Friends and Family Test for NHS Staff

Communications Resource Pack

March 2015 (updated) Contents

2 1. About the Staff Friends and Family Test

Overview

The purpose of the Staff Friends and Family Test (FFT) is to enable all NHS staff to provide feedback on their organisation at least once per year. It is hoped that the Staff FFT will help to promote a cultural shift in the NHS, where staff have greater opportunity and confidence to speak up, and where their views are increasingly heard and are acted upon. Some fantastic improvements have already been driven through the patient FFT, simply from organisations listening to, and acting on, feedback from their patients.

There is good evidence that the more engaged staff members are, the better the outcomes for their patients and the organisation generally. It is therefore important that the staff voice is strengthened, as well as the patient voice. The Staff FFT is a channel for organisations to do this.

NHS England will review the Staff FFT after the first year of implementation to understand which approaches have worked most effectively in terms of giving staff a voice and driving improvements for both staff and patients.

NHS staff have the opportunity to answer two FFT questions:

“We would like you to think about your recent experience of working in …

 How likely are you to recommend to friends and family if they needed care or treatment?

 How likely are you to recommend to friends and family as a place to work?”

Organisations can deliver the Staff FFT using a variety of methods, or via existing staff feedback channels. They just need to make sure there is a free text option under each question to give staff the opportunity to expand on their chosen response.

A proportion of staff should have the opportunity to provide their feedback via the Staff FFT in quarters 1, 2 and 4, with all staff having the opportunity at least once per year. Organisations can provide their staff with the opportunity to respond more frequently, if they wish.

It is essential that the Staff FFT is conducted in a way that confidentiality is respected and given the highest priority. Staff giving feedback will need to be re- assured that their responses will be handled confidentially.

The Staff FFT is not intended to replace the annual NHS staff survey; it is designed to complement the survey and provide a more up to the minute picture of staff experience. The annual NHS staff survey remains a valuable tool, providing more detailed information about staff experience, whereas, the Staff FFT provides a regular ‘temperature check’ in the periods between the annual survey.

3 The real power of the Staff FFT is the free text comments which give organisations quick and honest feedback from staff about what is working well in the organisation and what could be improved.

2. Key messages

 The Staff FFT gives all NHS staff the opportunity to provide feedback about their organisation.  This is an opportunity for staff to say what they think.  The Staff FFT is available to all staff at least once a year.  Giving staff the opportunity to complete the FFT should lead to service improvements which will benefit both staff and patients.  Through the FFT, NHS staff have the opportunity to respond to two questions and give free text feedback.  The Staff FFT is confidential and staff should feel able to leave genuine feedback and their ideas for service improvement.  Organisations will provide regular feedback on the insight they get from the survey and what they are doing with the results.

3. Communications resources

Template copy for use in bulletins, newsletters and websites.

Short copy (95 words)

‘Would you recommend this organisation to friends and family as a place to work or if they needed treatment?’

Since April 2014, all staff working in [insert organisation] have had the opportunity to give their feedback via the Staff Friends and Family Test (FFT). The FFT launched in April 2013 and has been offered to patients using A&E, inpatient, maternity, GP, community and mental health services. The Staff FFT is an opportunity to give feedback which will support service improvement for the benefit of both staff and patients.

For more information on how to get involved, visit [insert channel].

Long copy (250 words)

‘Would you recommend this organisation to friends and family as a place to work, or if they needed treatment?’

4 The NHS Friends and Family Test (FFT) is being rolled out to all staff working in [organisation] so you can give feedback on your experiences. Since April 2014, all staff working in [organisation] have had the opportunity to give their feedback via the Staff FFT. The FFT launched in April 2013 and has been offered to patients using A&E, inpatient, maternity, GP, community and mental health services. The Staff FFT is an opportunity to provide feedback which will support service improvement for the benefit of both staff and patients.

Through the Staff FFT, you will be asked for feedback on your recent experience of working here in the form of two questions, both of which include free text comment boxes so that you can add more detail:

 How likely are you to recommend to friends and family if they needed care or treatment?  How likely are you to recommend to friends and family as a place to work?

We will be asking you the FFT questions at least once a year through [insert channel] and the responses you give will be treated confidentially.

We will be regularly updating you on how we are responding to the feedback you give through the Staff FFT in [insert channel] and how these are supporting developments and improvements for both staff and patients.

For more information on how to get involved, visit [insert channel].

4. Downloadable resources

To support your local campaigns, a series of resources are available for you to download and use. These include leaflets/flyers, posters and web banners. To view and download printable PDFs for these materials, go to: http://www.england.nhs.uk/ourwork/pe/fft/staff-fft/staff-fft-resource/.

