First-ever patient survey of children and young people reveals problem areas

Mixed reaction from first Care Quality Commission inpatient and day care survey of children aged young people

Children and young people have been asked for their views on hospital treatment and the patient environment as part of a new poll aimed at improving services across the country.

For the first time, patients aged between eight and 15 have been surveyed by the Care Quality Commission (CQC) to gauge the standard of inpatient and day care at 137 acute trusts.

Carried out last year, the questionnaire covered everything from the quality of services and staff involvement to the overall patient environment.

Patients and families have a right to be involved in decisions about care, but too often, young people and their families are not given this opportunity. This has to improve if the NHS is to call itself a truly person-centred service

And the results revealed that, from a poll of almost 19,000 young patients and their parents, the vast majority have had good experiences overall. 87% of children and 88% of parents gave an overall rating of seven or higher out of 10, comparing favourably to an equivalent figure of 84% in the 2014 national survey of adult inpatients.

The first time children and young people’s feedback has been taken into account, the poll also showed NHS staff were generally good at making patients feel cared for and well looked-after.

However, by contrast, poorer ratings were afforded to three key areas of care: communication, involvement and care co-ordination. 43% of children and young people aged 12-15 did not feel that they were fully involved in decisions about their care or treatment, and more than one in five young people and parents did not feel that staff always listened to them.

Alongside this, over a third of parents felt they were not always encouraged to be involved in decisions about their child’s care and treatment, and 37% of children and young people said they were not fully aware of what would happen after they left hospital.

In terms of the physical environment from which services are delivered, the poll showed that 97% of those questioned were treated on dedicated children’s wards. 89% of patients felt safe on the wards at all times, and 67% thought the wards were ‘very clean’. However, 28% described them as ‘quite clean’, and 2% said they were ‘not very clean’. 80% said there was enough appropriate equipment on the wards and necessary adaptations had been made.

There is still some way to go on the standard of food, with only6 36% of children aged 0-7 liking the food on offer. In the 8-11 age group, 45% of patients said they liked the food, with 41% of the 12-15 age band giving the same answer.

The CQC report states: “It is encouraging that most children and young people feel safe while in hospital and that parents and carers found that inpatient and day case environments were clean. However, it is not acceptable that some children have received care and treatment in environments that are not age appropriate.

“1% of children stayed on an adult ward for most of their stay while in hospital, while only 10% of 12-15 year olds stayed on an adolescent ward. Children’s wards are usually designed to meet the needs of toddlers and children.

“Children must also be treated using appropriate equipment or adaptations that are suitable for their individual or special needs, and their age. Trusts need to review the results of this survey carefully and consider how they can improve the facilities to ensure that patients with special and individual needs are cared for in an environment that is appropriate for them. “

Five trusts were singled out in the report for getting ‘worse than expected’ results when compared to other trusts. They were: North Middlesex University Hospital NHS Trust, Bradnford Teaching Hospitals NHS Foundation Trust, Luton and Dunstable University Hospital NHS Foundation Trust, Milton Keynes University Hospital NHS Foundation Trust, and The Dudley Group NHS Foundation Trust.

All these trusts must review their performance to ensure they deliver a good-quality patient experience within children’s services.

The report states: “NHS England will use the results to check progress and improvements against the objectives set out in the NHS mandate, and the DH will hold them to account for the outcomes they achieve.

This demonstrates what we have long known – that children and young people are ready and able to give feedback to help hospitals measure and understand the quality of care they provide. The challenge for the NHS is to ensure that it continues to gather this feedback and use it to improve services

Commenting on the results, Dr Andrew McCulloch, chief executive of the not-for-profit patient support group, The Picker Institute, said: “Everyone using NHS hospitals deserves to be treated with care, understanding, and attention to their personal circumstances – and so it is encouraging that most young people and parents report positive experiences of care. To the credit of NHS staff, it is clear from the findings that young people in hospital are almost always treated with respect and compassion.”

But, commenting on the areas in need of improvement, he added: “Patients and families have a right to be involved in decisions about care, but too often, young people and their families are not given this opportunity. This has to improve if the NHS is to call itself a truly person-centred service.

“Today’s publication is a landmark for the NHS in how it monitors and uses children’s experiences of care. It is the first time since 2004 that a national survey has focused on children and young people, and it is important that children from the age of eight have been given the opportunity to give their own feedback. This demonstrates what we have long known – that children and young people are ready and able to give feedback to help hospitals measure and understand the quality of care they provide. The challenge for the NHS is to ensure that it continues to gather this feedback and use it to improve services.

To read the report, click here.

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