Most patients are positive about their hospital care, but too many let down by a lack of information and support when they leave

20 Oct 2021 10:09 AM

The majority (75%) of respondents in the latest national survey of hospital inpatients published by the Care Quality Commission (CQC) yesterday (Tuesday 19 October) rated their overall experience as eight or higher out of ten - with more than a third of people rating it ten out of ten.

The survey captures the views and experience of more than 73,000 people who stayed in one of 137 acute and specialist NHS trusts in England for at least one night during November* 2020.

The findings reveal that most people had confidence in the doctors and nurses treating them, felt that staff answered their questions clearly and that the hospital ward or room where they stayed was clean. However, some people surveyed were less positive when asked about the information provided to them at the point of discharge – particularly in relation to medication and how to manage their condition or access further support once home.

The survey asked people to give their opinions on the care they received, including quality of information and communication with staff, whether they were given enough privacy, the amount of support given to help them eat and drink, and on their discharge arrangements.

The adult inpatient survey has been carried out annually since 2002. In 2020 - for the first time - respondents were able to complete the questionnaire online as well as by post. This is likely to have led to the increased response rates seen from younger people (under 35) and those from Black and minority ethnic groups – both of which have been underrepresented in previous years.

New questions were also added to the survey to allow comparisons between the experience reported by COVID-19 patients and people being treated as inpatients for other conditions and significant changes were made to improve the accessibility of the questionnaire.

The responses to the 2020 survey show:

  • Most people surveyed (85%) said they had “always” been treated with dignity and respect during their hospital stay and this was the case for COVID-19 (84%) and non-COVID-19 (85%) patients.
  • The majority of respondents felt they “always” received answers they could understand when asking doctors (75%) and nurses (77%) questions about their care.
  • When asked about how clean their hospital room or ward was, 98% of respondents said it was either “very clean”, or “fairly clean” and three quarters (75%) said they “always” got the help the needed from staff to wash and keep themselves clean.
  • Two thirds (67%) said they were “always” able to get a member of staff to help them when they needed attention, but 38% said there were “never” or “sometimes” not enough nurses available.
  • Of those surveyed, 42% said did not have to wait to get a bed and 38% said that they “had to wait but not for too long”. A greater proportion of COVID-19 patients (25%) than non-COVID-19 patients (19%) stated they had to wait “a bit too long” or “far too long” for a bed after arriving at hospital.
  • Only 13% of respondents said that they had been asked to give their views on the quality of care received during their stay – with COVID-19 patients less likely to say they had been asked to provide feedback.
  • One in five people (21%) said their family or home situation was not taken into account when staff planned for their discharge. And, almost a third (30%) of people surveyed were not given any written information about what they should or should not do after leaving hospital.
  • Of those who were given medication to take home, only 28% were told about the possible side effects to watch out for and only 55% were given an explanation of how to take it.
  • Just under a quarter (24%) of respondents were not told who they could contact if they were worried about their condition or treatment after leaving hospital and 21% of people said they did not get enough support needed to help them recover or manage their condition once they were back at home.

The responses to the 2020 survey show that younger people (under 50 years old), those admitted to hospital as an emergency, and patients receiving medical treatment rather than surgery, all reported poorer than average experiences. In contrast, older people, people who were in hospital for an elective admission, and people who stayed in hospital for only one night were generally more positive about many aspects of their care. Overall, the differences in experience reported by COVID-19 and non-COVID-19 patients were minimal suggesting that care provided was consistent.

As well as a report of the national findings, CQC has published the results for each of the 137 individual trusts that took part, and a report identifying those trusts that have performed better or worse across the survey overall, so that people can see how their local services performed.

Professor Ted Baker, Chief Inspector of Hospitals said:

“The survey captures the views and experiences of people in hospital during November last year. At that time inpatient admissions were slightly lower compared to November 2019, but the number of beds occupied by COVID-19 patients was on the increase as a second wave of COVID infections began to take hold.

“Given this context and the unprecedented pressure on staff it is excellent to see such positive feedback in a number of areas. The high levels of satisfaction reported by so many people reflect the tremendous efforts of healthcare professionals on the front line and their dedication and resilience is to be commended.

“Patient feedback is incredibly important in helping shape how care is delivered and the survey results provide an incredibly useful guide to where improvements can be made. More can be done to ensure all patients are provided with sufficient information and have access support to help them recover and manage their condition outside of the hospital setting.

“I would like NHS trusts to reflect on their individual survey results to help them pinpoint what individual changes they can make to drive improvements. But it is not just hospital trusts that can take learning from the results. As pressures on services and staff continue to mount, ensuring the best possible experience throughout the entirety of the patient journey is a task that needs input from all parts of the health and care system. To this end, we must support services to continue in their efforts to collaborate locally and to build a truly integrated system approach going forward.”

The survey findings have been shared with each participating trust so that they can review their individual results and take steps to address any areas where improvements are needed. CQC will continue to use the findings as part of its wider monitoring of the quality of hospital services and to plan and target its inspections.

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Notes to editors

  • Further information about the 2020 adult inpatients survey, including the national summary of results.
  • See individual results for all 137 NHS trusts that took part.
  • The adult inpatient survey is the largest and most authoritative of its kind in England. It has been conducted annually since 2002 and is the longest running survey in the NHS Patient Survey Programme (NPSP).
  • Participating trusts drew a sample of 1,250 patients, aged 16 or over who had stayed at least one night in hospital during November 2020. * A small number of trusts with smaller patient throughput (such as specialist trusts) had to sample back to earlier months.
  • Due to the changes made to the survey methodology and sampling period, it is not possible to compare the 2020 inpatient survey findings with the findings from previous years.
  • The 2020 adult inpatient survey rolled out several new accessibility measures to ensure it followed best practice for survey accessibility. The online survey was translated into nine non-English languages and British Sign Language. Additionally, participants were able to change font size, background colour of the online survey and it was tested thoroughly to ensure screen reader compatibility. A paper Braille, large-print and easy read questionnaire were available on request.
  • The NHS Patient Survey Programme collects patient experience data across maternity, children and young people’s, inpatient, urgent and emergency, and community mental health services.

Results for the 2020 adult inpatient survey