Inpatient survey: Longer waits and growing worries over discharge

The major annual survey, for the Care Quality Commission, published today, found that when asked about their overall experience of care, results were broadly the same in 2016 to 2015. They were asked to rate it from 0 (very poor experience) to 10 (very good experience). The proportion saying “very good” (10) increased by 1 per cent, while the CQC said the number saying very poor (0) had seen a “significant” increase on 2015, albeit remaining at only 1 per cent. The overall picture on this question was very similar to 2015.

The results come amid the longest sustained squeeze on NHS spending in its history, and growing waits for hospital emergency and planned care.

The report published by the CQC said: “Whilst longer term trends are positive and indicate overall improvement, there are a substantial number of areas where results have declined in the last year (between 2015 and 2016). This is particularly around patients feeling involved in their care, waiting for a bed on a ward, and care after leaving the hospital.”

Details in the survey reflected some of this. The number of people saying that they felt they waited too long to be admitted to hospital increased by 2 percentage points overall, with 17 per cent of patients saying they should have been admitted “a bit” sooner, and 10 per cent saying “a lot” sooner.

Similarly there was a 2 percentage point increase in those reporting they had to wait a long time to get a bed on a ward once they arrived in hospital. This increased from 12 to 14 per cent year on year.

The survey results reflect pressure on A&E, the discharge process and in some aspects of basic care. There was a 3 percentage point increase year-on-year in the proportion saying they were not offered support after discharge despite needing it.

Twenty-one per cent of people in 2016, compared to 18 per cent in 2015, said they were not offered enough support from health or social care professionals to manage their condition after discharge.

Just over half (56 per cent) felt definitely involved in decisions about their treatment, which is 3 percentage points lower than the previous year, and just under two thirds of patients (64 per cent) said they received enough information when leaving the hospital, a decline of 2 percentage points since last year.

In a new question asked this year, only 53 per cent said they ”knew what would happen to their care” once they left hospital.

Other new questions showed nearly a third of patients (28 per cent) who needed help with washing said they were not offered it either all or some of the time.

Similarly, more than one third of those inpatients who chose to manage their own medication were not able to take it when they needed it, although the survey did not ask the reasons why this occurred.

Nuffield Trust chief economist and research director John Appleby said: “It’s worrying that they feel some more fundamental aspects of their care - such as being found a bed quickly and getting enough support when they leave hospital – have got worse in the last 12 months.

“Those perceptions are not surprising, however, given that the various targets and standards in these areas have been repeatedly missed this year across the NHS.”