legal team, May 2024).
AI-generated summary of the record on this page, checked by a second model and automatic checks, 26 Sep 2026. The record below is the sources' own words.
About this summary
This recommendation applies across many organisations. The record reflects central policy activity; adoption in individual organisations may vary.
Government response
Accepted.
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 (26 March 2013) pledges that the NHS will encourage and welcome feedback on your health and care experiences and use this to improve services. Similarly, The Mandate for NHS England (Department of Health, November 2013) 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.
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.
How this response relates to the recommendation
Site note: This is volume two of "Hard Truths: The Journey to Putting Patients First" (Cm 8777-II), the government's response to the Inquiry's 290 recommendations, published by the Department of Health on GOV.UK on 19 November 2013 and dated to that day here. The PDF the row links to is the accessible edition, whose title page reads "January 2014". The Department of Health has been the Department of Health and Social Care since January 2018. The volume says it includes accounts from each of the national organisations the recommendations name, but it does not mark which passage each organisation wrote, so every row is filed under the Department that published it.
Blanket government agreement does not establish acceptance or delivery by each addressee. Some response passages cover groups of recommendations.
Scope of the government response
Government responded via "Hard Truths: The Journey to Putting Patients First" (2014), a single document covering all 290 recommendations with a blanket acceptance. Individual recommendation responses were not broken out.
Delivery
DHSC and NHS England say in progress (27 February 2026)
Article 4 of the NHS Constitution states that the NHS will actively encourage feedback from the public, patients and staff, welcome it and use it to improve its services. Organisations should regularly promote their wish to hear from service users and show how they use learning from all feedback (including complaints) to improve services.
After being launched in April 2013, the Friends and Family Test (FFT) was rolled out in phases to most NHS-funded services in England over a two-year period, and now gives all patients, users of services, their carers and loved ones the opportunity to leave feedback on their care and treatment, alongside other means of feeding back as set out on the NHS website. The NHS Standard Contract requires providers to publish complaints monitoring reports (schedule 6).
Note that as a continuous feedback tool, the FFT is not intended to provide data that can be used to compare different organisations. This is to encourage a focus on good quality feedback and opportunities to identify good practice.
Site note: DHSC and NHS England's own account of progress, supplied to the Thirlwall Inquiry in September 2024 and printed in the Inquiry legal team's Review of Implementation of Recommendations from Previous Inquiries into Healthcare Issues (version dated April 2025, published 27 February 2026). It is not a finding of the Inquiry. Their reviewed extent of implementation reads “Implemented - Ongoing”. Table row: section 18.2 No. 254, PDF page 560-561.
Department of Health and Social Care says in progress (11 February 2015)
Ensuring that patients, carers and the public can give feedback on the quality of care is an on-going commitment. The 2014-15 NHS Mandate sets out how there will be rapid progress in measuring and understanding how people really feel about the care they receive and taking action to address poor performance.
In July 2014 NHS England published a Review of the Friends and Family Test which found that Friends and Family Test is performing well as a service improvement tool, with 85% of trusts reporting that it is being used to improve patient experience, and 78% saying that Friends and Family Test has increased the emphasis placed on patient experience in their trusts. In particular, the open-ended follow-up question is proving a rich source of patient views at ward and Accident and Emergency departmental level that can be used, where implemented, to highlight best practice and identify and address concerns. NHS England is working with NHS Choices to look at ways to enhance the presentation and profile of the Friends and Family Test data for patients and the public to use.
A number of organisations already enable patients, carers and the public to provide online feedback about their care. NHS England will make such comments accessible through a new national Health & Social Care Digital Service, which will be replacing NHS Choices. The new online service will 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.
Results from the Friends and Family Test are published monthly in all acute inpatient services, Accident and Emergency and in maternity.
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.
Site note: This is the supporting annex published on 11 February 2015 with "Culture change in the NHS: applying the lessons of the Francis Inquiries" (Cm 9009), attached to the GOV.UK page as "Culture change in the NHS supporting annex". The annex has no title page; that title is GOV.UK's and the PDF's own. Its table has four columns (No., Recommendation, Hard Truths Government response, Progress update), and the row carries the Progress update cell. No column says which organisation wrote an update, so the row is filed under the Department of Health (now the Department of Health and Social Care), which published it.
Site note: The Inquiry addressed this recommendation to NHS England, not to the Department of Health. The annex gives this update in the Department's publication and does not say who wrote it, so the row is the Department's report of the progress made on it.
What other bodies have found
In their own words. These do not change the delivery statement above.
Thirlwall Inquiry legal team (15 May 2024)
This recommendation was accepted by the Government.
In the January 2014 Hard Truths report, the Government said that the mandate for NHS England for April 2013 to March 2015 stated that NHS England would consider how to make it easier for patients and carers to give feedback and see reviews by other people. Unclear to the extent this consistency was implemented.
In the February 2015 Culture Change report, the Government referred to the roll out of Friends and Family test, asking patients in acute inpatients and A&E if they would recommend the care they have received to their friends and families, with the results published monthly in all acute inpatient services, A&E and in maternity.
Site note: The Thirlwall Inquiry legal team's own notes on implementation, from its Review of Implementation of Recommendations from Previous Inquiries into Healthcare Issues (version of 15 May 2024). The review does not colour its Extent of Implementation cell for this recommendation green; it leaves the cell uncoloured where a recommendation was rejected, where evidence of implementation was insufficient, or where steps had been taken but implementation was not yet complete. Table row: section 16.2 No. 254, PDF page 516.
Source
Responsible bodies
Themes and tags
Who has spoken
- Department of Health and Social Care
Response, delivery statement - DHSC and NHS England
Delivery statement - Thirlwall Inquiry legal team
Finding