Group of children

The NHS Friends and Family Test (FFT) is used across a range of services to collect feedback from adult patients and service users. From April 2015, providers will also be required to offer the FFT to children and young people. Ahead of this change, Picker and Barts Health NHS Trust explored children’s views of the FFT question to recommend a version that is suitable for a younger patient population.

How we did it

An FFT question suitable for children and young people was recommended after completing the following stages:

Focus Group –> Question Development –> Ward Interviews –> Cognitive Testing –> Pilot 

A focus group with young patients at the Royal London Hospital explored views of the FFT question and different ways it could be asked. This informed the development of four versions of the FFT question, with views on the wording and presentation styles sought during subsequent ward interviews. The preferred version was developed into a full survey form before being cognitively tested with a new set of patients to check for comprehension and overall format. A pilot of the data collection phase was conducted across two NHS Trust sites.

What we found

After accounting for children’s views on question text, response options and pictures/images, the recommended FFT question for children and young people, based on their preferences, was as follows:

The Monkey character and Monkey brand designs are trademarks of AhHa Publications Limited. © Copyright AhHa Publications Limited 2015.

The question was incorporated onto a survey form which included freetext follow-up questions, and piloted across six paediatric inpatient and day case wards using a hand-out paper methodology with an additional online option. A total of 672 completed forms were returned during the six-week fieldwork period.

  • The majority of respondents agreed either ‘a lot’ (90%; n=600) or ‘a bit’ (8%; n=51) that the hospital was a good place for their friends and family.
  • Approximately two thirds of respondents left freetext comments.

To summarise…

It is essential to involve young patients in the development and design of any new data collection method to ensure it is appropriate and appeals to their needs, abilities, and preferences. Our pilot data collection found that the vast majority of children gave positive responses to the closed question element of the FFT. A majority also left written comments alongside this, and these were found to be particularly useful and informative.

Based on this research, we recommend that our child-friendly version of the FFT question is used with children and young people – and we are pleased to announce that this is freely available for use by NHS providers. Use of this question should always include the free text follow up, and, in line with national guidance, providers should therefore encourage as many children as possible to complete this.

Please click here to view the full report.

Please note some changes were made to the form in March 2020 to ensure the main question aligned with the revised national guidance effective from 1st April 2020. However, the remaining questions and overall design of the form remained unchanged, in line with the preferences of children and young people.

Click here to download our recommended FFT Form for children and young people.

The Monkey character and Monkey brand designs are trademarks of AhHa Publications Limited. © Copyright AhHa Publications Limited 2020.


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