NHS pressures ‘causing decline in patient experience’ – new CQC survey

Pressures within the NHS are leading to a decline in patient experience, new research suggests.

Less than half of people (48%) admitted to hospital in England rated their overall experience as nine or above out of 10, the results of the 2018 Care Quality Commission (CQC) inpatient survey show.

The proportion reporting a very positive experience has dropped from 50% in 2017 – and the figure also marks an end to the year-on-year improvement seen since 2012.

Across most other areas, responses remained static or had declined since 2017.

“While last year we reported on a system still delivering improvements in patients’ experiences despite growing pressure, this year, the improvement is not sustained,” the CQC said in its report.

“In 2018, there is a lot of evidence to suggest that pressure on the system is having a real impact on patients’ experiences of care.”

Professor Ted Baker (pictured), chief inspector of hospitals at CQC, said he was “disappointed to see the overall lack of progress”.

The CQC survey of 144 NHS acute trusts in England included more than 76,000 inpatients who stayed for at least one night in hospital during July last year.

More than a third (39%) of patients surveyed said they had to wait a long time before getting a bed, and the proportion satisfied with their wait dropped from 63% in 2017 to 61% last year.

Of the 41% of people who said their discharge was delayed in July 2018, 26% said this was by longer than four hours, compared to 24% the previous year.

Around 17% of respondents said they did not feel involved in their care, up from 16% in 2017.

The CQC said there had been no improvements in this area for 10 years.

While the majority of people reported being treated with dignity and respect (80%), this number had also decreased from 82% the previous year.

“Most people continue to report positively about their interaction with staff, reflecting the significant efforts of healthcare professionals working tirelessly to meet increasing levels of demand in hospitals across the country,” Prof Baker said.

“However, I am disappointed to see the overall lack of progress this year and that in some cases people are reporting poorer experiences, particularly around the quality of information when they were discharged and the integration of their care from different parts of the system.

“Last year’s survey showed a healthcare system still delivering improvements despite growing pressure. But this year, the improvement trend we have seen for the past six years has not been sustained.

“Staff are working incredibly hard, but it is clear we have reached a point where this alone is not enough.

“The mounting pressure on the system is having a direct impact on how people are experiencing inpatient care and the need for greater collaboration between local health and care services has never been more apparent.”

Dan Wellings, senior fellow at think tank The King’s Fund, said “today’s figures show that workforce shortages, funding pressures and increased demand for services are clearly taking their toll”.

“The majority of patients do still report positive interactions with the doctors and nurses treating them, reflecting the tireless efforts of NHS staff to maintain quality of care in difficult circumstances, but they cannot continue to act as shock absorbers for the pressures on health and care organisations,” he said.

An NHS spokeswoman said: “This survey is further evidence that in the vast majority of cases patients are happy with the care they received, but also that the NHS and its local partners need to continue to join up services around the needs of patients, as set out in the NHS Long Term Plan.

“Where experiences don’t match the high expectations people rightly have of the NHS, it’s important that they are able to feed that back so that services can learn and improve, and this survey is just one useful way they can do this.”

Copyright (c) Press Association Ltd. 2019, All Rights Reserved. Picture (c) Care Quality Commission.