How to Report on the NHS Friends and Family Test

Last Updated: Tuesday, February 11, 2014 by Johnathan Briggs

“The Friends and Family Test is different. It is a quick, consistent, standardised patient experience indicator."

The NHS Friends and Family Test: Implementation Guidance, Feb 2013

Since April 2013, the NHS has adopted the Friends and Family Test (FFT) as the primary way for it to measure how satisfied patients are with the NHS service they have received. As a result, all organisations under the NHS are implementing the test to offer transparency to their customers.

However, while organisations are required to submit overall and departmental FFT data via UNIFY2 for wider publication, this high-level data hides more detailed, valuable information.  By viewing this FFT data in more detail over time, you can see how well individual wards and even practitioners in your organisation compare, and uncover areas which are outstanding or need immediate action.

This article will show you how you can easily use Target Dashboard to report on your FFT data. Setting this up takes no time at all and you can implement this system with your current method of data collection. This article will show you the following:

· What the Friends and Family Score is, and how it's calculated

· Collecting and sorting FFT data in Target Dashboard

· Using Target Dashboard to report on your FFT scores for decision-making

1. Calculating the Friends and Family Score

At the heart of it, the Friends and Family Score is a variation on the Net Promoter Score, a common metric used by many companies as an indication of how likely customers would recommend their product/service to others.

i. Net Promoter Score Overview

Have you ever taken a survey, or any form of questionnaire? Even if you haven’t, you’ll likely have come across the following format of question:

As you can see, the recipient selects only one answer out of the 5 options which best describes how they feel, on a scale of ‘strongly disagree’ to strongly agree’. Some companies calculate their Net Promoter Score using 5, 6, or 10-option questions.

The net promoter score takes the form of a number between -100 (indicating that every person who responded wouldn’t recommend the service) and 100 (everyone would recommend). This number is calculated using a formula that treats every respondent to the survey as one of three categories depending on their opinion. Depending on the answering option they selected, (disagree, strongly disagree, etc.) they are treated as either

  • a promoter - someone who would recommend the service to others
  • a detractor - someone who would not recommend the service
  • passive, someone with a neutral opinion

The Net Promoter Score is then calculated by this formula:

([number of promoters] – [number of detractors]) / (total number of respondents) x 100

The number of passive respondents isn’t used in the calculation, but passive respondents obviously factor into the total number, making them essential to collect.

ii. Why the Friends and Family Test is different from NPS

The FFT Score is calculated in the exact same way as the NPS, but differs in three key ways:

- The question respondents are asked

- The number and wording of answer options

- How the answer options are categorised for the score calculation

The Friends and Family Test uses a 6-answer format, with the following question, answer options and option categorisation.


“How likely are you to recommend our (ward / A&E department) to friends and family if they needed similar care or treatment?”

Answer Options and categorisation:

You’ll note that ‘Likely’ is classed as passive here. In the NPS example in the previous section, you could expect people who “strongly agree” and “agree” to be promoters of a service, “strongly disagree” and “disagree” to be detractors, and “neither” to be passive. For the FFT, the balance between promoting and detracting answers is tipped so that organisations are penalised more for any option that isn’t ‘Extremely Likely’. The ‘Likely’ and ‘Don’t Know’ options are still factored into the total, but have no direct impact on the score result.

It is important to understand this, as this makes it harder for organisations to score favourably, encouraging them to drive improvement to earn an ‘Extremely Likely’ rating.

2. Collecting and reporting on Your FFT Data

According to the Implementation guidance published in October 2012, it’s recommended that organisations use several different ways of asking patients for FFT responses, including:

- Text Messaging

- Online Surveys

- Postcards

- Phone Surveys

Now that you have your data in the application, you can now create dashboards and charts to monitor and report on it. This will let you pre-empt and take action should the score go beyond acceptable levels (below 50, for instance).

Here are a few charting ideas to get you started.

i. Monthly Display of FFT Scores

This area chart shows the daily performance of your entire organisation every day, allowing you to take action immediately should the score fall below a certain level. It waas made in our application, Target Dashboard.

As you can see, Saturday had a score of -50, so action was taken and the score has returned to more acceptable levels. This is incredibly useful for seeing if changes made to initiatives at your organisation have any short term effect on patient satisfaction.

If you’ll notice at the top of the chart, there is a small dropdown menu with ‘Month’. This menu lets you choose between different timeframes, such daily, weekly, monthly, and yearly data.
As you can see, changing the view to 'Quarterly' lets us see that our FFT has been improving over time.

The great thing about Target Dashboard is that when you select another time-frame such as weekly, it automatically re-calculates the formula for that time-frame, and doesn’t just add up the values.

ii. Current Overall FFT Score


This gauge provides a simple, effective heads-up display of the current FFT score to-date, taking into account every response that has been collected in 2014. If you want, you can set a filter on this gauge so that it only displays the current FFT Score over a specific ward.


iii. FFT Scores by Ward

This scorecard gives a detailed overview of each ward, so that managers can keep an eye on everything without having to refer to many different sources. Creating a scorecard like this is incredibly easy (it only took me around 5 minutes!) and provides you with everything you need to take decisive action on potential patient issues.For more information on using scorecards, you might find our best practice guide for reporting in a dashboard.

Easily Report on your Friends and Family Scores

While it is now mandatory for NHS organisations to report on the Friends and Family Score for nationwide analysis, organisations can also use this data to report internally on how their patient care is being received, and what actions they can take to improve it. Target Dashboard can help managers highlight and take action on important issues in quick, easy and effective way. It takes the data you’ve collected, and lets you easily calculated and report accurate FFT scores for your wards, departments and even your entire organisation.

Do you work in the NHS, and are interested in reporting on your FFT data in a way which suits managers, not IT experts? Target Dashboard can help you. Contact one of our experts to discuss your requirements, or get a one to one demo and try it out for yourself.