Two weeks ago, I was at a Nuffield Trust conference on choice and competition in health when I found myself in urgent need of some healthcare.
I called my GP and, because I had a potentially serious problem with my eyes, she sent me to the emergency department of Moorfields Eye Hospital. She did not, thankfully, offer me a choice of accident and emergency departments.
However, because this A&E attendance occurred post April 2013, when I was discharged I passed a sign asking me to tell the hospital if I would recommend it to a friend or relative with a similar problem.
I understand the “friends and family” test and − as far as I can judge − the care I received was very good. But I didn’t fill in the form. In the context, the question was absurd.
Of course I would recommend the hospital to someone with a similar problem. It’s almost impossible to imagine an experience that would dissuade me from telling someone with an urgent and serious eye problem to visit their nearest eye hospital.
Businesses like the hotel industry, which have traditionally used the “friends and family” test, or “net promoter score”, share certain characteristics. Their customers have a sophisticated understanding of what they need from the service; are capable of judging its quality; and have a range of similarly attractive choices.
Almost by necessity, these characteristics are not shared by emergency specialist healthcare. I would expect when the first national “friends and family” rankings are published in July, specialist hospitals will be near the top − but the reasons will tell us little about patient experience.
However, I later thought back to that Nuffield Trust conference, where iWantGreatCare founder Neil Bacon argued that even crude measures of customer satisfaction could be predictive of hospitals’ care quality. Dr Bacon cited two studies: in one, he said, US researchers found that the 1-5 ratings people gave hospitals on yelp.com correlated with the hospitals’ mortality and readmission rates. In another, Imperial College found that the scores the public gave hospitals for cleanliness on NHS Choices could predict MRSA rates and deaths from C. difficile. If Dr Bacon is right, perhaps I was remiss to shun the test.
So, for the record: if a friend or relative had a serious eye problem in central London I would be very likely to recommend the casualty department of Moorfields Eye Hospital. And if their house was burning down, it’s very likely I would suggest they call the fire brigade.