Restrict friends and family test to hospitals, says DH

The impact assessment, signed off by officials on 15 November, said the costs of extending the test beyond acute settings and maternity services to areas such as primary and community care were considerable and the benefits were “low”.

The DH’s preferred option is to use the test for adults in accident and emergency and overnight inpatient services before extending the service to maternity episodes.

The assessment said: “Given high levels of satisfaction with GP services in the GP Patient Survey, if the friends and family test were extended to GP services there is a risk that gains in patient wellbeing will not be realised. It will be expensive because of the high number of GP consultations.”

The department estimated rolling out the test in the more limited form − “option 2” − would cost £25m over five years. Extending the test − “option 3” − would see the cost rocket to £399.4m over the same period.

Its assessment concluded: “All things considered, the preferred option is option 2. This is the preferred option because it delivers a high level of net benefit at a relatively low cost (relative to option 3) and without any of the downside risks of option 3. By extending to maternity services it allows patients from an important group to be covered by the friends and family test at an early stage of implementation.”

The impact assessment also concluded the test “may not be compliant with the quality, innovation, productivity and prevention programme”.

“Although the service will support service improvement it is unlikely to yield net cash savings,” it said.

When the prime minister announced plans to roll out the test in May, he spoke about its use in acute care settings.

Neil Bacon, founder of provider iWantGreatCare, which is offering the test free for other trusts through the NHS Confederation, is one of a number of supporters who has called for the test to be rolled out to GPs.