Friends and family could be just another box-ticking exercise

The friends-and-family test is intended to provide guidance for patients' loved ones, helping them choose the best hospital should they need an operation at a later date, for instance.

Based on the customer satisfaction survey known as the Net Promoter Score, used by companies including Apple, Virgin and British Airways, patients will use it from next April. Its detractors point out that a recommendation from a friend is no guarantee of good care. Harold Shipman, the serial murderer, was highly popular with his patients

According to national guidance from the Department of Health, patients will be asked: "How likely are you to recommend our ward/A&E department to friends and family if they needed similar care?"

The answers will be scored out of 10 ranging from "extremely likely" to extremely unlikely, with patients able to add comments. NHS Trusts with good scores will be financially rewarded.

Toby Knightley-Day, managing director of Fr3dom Health, who helped develop the test for the NHS, warned that it must be seen as more than just a score, and trusts must focus on the cultural and behavioural changes needed to drive it up.

But critics say the test will distract trusts from their main purpose and become another box-ticking exercise, adding to their bureaucratic burden.