Care Quality Commission
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MORE PATIENTS SAY HOSPITAL WARDS AND BATHROOMS ARE CLEAN, FINDS MAJOR SURVEY

But new regulator urges hospitals to tackle persistent problems in areas such as help with eating and involvement in decisions

Significantly more patients have rated their hospital wards and bathrooms as “very clean” and more have noticed doctors and nurses washing their hands between patients, the Care Quality Commission (CQC) said today (Wednesday).

The CQC, the new health and social care regulator, is publishing results from the sixth national inpatient survey, carried out by 165 acute and specialist NHS trusts in England.

Participating were over 72,000 people who stayed at least one night in a hospital during summer 2008, making this one of the biggest surveys of the experience of NHS hospital patients. The survey is co-ordinated by the Picker Institute.

The 2008 survey results overall show significant improvement in the experience of patients in key areas relating to infection control.

But the survey highlights persistent problems in important aspects of care. Despite some improvements, the NHS must do more to ensure hospital food is consistently of good quality and that patients are sent copies of letters between hospitals and GPs.

Performance remained poor in other key areas such as help with eating, mixed-sex accommodation, involvement in decisions about care and answering call buttons.

Cynthia Bower, CQC Chief Executive, said: “We want to ensure that the voice of patients rings loud and clear in every NHS trust. We are passionate about this and make no apologies for demanding high standards in this area. We expect trusts to be interrogating these results and asking themselves how they can improve.

“It’s great to see patients noticing improvements in cleanliness and hand washing. There are now real signs that the NHS is beginning to get to grips with infection control – it’s important that trusts keep the momentum going. Our survey of NHS staff suggests important improvements in this area and our inspectors say more trusts have infection control systems in place. Critically, rates of MRSA and Clostridium difficile are now falling.

“However, patients are clearly highlighting some persistent problems, in particular in some of the basics of care such as help with eating and involvement in decisions. It is a great shame that the NHS has not managed to get a stronger grip on these issues when patients have been highlighting them for so long. As the regulator, we will be doing more to ensure people’s views have more clout.”

Patients and the public can access the results for their trust and see how it compares to other trusts on the CQC website at www.cqc.org.uk 

Key findings include:

Cleanliness (questions 22 & 23): In 2008, 95% of patients described their room or ward as “very clean” or “fairly clean”, up from 93% in 2002. There has been an improvement in the percentage of patients describing their room or ward as “very clean”, up from 56% in 2002 and 53% in 2007, to 60% in 2008.

Ninety-one per cent of patients said their toilets and bathrooms were “very clean” (52%) or “fairly clean” (39%), up from 88% in 2002.

Doctors and nurses washing or cleaning their hands (questions 32 & 37): Since the question was first asked in 2005, there has been continued improvement in patients saying that as far as they knew, doctors and nurses washed their hands between touching patients.

In 2008, 74% of respondents said that, as far as they knew, doctors “always” washed or cleaned their hands between touching patients, up from 67% in 2005. Eight per cent said doctors did not wash their hands, although this is down from 12% in 2005.

Similarly, 76% said nurses “always” washed or cleaned their hands between touching patients, up from 69% in 2005. Only 4% said nurses did not wash their hands, down from 7% in 2005.

Quality of food (question 26): Since 2002, there has been improvement in how patients rate food. In 2008, 57% of patients rated the food as “very good” (21%) or “good” (36%), up from 53% in 2002. In 2008, a further 30% rated the food as “fair, however 14% said it was “poor”.

Help to eat meals (question 28): Of those patients who said they needed it (30%), 18% said they did not get enough help from staff to eat their meals. This is an improvement since 2007 when 20% said they did not get enough help, but no change from 2002 (18%).

Involvement in decisions about care (question 39): Fifty-two per cent of patients said they were “definitely” involved as much as they wanted to be in decisions about their care, up from 51% in 2007 but down from 53% in 2005. One in ten patients still say that they were not involved as much as they wanted to be, the same as in 2005.

Mixed-sex accommodation (questions 14 to 19): Of those patients whose admission was planned (not admitted through the emergency department), 10% said they shared a sleeping area with a member of the opposite sex when first admitted and nine per cent said they shared when they were moved to another ward (no change since 2007). Among patients admitted as an emergency, 29% said that they shared a sleeping area with members of the opposite sex when first admitted (no change from 2007) and 13% when they moved to another ward, an improvement from 15% in 2007.

Thirty percent of all respondents said that they shared the same bathroom or shower area as members of the opposite sex, no significant improvement from 2007.

Patients receiving letters sent between hospital doctors and GP (question 68): Fifty-seven per cent of patients still say they don’t receive copies of letters sent between hospital doctors and their GPs. Although this represents progress on previous surveys (down from 65% since the question was first asked in 2005) it remains an area needing improvement.

Noise at night (question 20 & 21): Thirty-nine per cent said they were bothered at night by noise from other patients, up from 37% since the question was first asked in 2005. The proportion bothered by noise from staff (21%) shows no improvement on 2007 and compares with 18% in 2005.

Answering call buttons (question 47): There was no improvement from previous surveys in the length of time patients waited for staff to answer call buttons. In 2008, 17% said the bell was usually answered “right away”, 39% said it took between one and two minutes and 28% said it was usually answered within three to five minutes. However, 15% said they usually waited longer than five minutes and 2% said the call button was not answered at all.

Choice (questions 10 & 11): More patients said they were offered a choice of hospital admission dates (30% compared with 27% in 2007) and 80%, reported that their admission date was not subsequently changed by the hospital, up from 79% in 2007 and 78% in 2002.

Delays in discharge (questions 58 & 59): The percentage of people who said their discharge was delayed continued to rise, from 38% in 2005 to 40% in 2008. Of those who waited, 21% waited for longer than four hours. Waiting for medicines remained the main reason for delay.

Patients being asked to give feedback (question 72): In 2008, 9% said they were asked while in hospital to give their views on the quality of their care, up from 7% in 2007.

Complaints (questions 73 & 74): The proportion of people who said they wanted to complain about their care in hospital increased from seven per cent in 2007 to eight per cent in 2008. There was also an increase in the proportion who could recall seeing posters or leaflets in the hospital explaining how to complain, up from 37% in 2007 to 38% in 2008).

Respect and dignity (question 69): There has been an increase in the proportion of people who said they were “always” treated with respect and dignity, up from 78% in 2007 to 79% in 2008. Eighteen per cent said they were “sometimes” treated with respect and dignity and three per cent said they were not.

Ratings of overall care (question 71): The percentage of respondents rating their overall care as either “excellent”, “very good” or “good” has increased from 92% in 2007 to 93% in 2008. This includes 43% who rated their care as “excellent”, up from 38% since the first survey in 2002.



Notes to editors

What we are publishing:

- National briefing outlining significant trends and issues

- Tables of national results with comparisons to previous years and highlighting changes that are statistically significant

- Results for each trust under the ‘Find care services’ search tool on the CQC website, identifying where a trust did ‘better’, ‘worse’ or ‘the same’ as other trusts, for each question and groups of questions.

- Reports for each trust comparing their results to all other trusts

As usual, data from the survey will be deposited in the UK Data Archive at the University of Essex.

To get the results for your trust, go to: http://2008ratings.cqc.org.uk/findcareservices/informationabouthealthcareservices/overallperformance.cfm 

Enter a postcode or organisation name, select the trust then scroll down to ‘‘What patients said about this trust’ 
 

 

 


 

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