Hospitals face 'voting booths' in A&E to measure patient experience

The proposal for voting kiosks or “hand-held devices” to allow patients to rate their hospital stay comes in draft guidance from the Department of Health on implementing its “friends and family” patient satisfaction measure.

From April 2013 trusts will be contractually obliged to ask inpatients and A&E attendees who are not admitted whether they would recommend the hospital to their friends and family. This will result in each hospital receiving a “net promoter score”.

The move was announced by prime minister David Cameron in May but the DH documents reveal trusts will have to collect the data for at least seven consecutive days of every month, for every ward and A&E – placing a significant administrative burden on some organisations.

“Voting booth kiosks”, hand-held devices, text messages and questionnaires were all suggested as means of collecting the data.

The friends and family system is already used to measure inpatient satisfaction in the NHS Midlands and East region and widely used in the private sector.

Patients are asked: “How likely is it that you would recommend this service to friends and family?” with scores determined by the number of patients unlikely to recommend a trust subtracted from the number of patients who would recommend it, to calculate a percentage score ranging from -100 to 100.

The scheme was endorsed by the Royal College of Nursing in May.

But the documents obtained by HSJ show the DH has not yet agreed the wording of the question to be asked across the NHS.

One paper said: “Testing by [the] Picker Institute of the versions of the question has resulted in further work to do. NHS Midlands and East SHA was the national pilot region for the introduction of this initiative and have now commissioned this further work on the question. We therefore expect to know the exact wording of the question in September.”

The DH document also confirmed there would be no extra money to support trusts in collecting the data.

It said: “We recognise the systems and technology to collect this volume of data may not be available initially.” But it added that there would be “no additional financial support available to trusts in implementing this work”.

“Future work is planned to explore the possible extension of the use of the friends and family test to additional patient groups and care settings, and the merits of standardising the collection of follow up questions,” the paper said.

“A longer-term vision of the work is to extend the friends and family test to all patient groups with automatic links to patient-level data, to enable drill downs and deeper levels of understanding of services.”