Derriford Hospital rated among worst in the country in new friends and family test

Plymouth's Derriford Hospital has been rated among the worst in the country in a new TripAdvisor-style national survey.

Plans for the Friends and Family Test (FFT) were first announced by Prime Minister David Cameron in January 2012 and the survey was introduced in April this year.

The FFT asks patients whether they would recommend A&E and inpatient wards to their nearest and dearest based on their own experience. The new data was released on Tuesday 30 July.

Responding to the question “how likely are you to recommend our ward/emergency department to friends and family if they needed similar care or treatment?”, 9.8% of Derriford Hospital patients responded giving the hospital a score of 65 from 305 responses, placing it in the bottom 20% nationally.

The test results rated the hospital "among the worst" despite an overwhelming number of the respondents (286) saying they were "likely" or "extremely likely to recommend Derriford Hospital" and a range of often very positive feedback comments.

The system compiles the scores via a calculation based partly on the number of respondents, a factor which may have skewed the Derriford result to some extent. The hospital is then marked according to the outcome; with either a green tick for "among the best", an "OK" for "in the normal range" or a red cross for "among the worst".

The survey results follow a recent formal warning by the Care Quality Commission (CQC) handed to Derriford Hospital after an investigation into a series of so-called 'never events'.

The CQC will use the data as part of its new surveillance system when assessing risks at hospitals, together with other data such as mortality rates and never events.

The survey, which will grow into the most comprehensive ever undertaken, covers around 4,500 NHS wards and 144 A&E services. It allows hospital trusts to gain real time feedback on their services down to individual ward level and increases the transparency of NHS data to drive up choice and quality.

Responding to the survey data, Greg Dix, Director of Nursing at Derriford Hospital said: “Improving patient experience is a key priority for the Trust. The FFT forms part of our wider patient experience strategy which is driving improvements in patient centred care at the Trust.

“The Friends and Family Test provides a mechanism to identify poor performances and encourage staff to make improvements where services do not live up to the expectations of our patients.

“A score of -100 could reflect a very low response rate rather than a poor patient experience. We are working to increase awareness of the FFT with patients in order to increase the number of responses."

“The most valuable feedback we receive is through patient comments as these specifically identify areas of concern for patients as well as areas where patients feel we are performing well.

“There are many ways for patients and their carers to tell us how we are doing such as patient surveys and through our Patient Advice and Liaison Team. Actions have been put in place to increase our FFT response rate and we will be further analysing the FFT rate and comments to understand areas for improvement.”

The launch of the FFT has been strongly welcomed by the Government. The Prime Minister said, in a statement:

"I am determined to give patients a far greater voice within the NHS as a way of highlighting the best and worst of care within our hospitals.

"With the friends and family test, we now have a single measure that looks at the quality of care across the country.

"I want the NHS to put patient satisfaction at the heart of what they do and expect action to be taken at hospitals where patients and staff say standards are not good enough."

However the Patients Association expressed reservations:

"Asking patients whether or not they would recommend a hospital or ward is not straightforward," said Katherine Murphy, its chief executive.

"If patients want to be honest and they give a less favourable answer they fear retribution.

"Healthcare is complex and no one wants to be ill or in hospital or indeed recommend a hospital. Asking this one question at a given time will not address some of the systematic failures in the NHS – other issues need to be addressed as well, staffing levels and skills mix. If it highlights an area of poor care we welcome it, but where problems are highlighted who is going to address this?"

Tim Kelsey, NHS England’s National Director for Patients and Information, said: “From this first publication, we can see a significant and real variation in the quality of customer service across the NHS. There are home truths here and everyone will expect those Trusts who have large numbers of their patients choosing not to recommend their services to respond as quickly as possible.

“It is important, however, this early data is treated carefully. Low response rates can have a dramatically disproportionate impact on scores.

“As more and more patients respond, the data will become more and more robust. Just as important is the additional information given around the chosen score, as this can identify the care, the staff, the processes that make a real difference to patients.”

The health secretary, Jeremy Hunt, called the FFT an "historic moment" for the NHS.

"This simple survey will give us the information we need to celebrate the best in our NHS and root out poor care," Mr Hunt said.

"By making these ratings public we're giving patients the power to choose the best place for their care – and driving other hospitals to raise their game."

The Friends and Family Test survey and results can be found on the NHS Choices website.

Derriford Hospital results and feedback

Derriford Hospital's Emergency Department has an FFT rating of 62 with a response rate of 9.8% (against a target of 15%).

Through FFT, Emergency Department patients commented:

“I was seen within 1/2 hour of entering A&E by triage nurse, then staff nurse and doctor thoroughly questioned and blood test, ECG etc. in a very professional manner at all times. Only hitch was a two hour wait for blood test results but Dr kept us informed twice regarding delay.”
“I was treated extremely well and efficiently at the A&E dept. I was given an idea of how the wait would be which was very useful, the staff were excellent, thank you.”
“Very prompt and comprehensive service. Friendly nurse and good experience.”
“I felt that my visit took much too long as I was seen in triage and had an x-ray done in 30 minutes approximately and still did not come out of the department until three hours had passed. I feel that this could be cut down a bit.”
“I was treated courteously. However I waited for nearly an hour for x-ray results. A&E was not very busy I felt I had been forgotten about.”

The hospital's inpatient areas have an FFT rating of 65 with a response rate of 12.2% (against a target of 15%)

Through FFT inpatients commented:

“The staff have been very friendly and helpful”
“I am very impressed with the facilities, treatment and compassion of all staff.”
“Suffice to say I have no complaints only praise for all staff and nurses on Stonehouse ward the cleaners, also keep clean and tidy desk. I was very satisfied all round and I have nine and a half out of 10. I can't give 10 or else there would be no room for improvement.”
“The ward nurses were very nice and it was clear they were very busy. When I was discharged there was no number given if I had any problems, questions or worries. After asking for stronger pain relief I had to wait an hour then I asked again as I didn't want to feel a burden”
“Due to the doctors busy schedule I left without my discharge noted. However this was not a problem for me. I felt the ward Drs were under a lot of pressure to be in several places at once.”