NHS has a 'way to go' to meet patient expectations on quality of care

Privacy and dignity, hygiene, and food quality need to improve, according to 2016 NHS Adult Inpatient Survey

Despite some of the highest satisfaction scores to date, hospitals across the country still have a way to go to raise the standard of buildings and ward spaces, according to the results of the 2016 NHS Adult Inpatient Survey.

Despite a decline in the overall quality of key aspects of care, issues such as whether patients were treated in same-sex accommodation, how clean wards were, and the quality of food appear to have improved.

When questioned on privacy and dignity, 91% of patients said they were admitted to a ward or bay which was single-sex. 86% said they had separate toilet and shower facilities.

Reporting on this issue was made mandatory by the Department of Health as part of a drive to enhance privacy and dignity.

The survey highlights declines in patients' experiences of involvement in their own care and in co-ordination when leaving hospital and this is a concern

Under the scheme, NHS trusts or private health organisations treating NHS patients are fined £250 for every person not treated in a same-sex environment.

This means that on a four-bed ward, even if there are three men and one woman, the trust has to pay the fine four times over.

The fact that 9% of people are still being treated on mixed-sex wards, and 14% do not have their own shower and toilet facilities is an issue estates and facilities managers will need to take action on.

Commenting on the cleanliness of rooms and wards, there has been a steady increase in the proportion of people who consider them to be ‘very clean’, at 72%, the same figure as in 2015.

Data for toilets and bathrooms followed the same trend, with 64% describing them as ‘very clean’, and 31% as ‘fairly clean’ in 2016.

But this still leaves room for improvement, with hospital cleaning teams forced to look at ways to improve standards.

Other areas of hygiene, such as whether patients were given enough help from staff to keep themselves clean, are also covered by the survey.

On this question 72% answered ‘yes’, 20% said ‘yes, sometimes’, and 8% answered ‘no’.

This was the first time this question had been covered by the survey, so will prompt action from trusts in order to show an improvement in 2017.

When asked about the quality of hospital food, in 2016 24% rated food to be ‘very good’, 27% said food was ‘fair’ and 12% said quality was ‘poor’.

This is an area that has garnered attention over the past few years, with a new legal obligation announced by the Government in 2014 aimed at stamping out the significant variations at hospitals across the UK.

The quality of food is still an issue for some patients

In addition, only 65% of patients said they received enough help from staff to eat their meals, showing a need for more support, particularly among older patients.

Other areas covered in the survey included the response of staff to patient call bells, which showed that 49% of people had to wait longer than two minutes, more than last year (47%) and when the survey began in 2006 (43%).

But most of the action points for hospitals are around care and treatment, with the number of people ‘definitely’ involved in decisions about their care falling to 56% having increased steadily from 52%-59% between 2011-2015.

In addition, only 38% of respondents stated they were ‘definitely’ able to find someone on the hospital staff to talk to about their worries and fears, significantly lower than results from previous years.

And patients were also less likely to report positive experiences of leaving hospital than in last year’s survey.

In 2016, only 38% of respondents said that medication side effects to watch out for had been ‘completely’ explained to them, a 2% drop from the year before, again reversing improvements achieved in recent years.

This year’s findings also suggest that patients are having more difficulty in accessing support from health and social care services.

Commenting on the results, Jenny King, chief research officer at Picker, which developed and co-ordinated the survey on behalf of the Care Quality Commission (CQC), said: “From our research we know that communication, involvement, and continuity of care are all critical aspects of person-centred care.

“Results continue to show that patients value NHS staff and report good communication in some area, which is positive to see.

“Nevertheless, the survey highlights declines in patients' experiences of involvement in their own care and in co-ordination when leaving hospital and this is a concern. “

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