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Healthcare Commission highlights variations in performance, urging poorer performing trusts to learn from the best

More patients are rating the care provided by NHS hospitals as “excellent”, according to a survey published today by the Healthcare Commission (Wednesday).

In the biggest survey of patients staying overnight in English NHS hospitals, 42 percent of respondents gave their care the top possible rating, up from 38 percent in 2002 and an increase from 41 percent in the last survey.

The survey also shows that satisfaction with overall care remains high with the proportion of patients saying their care is “good”, “very good” or “excellent” at 92 percent.

But the Commission added that there were striking variations in the responses of patients at different NHS trusts, suggesting that some trusts must take more action if they are to achieve the standards of the best. For example, 77 percent of patients rated their care as “excellent” in the best performing trust, but only 24 percent in the lowest performing.

The survey, coordinated for the Commission by the Picker Institute, considered responses from just under 76,000 recent adult inpatients at 165 hospital trusts in England.

For the first time, the Commission is today releasing on its website a national overview showing the comparative scores for all NHS trusts on topics such as hospital food, cleanliness and levels of privacy.

The Commission says the results will help trusts to understand the views of their patients and respond to any concerns.

It expects NHS trusts to use the results to improve standards of care. It will also use the survey results in its assessments of NHS services, which include the annual NHS performance ratings.

The survey suggests there have been recent improvements in areas that matter to patients.

For example:
• A higher percentage of patients said they waited less than four hours to be admitted to a bed from A&E (67 percent in 2002, to 72 percent in 2006, and 73 percent in 2007);

• A higher percentage of patients said the quality of food is “very good” (18 percent in 2002 and 2006, 19 percent in 2007) although there is still room for improvement;

• A higher percentage of patients said the way that doctors and nurses work together was “excellent” (36 percent in 2006, 39 percent in 2007), while 92 percent of patients described teamwork as “excellent”, “very good” or “good”;

• A lower percentage of patients coming into hospital for a planned admission said they had shared a mixed-sex sleeping area when first admitted (ten percent in 2007, 11 percent in 2006).

But the survey also highlights variation in performance between trusts.

The Commission said this was a particular issue in areas such as: waiting for hospital admission; mixed-sex sleeping areas and bathrooms; help from staff both with eating meals and in response to call buttons; cleanliness of wards and bathrooms; hand washing by staff; the quality of food; patient involvement in decisions; and arrangements for discharge.

For example, in getting help with eating meals, at the lowest scoring trust 42 percent of patients said they did not receive the help they needed, while in the highest scoring trust the figure was three percent.

Anna Walker, the Commission's Chief Executive, said: "The government has made absolutely plain that it wants the NHS to listen to the views of patients and respond to their concerns.

"That is why this survey is so important. It gives the most comprehensive picture available of how patients feel about NHS hospitals. And importantly, it allows comparisons between trusts across the country.

"Overall, it's encouraging that a steadily increasing percentage of patients say care is “excellent”. It’s good to see advances on issues like the quality of food, waiting times, and team working between doctors and nurses.

"But the survey also shows that in some hospitals the NHS is struggling to deliver on some of the basics of hospital care. There are striking variations in performance in key areas such as providing single-sex accommodation and giving people help when they need it. Those performing poorly must learn from those who perform well.

'It's crucial that trusts take this information on board. The patient voice must be heard loudly on the boards of trusts across the country. Our annual assessment takes account of patients’ views to ensure this occurs.”

More information on the National survey of adult inpatients 2007

For more information please contact Sarah Robertson on 020 7448 9313 and out of hours on 07917 232 143.

Editor’s Notes

The term “more” in the above context refers to a higher proportion of patients compared to previous years, as opposed to a greater number of patients.
The Healthcare Commission is the health watchdog in England. It keeps check on health services to ensure that they are meeting standards in a range of areas. The Commission also promotes improvements in the quality of healthcare and public health in England through independent, authoritative, patient-centred assessments of those who provide services.

Responsibility for inspection and investigation of NHS bodies and the independent sector in Wales rests with Healthcare Inspectorate Wales (HIW). The Healthcare Commission has certain statutory functions in Wales which include producing an annual report on the state of healthcare in England and Wales, national improvement reviews in England and Wales, and working with HIW to ensure that relevant cross-border issues are managed effectively.

The Healthcare Commission does not cover Scotland as it has its own body, NHS Quality Improvement Scotland. The Regulation and Quality Improvement Authority (RQIA) undertakes regular reviews of the quality of services in Northern Ireland.