No one-size-fits-all feedback strategy
It’s fascinating sitting across the worlds of local government and health at the moment to see two parallel – yet completely separate – debates on how to measure the experience of those who use our services.
In local government, the sweeping away of Comprehensive Area Assessments and central inspections and targets has taken with it the Place Survey we’d come to know and love. Many authorities will continue to use it, but in different formats, with different sample sizes, and using different questions.
Great for localism, but tricky for comparison – particularly in a new world where the Local Government Association is arguing on behalf of the sector that we can manage our own performance. Through LGInform, the LGA is bravely trying to plug the gap; but already – and inevitably – hitting difficult issues about what to include (e.g. from the really valuable information that comes from Residents’ Panels).
Meanwhile, the NHS is moving in a different direction. Nationally mandated surveys of patients and staff have been run consistently and systematically for years. Huge (open) data sets allow statistically significant comparisons over time and between Trusts. And the new Department of Health Outcomes Frameworks (which cover social care as well) will drive a huge expansion in the recording, analysis and comparison of the real outcomes of healthcare (around the positive measures of quality of life, rather than the traditionally negative measures of death rates) as measured by patients themselves, rather than their doctors. This is genuinely exciting stuff from a public policy point of view.
But the bigger debate around experience measures in the NHS at the moment is about the so-called ‘Friends and Families Test’.
Originally developed in the US by the management consultancy giants Bain and Co, this has been around for many years in the private years – touted as the single most important measure for any company. It asks the simple question: “Would you recommend this product/service to your family and friends?”. And from April 2013, it’s coming to a hospital near you (apparently following a direct instruction from Number Ten). But the NHS isn’t (yet) the private sector; patients don’t (yet) have complete choice about where to go for operations; and those of us in need of healthcare wouldn’t really recommend to any of our family and friends that they put themselves in the same position.
So it will need to be introduced and interpreted with care; but where it is, it has the potential to add a useful additional insight into our understanding of patients’ experience of our health service – and so, how we might improve it.
All of which has led me to think about how we might introduce a similar test in local government. Would you recommend your council to your family and friends? Your street cleaner? Your waste collection service? Your local library? Are these meaningful questions; and as managers of these services – or as politicians – would this information be useful, and could we act on it?
I’m not (yet) convinced; and like most of our more traditional survey questions, the answers would only be useful if we can compare them over time, or with others. And only in the context of the much richer data we get from Residents’ Panel, social media and the continuing hard work of our councillors in speaking directly to residents to gain their views. Not easy to capture on LGInform, I fear…
Daniel Ratchford, chief executive, Quality Health