National patient survey says 80% report a good A&E experience, but there are still problems with patient discharge and people waiting too long for pain relief

2 Dec 2014 12:04 PM

A national Accident and Emergency survey shows some encouraging results with almost eight out of 10 respondents saying their overall experience was good rating it seven or more out of ten and only 3 per cent of patients saying the doctor or nurse did not listen to what they had to say.

The Care Quality Commission (CQC) today (2 December) publishes results from the fifth accident and emergency (A&E) survey which almost 40,000 people took part in.

A&E is one of the eight core services that CQC inspects and rates in acute hospitals, and patients’ experiences of care are a key aspect in determining these ratings. The national findings are presented under the questions inspectors ask about A&E departments: are they safe, caring, effective and responsive to people’s needs.

The findings demonstrate that departments are largely caring, however, more work needs to be done so that services are safer, are more effective and are more responsive to people’s needs.

Caring: Most of the questions (22 out of 35) relate to ‘caring’. The results are encouraging as 79 per cent of patients reported that they were treated with respect and dignity all of the time and 75 per cent ‘definitely’ had confidence and trust in the doctors and nurses examining them. Eighty six per cent of patients said staff explained the purpose of the medication in a way they were able to understand. Just over four in 10 (41 per cent) said the side effects of their medicine were not explained to them or they were not told when they could resume normal activities (42 per cent).

Safe: Forty per cent of patients waited less than 15 minutes to speak to a doctor or nurse when they first arrived, with almost three quarters (73 per cent) waiting less than one hour to be examined by a doctor or nurse. Around four in 10 patients (41 per cent) arrived at A&E in an ambulance. Of these, around one in 10 patients (11 per cent) said they waited over 30 minutes for their care to be handed over to the A&E staff; 5 per cent experienced waiting times of over an hour. The large majority (94 per cent) of patients did not feel threatened by other patients or visitors, but 2 per cent did.

Effective: Almost eight out of ten patients (79 per cent) said they got their pain relief medication within 30 minutes, however 13 per cent of people who requested pain relief medication waited for more than 30 minutes. While 63 per cent of patients thought that staff did everything to control their pain, 13 per said that staff did not do enough.

Responsive: Two thirds (66 per cent) of patients said that their visit to the A&E department lasted less than four hours. Most patients (82 per cent) reported having enough privacy when being examined or treated. However, the figure was much lower (53 per cent) when asked about discussing their condition with the receptionist.

Commenting on the findings, Professor Sir Mike Richards, Chief Inspector of Hospitals, said:

“Overall the results of this survey are encouraging, with better results in 2014 than in 2012 despite the known increase in pressures on A&E departments.

“However, we do see significant variations between trusts. This highlights the need for all trusts to review their own results and to take action where necessary. The findings are set out in the report according to the same key questions as we use for our inspections. This will assist us in making judgments about the quality of individual A&E services.”

Further results reveal over half (51 per cent) of patients between the ages of 76-85 said that their home and family circumstances were not always taken into account as part of discharge planning.

Nationally, 22 per cent of patients did not feel staff helped to reassure them if they were feeling distressed while in A&E. Almost one third of people (33 per cent) with a mental health condition and 31 per cent who had a learning disability, said that A&E staff did not help to reassure them.

Twelve trusts achieved ‘better than expected’ results for 7 or more (20 per cent) of the 35 questions in the survey with a score. For the 2014 A&E survey, Dorset County Hospital NHS Foundation Trust, Salisbury NHS Foundation Trust and Taunton and Somerset NHS Foundation Trust have the highest numbers of ‘better than expected’ results of all trusts.

Trust name	Percentage of question scores that were ‘better than expected’	Number of questions ‘better’
Dorset County Hospital NHS Foundation Trust	69%	24
Salisbury NHS Foundation Trust	46%	16
Taunton and Somerset NHS Foundation Trust	43%	15

For media enquiries, contact 020 7448 9401, during office hours, or out of hours, contact 07917 232 143. For general enquiries, call 03000 61 61 61.

Notes to editors

The 2014 A&E survey involved patients who had attended one of 142 acute and specialist NHS trusts with a major accident and emergency department. Patients visited A&E during January, February or March 2014.
Responses were received from 39,320 people and the national response rate for the survey was 34%. In 2012 the response rate was 38%. Patients were eligible to take part in the survey if they were aged 16 years or older and were not staying in hospital at the time the patients were sampled.
The survey does not ask questions directly about aspects of ‘well led’. This reflects the focus of the survey on the experiences of patients which is based mostly around the other key questions, particularly ‘caring’.
For each question in the survey that evaluates trust performance, responses are converted into scores from a scale between 0 to 10. The higher the score the better the trust is performing.
Barnet and Chase Farm Hospitals NHS Trust has merged with Royal Free since the survey was undertaken.
Where a trust performance is compared, data is standardised the data is standardised by age and gender to enable fairer comparisons between trusts that have different population profiles.
Data is benchmarked using an expected range which is the range within which we would expect a particular trust to score. The range takes into account the number of respondents from each trust as well as scores from all other trusts so that we can say if a trust is performing better or worse.
NHS England’s guidelines say patients who arrive at A&E by ambulance should have their care handed over to A&E staff within 30 minutes of arriving at A&E.

About the Care Quality Commission

The Care Quality Commission (CQC) is the independent regulator of health and social care in England.

We make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve.

We monitor, inspect and regulate services to make sure they meet fundamental standards of quality and safety and we publish what we find to help people choose care.