UK – Health-care Commission

Citation

(2005), "UK – Health-care Commission", International Journal of Health Care Quality Assurance, Vol. 18 No. 1. https://doi.org/10.1108/ijhcqa.2005.06218aab.004

UK – Health-care Commission

UK – Health-care CommissionWhat patients think about the NHS – overall “thumbs up” but patients need more information about their care

Keywords: Patients, Patient care, Decision making

Many NHS patients are not involved enough in decisions about their care and so cannot give meaningful consent to treatment, according to the Healthcare Commission in a report published in August 2004.

Over 300,000 patients were asked about their experiences in 568 English NHS trusts. Three surveys are the first of their kind – into the ambulance service, young hospital patients (under 18 years) and the mental health service. Response rates to the surveys varied from 63 per cent for the adult inpatient survey to 42 per cent for the mental health survey. This was the first survey of the mental health service, ambulance service and young patients The other two surveys – of adult inpatients and patients in primary care trusts – are carried out for the second time.

As regards all five surveys, the Healthcare Commission says it has particular concerns about information for patients and involvement of them in planning their care – especially in the services for people with mental illness. Many patients, particularly adults, are being discharged from hospital without enough information about how to cope at home.

A consistent positive theme across the NHS is the patients’ high opinion of the care they receive. They say they have trust and confidence in the clinical staff, they are listened to and they are treated with respect and dignity.

The surveys found:

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  Adult in-patients – an improvement in admission time from accident and emergency (A&E) department to a ward (only 26 per cent waiting more than four hours down from 34 per cent in 2002) but fewer people rated the toilets and bathrooms in hospitals as “very clean” (48 per cent down from 51 per cent).

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  Young patients – communication with staff was rated highly but there is still scope to improve the explanations given about procedures and the risks, benefits and expected outcomes of treatments.

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  PCTs – many more patients obtaining GP appointments within two working days (54 per cent up from 31 per cent in 2003) but one in five smokers who want help in giving up aren’t receiving it.

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  Ambulances – a very positive overall picture but one in five wanted more pain relief.

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  Mental health services – the majority of patients were positive about their care from clinical staff but they need to be more involved with decision making.

The Healthcare Commission’s Chairman, Professor Sir Ian Kennedy, said: “In general, patients have given a ‘thumbs up’ to the care they receive from the NHS. However, those patients who do not feel completely involved in decisions about their care and treatment are not able to consent to treatment in any meaningful sense. While there has been a great improvement in communication between NHS staff and heir patients there is still much to be done to ensure that patients understand the information they are given and can influence decisions. Asking patients, what they think about the care and treatment they have received is an important step towards improving care for patients in hospitals and other health services. Surveys such as the ones we publish today are vital for the Healthcare Commission to assess the performance of organisations and to monitor the action taken to address issues raised. But surveys on their own will not bring about improvements. NHS trusts need to give high priority to addressing the issues raised by patients. They must examine their own local results and plan suitable remedial action.”

The results of the survey and the patients’ experience in each NHS trust are available in detailed reports and can be found on the Healthcare Commission web site.