The 2018 NHS Inpatient Survey, coordinated by Picker and published today by the Care Quality Commission, provides the views of more than 76,000 recent hospital patients. The results make for difficult reading for those in the health service, as there are declines across many questions and elements of care.
In some cases this year’s declines reflect a continuing trend. Waiting times before admission have continued to worsen, as have patients’ experiences around leaving hospital. In 2018, less than half of all patients (49%) said they ‘definitely’ knew what would happen next in their care after leaving hospital, and questions relating to transitions between hospitals and primary and social care all showed drops.
In other areas hard-won improvements appear to have reversed. The proportion of patients who “always” had confidence and trust in nurses (77%) and doctors (79%) both fell year-on-year for the first time since 2011, and there was a 2% point drop in patients reporting confidence in the decisions made about their condition or treatment (from 71% to 69%). One of the biggest drops was a 5% point decline in patients receiving written or printed information about their medicines – this fell to its lowest level since 2010, down to 66% from 71% in 2017.
Some of the most concerning results are around personal care and support: almost one in three patients (32%) now report not receiving enough help to wash or stay clean. Similarly, one in three (33%) did not think hospital staff did everything they could to control their pain – a figure that worsened by 2% points year-on-year. It is not just physical care that has declined, though: this year only 53% of patients said that they ‘always’ received enough emotional support in hospital, down from a peak of 57% in 2015.
Commenting on the results, Chris Graham, Chief Executive of Picker, said:
“The inpatient survey represents the voice of patients in NHS hospitals. This year, their voices raise the alarm about the sustainability of care quality in the face of mounting pressures on the health service. Whilst healthcare providers and professionals have done a commendable job of maintaining or improving experiences over a number of years with slow funding growth, that progress appears to have halted – and in some areas it may even have slipped into reverse.
“The reasons for these declines are complex and multi-faceted, but the overwhelming impression is that the pressures on the service have taken their toll. It is well known that demand has risen and that many organisations face funding challenges. Providers should be particularly concerned that recent evidence from the NHS Staff Survey has shown more staff suffering work-related stress and health problems. There is strong evidence that staff wellbeing and experiences drive the quality of patient care, and so more must be done at national and at local levels to ensure that the NHS workforce are properly resourced and supported. The Interim NHS People Plan acknowledged the issues and provides a good starting point – this must be matched by effective planning and investment.
“The NHS remains committed to person centred care, and it is vital that the safe, effective, and personalised care of patients remains the service’s highest priority. But today’s results show declines in some of the most fundamental components of personal care – including interactions with staff and support with nutrition and hygiene. It is essential that policy makers, providers, and professionals alike take urgent action on these results to arrest this decline before it can be allowed to worsen further.”
For further information about the Adult Inpatient Survey, contact firstname.lastname@example.org