If you need access to the InDesign artwork files, please email: [email protected].

5. FAQs for the Staff Friends and Family Test

Fundamentals of the Staff FFT

What is the Staff FFT? The Staff FFT is a feedback tool for staff, predominantly for local improvement work; consisting of 2 questions (with options to give free text feedback for each) through which organisations can take a temperature check of how staff are feeling. It is a quicker feedback mechanism than the existing NHS annual staff survey, and at its best will enable staff to report what is working well in their organisation and to voice any concerns they may have and for organisations to respond.

5 What is the Staff FFT for? Recent research has evidenced a link between levels of staff engagement and the quality of the patient experience. The introduction of the Staff FFT represents a commitment at a national level to amplify and strengthen the voice of people working in the NHS and to promote positive listening and learning cultures (as per Francis and Berwick), which will further support service improvement.

What exactly is the requirement? Organisations should ensure that as a minimum, all staff are given the opportunity to participate in the Staff FFT once a year. Organisations can choose which cohorts of staff participate at what point over the course of the year (in Q1, Q2 and Q4) or could give all staff the opportunity to respond in each quarter. The results should then be reported centrally in Q1, Q2, and Q4.

Organisations should ask two questions as follows (giving a free text comments box after each question):

“We would like you to think about your recent experience of working in :

 How likely are you to recommend to friends and family if they needed care or treatment?  How likely are you to recommend to friends and family as a place to work?”

Which organisations have to implement the Staff FFT? The Staff FFT guidance makes clear that, at this stage, only NHS Trusts need to implement the Staff FFT.

Is it a contractual requirement? The provision to undertake the Staff FFT is listed in the NHS standard Contract under Schedule 6G in the Particulars.

Can we ask all of our staff to do the Staff FFT in one quarter? No, we have set out a flexible approach to the Staff FFT, but it is a requirement that the Staff FFT data is collected in three quarters (Q1, Q2 and Q4).

Can we include the Staff FFT in our full/census internal staff survey? You may of course include the Staff FFT questions in your internal staff survey – but this will only meet the requirement for the Staff FFT if it is collected in line with the national guidance and is collected in three quarters (Q1, Q2 and Q4).

Can we just do Staff FFT once a year (and speak to a handful of staff in the other quarters)? The guidance makes it clear that there should be a quarterly collection and assessment of staff feedback. Organisations may choose which staff to include each quarter, but it is important that a sufficient proportion of staff are included to allow for a quarterly publication of trust data. Organisations should use the quarterly results to make meaningful service and quality improvements within the organisation, and ensure that the quarterly data can be used to assess trends and track progress over the course of the year. NHS England will also publish the

6 results for quarters 1, 2 and 4. Don’t forget that the Staff FFT can be used as part of existing quarterly engagement activities.

Development of Staff FFT

Who have you worked with to develop the Staff FFT? We have worked with representatives from provider trusts, staff side representatives, NHS Employers and academic experts in staff engagement. We also shared our draft guidance with all NHS HR Directors so that they could give us feedback on the proposed approach.

Implementing Staff FFT

How should the Staff FFT be implemented? It’s really up to the organisation. Organisations may choose to adopt a similar methodology to the patient FFT, or incorporate it into their existing staff engagement plans, if appropriate.

Can a third party supplier be used? Yes

What are the pros and cons of using a 3rd party supplier? There are multiple considerations to bear in mind – cost, resource, technical capability both in terms of survey methods and of free text analysis, ability to maintain an anonymous or confidential collection, use of existing supplier for patient FFT. Each of these considerations is likely to have a different impact on each organisation.

Can we use different methods of collection for different staff groups? Yes

How frequently do we have to ask the question? The minimum number of times staff should be invited to respond to the Staff FFT questions is once in a financial year. If organisations want to ask the question more frequently, they can.

Who should we include in the Staff FFT? One of the fundamental principles of the Staff FFT is that everyone who works in a setting delivering NHS services, or who is employed by an NHS Trust, should be included. They may not be directly employed by the Trust (for example they could be bank, agency or hotel services staff) but the principle of inclusivity remains.

Should we include our volunteers in the Staff FFT? This is a local decision, but given the amount of time and dedication given by volunteers to delivering care, we would encourage organisations to seek input from volunteers as part of the Staff FFT.

How many people should be asked each time we do Staff FFT? There is no set target for the number of staff who should respond to the Staff FFT questions per quarter, but it is important that a sufficient proportion of staff are included each quarter to allow for a meaningful quarterly publication of trust data. Each organisation might want to chunk up their staff differently, according to what

7 works best for them to support local improvement work. Depending on how the Staff FFT is being implemented, it might be easier to include everyone each time, or to have a mixture of approaches, where the Staff FFT is open for all to complete if they wish, with a particular emphasis on hearing from certain groups of staff at certain times.

