A Healthcare Commission survey of hospital patients in England has revealed ‘striking variations’ in some aspects of basic care.

The research reveals gaps in performance between trusts in areas such as cleanliness, hand-washing by staff and the quality of hospital food. The views of just under 76,000 adult inpatients at 165 acute trusts were canvassed in 2007.

Nationally, more patients - 42 per cent - described their care as excellent compared with those surveyed in 2006. A total of 92 per cent rated care good, very good or excellent, but there were stark differences in performance.

Healthcare Commission chief executive Anna Walker said she was encouraged that the number of patients describing their care as excellent had increased, but added: “Those poorly performing trusts must learn from those who perform well.”

Ealing Hospital trust and Mayday Healthcare trust performed least well in the survey. Only 24 per cent of patients at both trusts said care was excellent, compared with 77 per cent at the best-performing Robert Jones and Agnes Hunt Orthopaedic and District Hospital trust in Shropshire.

Cleanliness was another area where there were stark differences in performance. Overall, just over half of patients said the room or ward they were in was “very clean” - no change from the previous year.

But while in some trusts more than 80 per cent of patients rated their accommodation as “very clean”, in others only around a third did so.

Sixty-eight per cent of patients said doctors always washed their hands between seeing patients, down from 69 per cent in 2006.

Maidstone and Tunbridge Wells trust, which was at the centre of a fatal C difficile outbreak, scored worst, with a quarter of patients reporting that doctors did not clean their hands between seeing patients.

Other areas where variation was marked included waits for hospital admission, mixed-sex sleeping areas and bathrooms, and help with eating meals. Just 19 per cent of patients said they would rate hospital food as “very good”, while 15 per cent branded it “poor”.

There was some good news, however, with more patients reporting that they had waited less than four hours to be admitted to a bed from accident and emergency.

A higher proportion - 39 per cent - said the way doctors and nurses worked together was “excellent”, up from 36 per cent the previous year.

Best and worst trusts for providing excellent care

Top 10, by % of patients rating their overall care as “excellent”

  • Robert Jones and Agnes Hunt Orthopaedic and District Hospital, 77

  • Queen Victoria Hospital foundation trust, 72

  • Papworth Hospital foundation trust, 70

  • The Cardiothoracic Centre - Liverpool trust, 69

  • Clatterbridge Centre for Oncology foundation trust, 69

  • Christie Hospital foundation trust, 68

  • The Royal Marsden foundation trust, 68

  • Walton Centre for Neurology and Neurosurgery trust, 65

  • Royal Brompton and Harefield trust, 64

  • Liverpool Women’s Hospital foundation trust, 57

Bottom 10, by % of patients rating their overall care as “excellent”

  • West Middlesex University Hospital trust, 30

  • North Middlesex University Hospital trust, 30

  • Barking, Havering and Redbridge Hospitals trust, 30

  • Maidstone and Tunbridge Wells trust , 29

  • Newham University Hospital trust, 29

  • Luton and Dunstable Hospital foundation trust, 28

  • Homerton University Hospital foundation trust, 28

  • West Hertfordshire Hospitals trust, 27

  • Mayday Healthcare trust, 24

  • Ealing Hospital trust, 24

Source: Healthcare Commission 2008

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