FREE: Family Reported Experiences Evaluation


To improve care in the NHS, the experiences of patients need to be fed back to the managers organising the care and the doctors and nurses providing the care. This is difficult for intensive care units (ICUs). Roughly one-quarter of the patients die. Few survivors remember their experiences. It is therefore important for family members to provide feedback on their satisfaction with the ICU.

The FREE study wanted to establish an effective way of evaluating how satisfied family members were with the care their loved one was receiving in ICU, by testing methods of collecting information from patients and reporting it to units.


We adapted the Canadian Family Satisfaction in the Intensive Care Unit questionnaire for the UK. We checked if the questions were relevant, easy to understand and important to family members in the UK. We then invited over 12,000 family members (of adult patients staying 24 hours or more in 20 ICUs across the country) to complete the UK version of the questionnaire after their relative left the ICU.


More than 7100 family members (close to 60%) filled in the questionnaire. The results showed that the questionnaire was useful in measuring family satisfaction. We also found that family members whose relative passed away were more satisfied with the ICU than family members whose relative survived.


Our version of the questionnaire could be used to measure family satisfaction in the future. However, more work needs to be done to make sure it picks up all the important details of family satisfaction. As so many people took part, we can now bring all of their information together (such as their age and how ill the patient was) to help improve family satisfaction in the ICU.

Who led the study?

  • Professor Kathy Rowan, ICNARC
  • Dr Stephen Wright, Freeman Hospital, Newcastle


Lyes S, Richards-Belle A, Connolly B, Rowan KM, Hinton L, Locock L. Can the UK 24-item family satisfaction in the intensive care unit questionnaire be used to evaluate quality improvement strategies aimed at improving family satisfaction with the ICU? A qualitative study. J Intensive Care Soc 2020; 21(4):312-9.

Ferrando P, Gould DW, Walmsley E, Richards-Belle A, Canter R, Saunders S, Harrison DA, Harvey S, Heyland DK, Hinton L, McColl E, Richardson A, Richardson M, Wright SE, Rowan KM. Family satisfaction with critical care in the UK: a multicentre cohort study. BMJ Open 2019; 9(8):e028956.

Harrison DA, Ferrando-Vivas P, Wright SE, McColl E, Heyland DK, Rowan KM. Psychometric assessment of the Family Satisfaction in the Intensive Care Unit questionnaire in the United Kingdom. J Crit Care 2017; 38:346-50.

Wright SE, Walmsley E, Harvey SE, Robinson E, Ferrando-Vivas P, Harrison DA, Canter RR, McColl E, Richardson A, Richardson M, Hinton L, Heyland DK, Rowan KM. Family-Reported Experiences Evaluation (FREE) study: a mixed-methods study to evaluate families' satisfaction with adult critical care services in the NHS. Health Serv Deliv Res 2015; 3(45).