Should we focus on certain staff groups? One of the principles of the Staff FFT is that it is available for all staff working in or for an organisation and all should have equal opportunity to participate. If, as part of local improvement work, an organisation wants to ask particular questions (in addition to the Staff FFT) of certain groups, or wants to focus on certain groups first as part of a phased approach, that is fine; equally, if data points to a need to carry out a more robust investigation in certain areas (as outlined in the Equality and Diversity System), that is also acceptable.

Is the Staff FFT confidential? Staff participating in the Staff FFT should be re-assured that their responses will be handled confidentially. Organisations may choose to implement the Staff FFT in a way that best suits staff and the needs of the organisation to support local improvement, but they are obliged by law to honour any statements they make about anonymity or confidentiality.

Do we need to collect protected characteristics? Whilst this isn’t compulsory, it is best practice to understand which cohorts of respondents are giving which messages, in order for local improvement work to be effective. Organisations can choose how they can best gather this information but are obliged by law to honour any statements they make about anonymity or confidentiality as part of that collection.

Does the Staff FFT include NHS Foundation Trusts? Yes, the Staff FFT does include NHS Foundation Trusts.

Reporting the Staff FFT results

What data has to be reported nationally and how often? Organisations should submit their Staff FFT data to Unify2 following Q1, Q2 and Q4. The data should consist of the number and type of responses to each question, and the number of responses per mode. The Staff FFT guidance (section 4) gives more detail.

Do we have to submit the number of people who were included in Staff FFT per quarter? No, this isn’t needed, but the number of responses will obviously be included. We will not be publishing response rates for the Staff FFT, but we will publish the number of responses along with established and existing data on workforce numbers, in order to get a sense of the size of an organisation and the proportion of staff responding to the Staff FFT.

We are planning to collect the Staff FFT data in Q3 – how do I report this so that it feeds into our national data? The results from Q3 should be included in the submission for Q4.

8 Using the Staff FFT results

Where should the results be published? Locally, organisations can publish the results where they feel most appropriate. If an organisation is considering publishing free text, consideration should be given to how respondent confidentiality or anonymity can be maintained.

How are the results presented? The results are presented nationally as a percentage of respondents who would be likely to recommend their organisation as a place to work and to receive treatment; and a percentage of respondents unlikely to recommend their organisation. The results are published on the NHS England statistical pages and on NHS Choices.

What will be published nationally? NHS England publishes the responses to both Staff FFT questions and the number of responses per Trust. Alongside the results, NHS England also publishes workforce statistics for each organisation, to give users of the data a broad indication of the levels of participation.

How will results be used? It is not the intention that the results should be used to performance manage organisations, nor compare organisations to each other. The results should be used locally to identify areas for improvement and develop associated action plans in partnership with staff side representation.

Staff FFT and other staff engagement tools

Does Staff FFT have to be used on its own? No, not if there are existing staff engagement mechanisms used on a quarterly basis to which the Staff FFT questions could be included. If an organisation wants to do this, the FFT questions should be positioned first in the larger survey.

How is it different from staff survey? The NHS staff survey is a well-established survey mechanism, from which official statistics are generated. Responses from all organisations are weighted accordingly, in order to give national figures which take account of response bias. Data from the staff survey can also be cut in different ways, allowing for analysis in different areas, for example, protected characteristics, staff grouping, organisation type etc.

In comparison, the Staff FFT is a different feedback tool; where the staff survey can be slow, the Staff FFT is fast; where the staff survey is structured, the Staff FFT finds its value in the free text comments; the staff survey is unbiased and representative in its sampling; the Staff FFT is inclusive in its approach, which may sometimes mean it is not wholly representative of all staff, but represents the views of those who participated; the staff survey is annual; the Staff FFT is an ongoing feedback tool. Given that they are different approaches, the results from the Staff FFT should be used in a different way from the results of the staff survey.

Is the Staff FFT instead of the staff survey? No – they are complementary staff feedback tools and both should be used.

9 Do we have to do the Staff FFT in Q3 if we’re doing staff survey? No – there is no requirement to do the Staff FFT if an organisation is doing the NHS staff survey in Q3.

6. Further development of the Staff FFT resources

This resource pack has been developed in discussion with some trust communication leads. We will be regularly reviewing the contents of this pack over time, so if there is anything that you would find useful to have included or good practice that you would like to share, please email us at: [email protected].