The prime minister has given his backing to plans to roll out the friends and family test to primary care, as part of a package of measures to be unveiled today to improve the quality of services.

The test is due to be rolled out to all acute trusts in England by April 2013 and will be used to produce league tables comparing performance. However, there has been opposition to its extension to primary care.

A Department of Health impact assessment concluded implementation in primary care would be significantly more expensive than in hospital services. The NHS Commissioning Board is understood to be exploring more cost effective ways of carrying out the test in GP practices.

See HSJ’s briefing on the friends and family test for full details of how it works

In an announcement scheduled for today, David Cameron was expected to say he wanted the NHS to “go further, with GP surgeries, district nursing and community hospitals using the test to improve the care they provide as soon as possible.”

British Medical Association GP committee chair Richard Vautrey told HSJ that although the existing system of collecting patient feedback on GPs was not perfect he had concerns about the suitability of friends and family for a primary care setting as well as the cost.

“The reality is most patients use word of mouth [to choose a GP] so I think these kind of measurements do not actually chime with what patients do in their local communities,” he said.

Mr Cameron also backed proposals, set out in the health secretary’s mandate to the commissioning board, to regularly ask staff the friends and family question about whether they would recommend a service to their friends and family.

He promised £50m to improve dementia care in 2013-14 when there would be a designated dementia champion in every ward and a dementia nursing specialist in every NHS organisation.

Healthcare assistants will be given more training and career development opportunities to train as registered nurses while all staff will have access to e-learning courses on dementia funded by the DH.

The 10 per cent of acute trusts who have not adopted hourly ward rounds will also be “urged” to do so by the end of 2013-14, the prime minister will say.

Meanwhile, the Care Quality Commission has been asked to carry out a “root and branch review” of induction training for care staff. It is most likely this will be done as part of their day to day inspection activity in 2013-14.

Mr Cameron will also announce that nurses and midwives at the beginning of their careers will be given the opportunity to become “care makers”. Building on the success if the London Olympic “games maker” volunteers, they will be chosen because they embody the values of compassionate care and will volunteer in hospitals and care homes to help improve care.