Results from over 83,000 responses to the NHS inpatient survey allow for a comprehensive evaluation of people’s experience of hospital care in 2015
In such trying times, is it possible to improve patient experience? Can an NHS that is struggling to manage the fallout from the junior doctors’ contract dispute and to provide healthcare to an ageing population on a challenging budget provide high quality, person-centred, coordinated care? The results from the 2015 inpatient survey, suggest that despite all the problems facing the NHS, it is doing better than some may expect in the aspects of care most valued by patients, as outlined in Picker Institute Europe’s eight principles of person centred care.
Despite the fractious climate, it seems that the inpatient experience has, in many areas, improved between 2014 and 2015. Some of these positive increases could be interpreted as a reflection of public support for junior doctors, but questions unrelated to medical staff have also seen positive changes since 2014, with questions on the cleanliness of both hospital wards and bathrooms seeing significant increases.
Generally, NHS inpatients feel that they can trust the doctors and nurses that care for them. The majority of patients (82 per cent) said they always had confidence and trust in their doctors (up from 80 per cent in 2014), and 79 per cent reported the same for their nurses (up from 74 per cent in 2006 and 2011). Similarly, 84 per cent of patients said they were always treated with respect and dignity (up 3 per cent points since 2014 and 5 per cent points since 2006) and 80 per cent said they were always well looked after (up 3 per cent from 2014).
Communication between patients and hospital staff also appears to be improving. Most patients (71 per cent) reported that when they asked an important question of a doctor or nurse they “always” got an answer they could understand – this is up from 69 per cent in 2014 for both doctors and nurses. This is encouraging, but leaves room for improvement: and 30 per cent of patients reported that they often or sometimes had members of staff telling them different things.
41 per cent of patients were not told about side effects related to their medicine (up from 40 per cent in 2014)
Sharing important information with patients helps them to be involved in their care and 77 per cent of patients said that they received the right amount of information about their condition or treatment when they were in A&E. This is up 3 per cent points from 2014, although 9 per cent of patients still receive no information.
However, despite the numbers of patients reporting that they felt they had been properly informed about their care, only 60 per cent said that they were definitely involved in decisions about their care. This is a significant improvement from the 57 per cent recorded in 2014 and 53 per cent in 2011, but still leaves two in every five patients wanting to be more involved. Involving patients is crucial if care is to be truly person centred, so clearly there is more work to be done in this area.
Discharge is still one of the most problematic areas for inpatients. A little over half (56 per cent) of patients felt involved in their discharge from hospital, a minor increase from the 2011 figure of 55 per cent.
Information about problems to watch out for after leaving the hospital is not being properly communicated to patients – 41 per cent of patients were not told about side effects related to their medicine (up from 40 per cent in 2014) and 35 per cent of patients reported that they were not told about danger signals to watch out for after leaving hospital (up from 34 per cent in 2014).
When you consider that an effective person centred service is continuous and takes a balanced approach to the delivery of care both within and outside hospital walls, there is still more to be done on improving the inpatient experience
One in five patients (20 per cent) stated that they did not get enough support from health or social care professionals after they were discharged from hospital and the proportion of patients who had hospital staff discuss whether they needed any further health or social care services after their discharge has declined since 2014 (83 per cent, down from 85 per cent).
When you consider that an effective person centred service is continuous and takes a balanced approach to the delivery of care both within and outside hospital walls, there is still more to be done on improving the inpatient experience.
Understanding people’s lifestyle needs and building a robust home treatment plan around them are key to supporting recovery, preventing hospital readmissions, and to minimising the already long list of issues facing the service. In such difficult times, such positive improvements are much needed and a reflection of how much can be achieved when the service pulls together and listens to its patients.
In addition to the national results discussed here, there are local results for every acute trust in England. I strongly encourage trusts to use their local results as a guide to pinpointing which areas they most need to improve.
Rory Corbett is a research associate at Picker Europe