Since the beginning of 2015, the Hospice has embarked on various new schemes, actively seeking the views of our patients and carers. Involving users in the development and evaluation of a service is increasingly being recognised as an indispensable means of ensuring quality healthcare provision (Help the Hospices, 2013).

The Friends and Family Test (FFT) is a well utilised healthcare measurement tool which originated in the National Health Service, asking'how likely are you to recommend our service to friends and family, if they needed similar care or treatment?’ The Hospice has favoured the FFT as it easy to manage, inclusive and has the benefit of providing real-time feedback. An innovative new role has also been created – 'Service User Engagement Co-ordinator' – to deal with rollout of the project and the collation of data. This specific role affords the Hospice the capability to implement organisational objectives on meeting the needs of our community, responding to user feedback and implementing changes as a result of this feedback.

Initial and ongoing barriers to overcome have been predominantly around gatekeeping, where patients are deemed too unwell to be capable of providing feedback. Processes to combat this include our Discharge Co-ordinator completing the FFT with patients, and using a database recording system to demonstrate to staff that 13 of the first 15 patients offered the FFT, elected to complete it.

Beginning life on our Inpatient unit, FFT has obtained 60 responses through asking patients on day 7 of their stay, as well as part of any discharge process. FFT has since evolved and is now offered within Day Hospice, Lymphoedema service and our Patient and Family Support Team. FFT has obtained the views of over 200 service users in its first 4 months of circulation.