Recommendation F255: Using patient feedback
From Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry, published 6 February 2013.
Recommendation
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.
In brief (written by this site)
In commentary submitted in September 2024, the Department of Health and Social Care and NHS England reported that the Friends and Family Test functions as a continuous feedback tool with results published monthly, classifying implementation as ongoing (DHSC and NHS England, Feb 2026). In May 2024, the Thirlwall Inquiry legal team reviewed progress, noting earlier government initiatives to publish patient feedback monthly and develop digital feedback options through electronic records (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.
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 (Department of Health, 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 (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.
The friends and family test is currently in use in all acute inpatient services, Accident and Emergency 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 Accident and Emergency 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 Accident and Emergency 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, as part of a national Health and Social Care Digital Service that 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 our 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.
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)
The FFT is a continuous feedback tool, designed to be quick and easy for patients to use and for staff to implement and collect. The results of the FFT are published monthly. The published data is not subjected to routine analytical processes and is not:
Please see our response to recommendation 254 above.
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. 255, PDF page 561-562.
Department of Health and Social Care says in progress (11 February 2015)
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.
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 many local Trusts were devising ways to take this forward. The Government said that NHS England would also make comments accessible in a coherent and consistent manner through NHS Choices, which would be part of national Health and Social Care Digital Service. In the long-term, the Government envisaged that electronic health and care records might be the main vehicle for rating experience of care and leaving feedback and comment. 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. 255, PDF page 516-517.
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