From X to why?

However it still falls well behind the genius of the creators of ITV’s X Factor who, by naming the show as they did, are able to conveniently ignore musical and vocal ability and instead say they are judging “X”. By its very nature “X” is indefinable, so they can promote and highlight those who make good TV rather than actually possess talent. Is the generic boyband more accomplished musically than the vacuous girl group or that quirky one who plays his own guitar? Who cares! It is about getting viewers.

Whilst placing ability in deference to popularity in music/entertainment is irritating, it is ultimately harmless. The same cannot be said however in healthcare provision. Clinical competence should be of prime importance. I raise the point because next April the NHS’s Friends and Family Test is to be extended to dental practices, on hearing this I wondered what exactly patients will be giving feedback on.

I first became aware of the FFT when taking my father into hospital after a fall a few months ago. We sat in the waiting room, my blood-covered father groggy and in pain, my mother worrying sick and desperately trying to will the clock forward, and my own attempt at ‘positive calmness’ dying a slow and painful death. Then I happened to glance up and see a sign asking if I would recommend the A&E department. Recommend an A&E department? Speaking objectively, I can definitely say it is not the best family day out I’ve ever had!

Despite being able to joke about it now there is a serious point to be made. If someone is to rate experiences of a healthcare service, what exactly would they be judging? An indefinable X factor? The friendliness of staff? The waiting time? The diagnosis and treatment? A trip to A&E can be a hugely emotional time for patients, are they necessarily in the best position to objectively rate staff friendliness or waiting times? Every second you are kept before being seen by a doctor can seem an age! And with regards to diagnosis – as lay people who are the patients to judge that? In my father’s case we were extremely happy because he was able to come home the same day, but we have no authority to say medically whether that was the right or wrong decision – so it will be interesting to see what can actually be learned from the FFT responses. Then of course a more fundamental question about the Friends and Family Test is - why is it necessary? After all, don’t we already have something similar in place… simply whether someone actually recommends their friends and family to a practice? Isn’t that just the market? To combat my cynicism and to explain the reasons behind its introduction to dentistry, NHS England’s Samantha Riley looks at the subject in some depth on page 32 of this issue.