As I was going through the Edinburgh Waverley station, I saw a notice that Waverley station is the only station in the world named after a novel, also there were some philosophical quotes by Sir Walter Scott. In my mind it somehow transported me to a strange mystical place with wizards and witches and fire breathing dragons, and of course, the fiery dentists. Below is the conversation from my head, but, if it all looks a bit surreal, I blame it fully on the Waverley station :)              wizard 

The wizard: The NHS is bringing out a patient feedback mechanism it calls Friends And Family Test, or FFT for short. It consists of a specific single question; with the wording: “We would like you to think about your recent experiences of our service. How likely are you to recommend our dental practice to friends and family if they needed similar care or treatment?” The patients provide answer on a six point scale (choice of one from six options): Extremely likely, Likely Neither Likely nor unlikely, Unlikely, Extremely unlikely and Don’t know.

This question is then followed up by a free text question (i.e. patients are asked something for which they can input their opinion in a text box, rather than needing to choose from a selection of responses). A practice can ask anything like Why have you given the above response? Or, What can the practice improve? Or, What do you like about the practice? etc.  Then provide a free text space underneath for patients to provide their responses…

The practice then needs to compile all the results and submit it to the NHS every month, as well as publish the results locally (e.g. by putting results on the practice website, displaying on the noticeboard in the practice   waiting room etc.)

The submission to the NHS is only required for the FFT recommendations scores, i.e. how many people would ‘Recommend’ or ‘Would not recommend’ the practice; the free text answers do not need to be submitted to the NHS, the practice should make sure this feedback is taken into account.

The opportunity to provide this feedback needs to be available to all patients.

The patients should get the chance to remain anonymous. 

The Wizard: If you are not based in England, or if you do not treat any NHS patients, you don’t need to be bothered at all. This requirement is applicable to the NHS Dental Contracts in England (it has been in operation for Hospitals and GP surgeries already). If you do have NHS patients, you need to be compliant as this is a legal requirement from 1st April 2015 for all NHS dental practices in England.

The Wizard: Right, perhaps the quickest way would be to put paper forms or cards in the reception area with these questions on it. You could also think about posting them to patients after their appointments. Unfortunately this wouldn’t be the cheapest or the easiest, because NHS needs the question to be asked immediately or within a recent time frame (like within 24 or 48 hours) of the appointment taking place, and they want all patients to be given the opportunity to be asked and respond, which means you can’t do a survey annually, it has to be ongoing. Plus, NHS is also moving towards achieving a consistent ratio of responses (like the similar drive in other areas such as hospital A&E and Maternity wards etc.) to get a certain number of feedbacks as percentage of total numbers. This means Your receptionists would need to constantly ask every one to fill it in (quite difficult at busy times- also quite a challenge to keep staff motivated to keep asking on an ongoing basis). Given that most patients are in a hurry to get back to their work or home, many of them might not stop and respond. The practice team would have to input all the results into computer and compile the FFT scores, because it needs to be submitted to the NHS on monthly basis You would also need to print it out monthly to display in the practice and / or put monthly results on your website (a bit of a challenge if you are not a techie yourself). Normally, patients coming out of the surgery are in a hurry to get back to work or home, the ones who tend to stop and fill up feedbacks may sometimes have good things to say, but quite often they have a gripe…. Over time your practice may accumulate a lot more negative feedbacks, it starts to skew the results negatively because the positive feedback majority’s voice isn’t included, – it is certainly not a fair reflection of the hard work of the practice team- a bit demoralizing if you ask me. You could put a little IT form on your website, however, that means patients would need to go to your website and fill it up (assuming they know your web address and remember to do it. Mind you, you would be filtering out some people who don’t have internet access (that’s a big No No with the NHS who wants access for all). For these reasons, paper based forms or just the web form are not the easiest or most hassle-free way, so I won’t recommend them.

The Wizard: Well, If you must put it that way- I prefer to call it educating , awareness raising and helping out. Anyway, I am suggesting a solution that facilitates the dental practices in compliance with the Friends and Family Test, in an easy, quick and hassle-free way. I call it “Solve your FFT requirement with one click”. Basically, you (the dentist) click a link, a software automatically installs on your computer. In the evening, it checks all the patients that came to the practice from your Practice Management System, it then automatically sends them an email with a request to provide FFT feedback. The computer system automatically compiles all the results, which means you or your staff don’t have to battle with Excel formulas. It creates monthly reports ready to submit to the NHS with a click of a button. It also creates a score in the form of a monthly achievement certificate that you can print and display in your practice. You also get pretty charts and graphs in the reports to see how many patients have responded, you can display the responses split by demographic segments (eg. Male/Female, age brackets etc.).

The Wizard: In that case your receptionist should be asking and collecting patient email addresses. It is a good business practice, as it would benefit the practice by enabling you to send additional messages and promotional offers to the patients (huge savings in postage costs). In addition, you can install a separate plug-in we provide that alerts the receptionist if the incoming patient does not have email address on practice record, or if their Post code or Date of Birth is missing- or if practice needs to get their consent for marketing communications. I call this plug-in Rapport (did you get it, from the French Rapporter meaning relation, connection, to bring back) it comes at a small monthly subscription cost, you should definitely check it out (Rapport link)

The Wizard: I am glad you asked, it would indeed work with the major practice management solutions in the UK. It works with Carestream Dental (CSD) R4 and R4 Plus, Software of Excellence (SoE) Exact, iSmile, Pearl, and a few others I can’t remember the names of, I will ask my apprentice to send you the list by a pigeon, I do know the list is ever expanding and the service can be provided to over 90% of UK dental practices.

