Using 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.
- The Friends and Family Test (FFT), launched in April 2013, provides near-real-time patient feedback with results published monthly by NHS England Digital. Approximately 2 million pieces of feedback are submitted monthly, making it the largest source of patient opinion in the NHS. The FFT question was revised in April 2020 from asking about willingness to recommend to asking about overall experience of using the service (NHS England, Friends and Family Test).
- FFT results are available at service level (ward, department, practice) and published with minimal delay, addressing Francis's call for feedback in "as near real time as possible." Trusts can access their FFT data continuously for internal monitoring.
- The CQC National Patient Survey Programme provides standardised annual patient experience data across five survey types (inpatient, maternity, community mental health, urgent and emergency care, children and young people). Results are published per trust with full data tables enabling comparison (CQC, NHS Patient Survey Programme).
- While the annual CQC surveys do not provide real-time feedback, their findings are made available to all stakeholders on publication. The combination of real-time FFT data and periodic CQC survey data addresses both elements of this recommendation.
How was this evidence gathered?
Response
Accepted
Response
AcceptedThe government published "Hard Truths: the Journey to Putting Patients First" (Cm 8777) on 19 November 2013, responding to all 290 recommendations of the Francis Report. This followed an initial response "Patients First and Foremost" in March 2013. Key reforms included a new Chief Inspector of Hospitals, strengthened Care Quality Commission inspection regime, a statutory duty of candour, and the fit and proper person test for NHS directors. Volume 2 (Cm 8754) contains the government's detailed responses to each of the 290 recommendations. See: https://assets.publishing.service.gov.uk/media/5a7cd486ed915d63cc65d167/34658_Cm_8777_Vol_1_accessible.pdf
Published Evidence
Published assessments of progress from inspectorates, select committees, official progress reports, and other sources. Source type badge indicates whether each assessment is independent or government self-reported.
Research published 2023 marking ten years since the Francis Report found mixed results. Structural and legislative changes largely delivered (duty of candour, FPPR, CQC overhaul, revalidation, Freedom to Speak Up Guardians). However, cultural change not fully embedded; understaffing, fear of speaking up, and poor complaint handling persist in parts of the NHS.
Government published "Culture Change in the NHS" (Cm 9009) reporting progress on all 290 recommendations. Key achievements: 19 hospitals placed in special measures; those trusts recruited 109 additional doctors and 1,805 additional nurses; 129 board-level changes made; excess avoidable deaths fell by 450 in less than a year.
Government published "Hard Truths: The Journey to Putting Patients First" (Cm 8777) in two volumes. Vol 1 set out new actions; Vol 2 provided detailed response to each of the 290 recommendations. Approximately 204 of 290 recommendations were fully accepted.