Aims The Friends and Family Test (FFT) is currently used nationally in adult acute care settings, and from April 2015 it will be compulsory for all children and young people (or their parents) to be offered the question. Although the guidance suggests wording for younger patients, there is no evidence that it has been rigorously tested with them. Our research therefore explored children’s views of the FFT question including wording, response options and overall design, to propose the most suitable version for children and young people.

Methods A focus group with young patients explored views on patient feedback and different versions of the FFT. This informed the development of several child-friendly versions of the question, differing in wording and style. Eight interviews were conducted with patients at a large acute hospital trust, and their preferred wording and presentation options were incorporated into a final survey form. This was cognitively tested with twelve young patients ranging from four to fifteen years old, to ensure that questions were appropriately worded and interpreted as intended.

Results The adult question phrasing was unpopular: the word “recommend” and the response options “likely” and “unlikely” were problematic and not always understood. The phrase “if they needed similar care or treatment to me” was essential for understanding of the question. A five-scale response scale was recommended over a three-scale option as it ensured that a range of responses were used. Children preferred to feedback using an “agree/disagree” scale, and favouredimages of a monkey character over cartoons and easy-read style photos.

Conclusion This research highlights the importance of involving children and young people in the design and wording of questions to ensure that they are appealing and appropriate to them. The question form is currently being piloted with two large acute NHS Trusts using a hand-out methodology with an online option. We encourage healthcare organisations to adopt our format when implementing the FFT for their paediatric patients, since it has been thoroughly tested to ensure that it is suitable for younger populations.