The Wizard: Aha, you think everyone wants to get as much gold coins as possible….Well, the best thing about our system is, this solution is totally Free, as in Free for Ever; not a trial or 3 or 6 months free, or free with reduced functionality; but fully functional solution free for the practice for as long as you need it.

The Wizard: You are quite sceptical my friend. There is no catch. It is like- what do you call that TV service-…. ah yes, the Sky Movies Pack; they give you the super duper premium bundle for free for 3 months, then if you want to continue, at your choice, you pay for the additional movie channels. We also have similar package, called PatientConnections that we would provide free for 3 months. PatientConnections enables feedbacks, e-complaints management, actions taking on the collected feedbacks, as well as digital and social marketing for your practice. Our hope is that some of the practices using FFT and PatientConnections would like it enough to stay with it, after the 3 months free service, at your choice and discretion you can continue with PatientConnections subscription, However, it is totally the practice’s choice. If you don’t take up the service, the FFT service continues on without any obligation. We are able to do it for free because we have been providing feedback services for many years now through PatientConnections (last year we processed over 38,000 feedbacks). The infrastructure is already in place, so it doesn’t cost us that much (at least for now) to add the services of FFT on top of it. At a later stage, with a lot of practices signing up, to cover the additional costs we might get some sponsors interested to support the initiative, at that stage we would consider adding their sponsorship messages to the certificate that is displayed in the practice waiting room- any income generated from that would be shared with the dental practice- thus it can become an income generation tool for the practices.

The Wizard: Well, first of all, any change takes time, it’s never wise to leave things till the last moment. However, there is a hidden opportunity in here. If you start now, you would have a couple of months to get your internal house in order, to streamline your operations and procedures to make sure majority of patients are selecting ‘Extremely Likely’ for you. This is very important, the way NHS scoring works, ‘Extremely Likely’ and ‘Likely’ options are counted as recommendations, the scoring process ignores ‘Neither Likely Nor unlikely’; and rest of the options are counted as Not Recommended (‘Unlikely’ and ‘Extremely Unlikely’). The effect of this method is that it increases the extent to which scores will be adversely affected by respondent choosing options other than the top two choices “Extremely Likely” and “Likely” (check out the FFT Calculator to understand the calculations process better). It is therefore important to organize yourself, your team and streamline your operations in order to get maximum number of ‘Extremely Likely’ and ‘Likely’ recommendations on the NHS FFT. Comes April 2015, by that time, if 99% or 100% patients are recommending your practice on the NHS Friends and Family Test, imagine what would happen when the NHS publishes these results on its websites like NHS Choices; this would act like a huge big advertising slogan with national exposure, your practice would be among the very few with very high ratings (like 99% or 100%) of recommendation rate from the patients, that would help generate new leads and instill confidence in patients (NHS sites have a lot of credibility and weight in influencing future patients to become your customers). You can simply convert this legal requirement- a chore- into a massive advertisement and marketing opportunity for your business growth.

The Wizard: Ah… Good, so you were paying attention. Yes, no system can cover 100% population (although with increasing trend of smart mobile phones ownership and over 95% of UK households connected to the broadband, the email communications through mobile and the Internet is increasing significantly). It has to be a mix of different options. With our system you get a free app for iPad (working with iOS, which means it can also run from an iPhone) as well as an Android app (allowing it to run from android phones or numerous tablets running Android)…. btw, the android tablets are a bit cheaper than iPads as there is more choice and variety available, so well worth considering (check out these links). When patients are coming out of the surgery, they can provide their feedback through the tablets. We also have a mobile form that can be accessed by scanning a QR code, I think this method would be more popular with youngsters (in my time we used to play with our wands, now kids play with these mobiles and console thingamajigs). Some of my apprentices are working on additional mediums such as the audio system alternative for the visually impaired, a multi lingual mechanism for people whose first language is not English, a very visual Icon and Video based mechanism for people with learning difficulties, so hopefully we would have all the bases covered. Finally, we can put paper based forms, for the few people who only want to use pen and paper. In this case (and hopefully these would be very few), these results can be quickly input by a practice team member into an especially provided web form. Results from all of these different streams would be aggregated and compiled in one central score and reports are submitted to the NHS and published locally.

The Wizard: Not really, it is a done through a bunch of formulas, however, it is a chore and needs to be done every time (it is boring). Have a look, I done a worked example here. Plus, you can use my handy magical web based Friends and Family Score calculator, simply input your own values, it does the math for you. Click here for the handy FFT Calculator you can use to find your own results

The Wizard: I am indeed glad to hear that. In essence this free and fully automated service means peace of mind for dentists and compliance with the regulations, trust me, you would have happier and relaxed practice team when they don’t have to do this stuff manually. Getting started with this solution is easy, simply fill up the form on the right panel and submit, we will help you with the process and send you the information, just follow the instructions, it is as easy as taking a tooth out, or making a magic concoction to straighten all your teeth. If you do get in trouble, note the phone number and give me a call, I will get one of my able apprentices to help you out.
OK. Adios my friend, So long, see you later…. Abracadabra…. Swish…..KabooOOOm!