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03rd September 2015

Friends and Family Test (FFT) for your dental team

Friends and Family Test (FFT) for your dental team

If following the introduction of the Friends and Family Test in April 2015, your practice is one of the many who have been delighted to find how highly their patients rate their experiences of care at your practice; have you taken the next logical step, and given your team the chance tell you how they rate their experiences as a team member at your practice?

Regulation 18 Staffing - (2)(a) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 (Part 3) highlights the need for employers to provide a arrange of team support measures. To deliver on this, leaders and managers need insight of their team’s perceived needs, so that they can take steps to ensure they are equipped to deliver continuously improving patient care. The Friends and Family Test for patients has proved to be an effective improvement tool, which can now be extended to ensure that the practice’s investment in providing excellent care for patients is matched by its investment creating an equally caring working environment for its team. Although there is not currently an official obligation to undertake a team FFT, practices that do so are sending out a clear message about their commitment to their team and patients.

NHS England is the driving force behind FFT, and their jurisdiction extends only to practices with an NHS contract. Even so, there are undeniable CQC compliance advantages for private practices if they choose to gather the same type of information from their patients and team, taking a lead from this example of good practice.

Asking the Questions

Just like the patients’ version, the team members FFT should give participants an opportunity to respond to the classic FFT questions. The team FFT should ask a mixture of fixed-response and ‘free text’ questions, with participants responding to the fixed response question using a response scale, ranging from 'extremely unlikely' to ‘extremely likely’.

Extremely likely Likely Neither likely nor unlikely Unlikely Extremely unlikely Don’t know


These results should be viewed as a signpost to further questions to define why the response was awarded – and what it means for the practice, its team and patients. The real strength of the FFT is the rich source of data highlighting strengths and weaknesses which will be available for making practice management decisions.

Practices should provide at least one free text follow-up question after each FFT question, to give respondents an opportunity to provide more detailed feedback about their organisation.

The questions could be presented in the following order and format:

Q1 We would like you to think about your recent experience of working here. How likely are you to recommend this practice to your friends and family when they need care or treatment?


Extremely likely Likely Neither likely nor unlikely Unlikely Extremely unlikely Don’t know


Q2 What is the main reason for the answer you have chosen?

Q3 How likely is it that you will recommend this practice to your friends and family as a place to work?


Extremely likely Likely Neither likely nor unlikely Unlikely Extremely unlikely Don’t know


Q4 How could we improve this workplace?

By using the results from this test – alongside other sources of staff and patient feedback and intelligence – the FFT will help to celebrate and build on what is working well and to quickly tackle areas in need of attention. The experience of patient FFT so far tells us that many issues once identified can be solved easily. If left unidentified they would have the potential to make a significantly negative impact on the patient experience. It is reasonable to assume that the similar benefits can be secured from the staff FFT.

Causal Links

The importance of the team Friends and Family Test is the causal link between the level of team motivation, the team’s level of job satisfaction and positive patient experiences. Research has shown there is also a causal relationship between staff engagement, working conditions, levels of absenteeism and staff turnover, as well as patient satisfaction and safety. The more engaged staff members are, the better the outcomes for patients – so it is important that the team voice is strengthened, as well as the patient voice. The staff FFT results should be used alongside the patient FFT results and other local intelligence to drive improvement, working in partnership with local staff-side representatives.

Respecting your team’s rights

It is essential that the team FFT be conducted in such a way that confidentiality is respected and given high priority. When carrying out their team FFT, practices will need to ensure compliance with the Data Protection Act (1998). The responses must not be presented or published in a way that allows individual members of staff to be identified. Practices will implement the survey in a way suited to the needs of the practice, but must be mindful of the legal obligation to honour anonymity and/or confidentiality.

Glenys Bridges – QCS Expert Dental Contributor

Topics: Dentists

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