the test has been criticised on a number of grounds. in february 2014 dr neil bacon, chief executive of iwantgreatcare, denounced the implementation of the test, in particular nhs england’s refusal to enforce standardisation of methodology to ensure the data could be trusted and truly competitive. research for the care quality commission carried out by the picker institute in 2012 concluded that the test was “not appropriate for use in an nhs setting”. one of the aims of the test is said to be to help patients make informed choices about healthcare providers (though many patients are in no position to make such a choice) and providers are given a rating score on the nhs choices website. however no explanation is provided about what this rating means. when tested on a group of undergraduate students none were able to accurately understand the meaning of the test headline score.