The friends and family test should not be viewed as a statistic but as a “line of sight measure”, the NHS England director leading the rollout of the new test has told HSJ.

NHS England national director of patients and information Tim Kelsey praised trusts for bringing about “authentic patient participation”, and announced the tool had recorded a million uses in its first six months.  

But he also presented a more nuanced message about the nature of the patient experience measure than that given by ministers in the past.

Mr Kelsey said it was legitimate to use the test to compare hospitals, but said this should be in the way that people would use “Trip Adviser” rather than as a “formal statistical measure”.

He said: “On the one hand we have hard statistical measures like mortality rates, risk adjusted etc, to enable statistical comparison  

“Something like the friends and family test is a line of site measure. It’s legitimate to compare one hospital’s results with another but not in any statistical sense.

“It’s not a statistical measure but a useful tool first to drive improvement and secondly to provide a line of sight comparison between different organisations and services.”

The friends and family test is classified as an official statistic by the government, but Mr Kelsey said this was for “bureaucratic reasons”.

In July, prime minister David Cameron said: “With the friends and family test, we now have a single measure that looks at the quality of care across the country.”

The friends and family test and how it is used is currently being reviewed by NHS England, HSJ reported this week.  

Mr Kelsey said a million people had rated hospital services using the friends and family test since its April national launch, and this marked “the beginning of a social movement”.

Mr Kelsey praised trusts facilitating such an “extraordinary public response” and said it represented the kind of “authentic patient participation which will secure the long-term improvement of the health service”.

He cited examples of improved care which he said could appear small but would make profound difference to patient experience.

They included Ipswich Hospital Trust’s move to give bereaved families free car park exit tickets after test feedback revealed families were receiving huge bills because they had spent longer than expected in hospital after losing a relative.

Hillingdon Hospitals Trust received feedback relating to noise and light at night along with some comments relating to responsiveness to patient need at night. 

The trust has since launched a campaign to rectify the issues supported by its director of nursing.