Scottish Inpatient Patient Experience Survey 2014 Volume 1: National Results

1. Executive Summary

Background

1.1. Over 21,000 patients took part in the fourth national inpatient patient experience survey. The survey included a range of questions covering topics such as accident and emergency, care and treatment, staff, leaving hospital and care and support at home.

Patients reporting a more positive experience

1.2. Overall, patients reported a more positive experience than the previous survey, with 'overall' ratings improving for all but one section of the survey (care and support services after leaving hospital), which itself stayed the same.

Overall questions	2014 per cent positive score	Change from 2012
Accident and emergency	87	+4
Admission to hospital	83	+2
Hospital and ward environment	88	+8
Care and treatment	89	+4
Staff	91	+4
Leaving hospital	79	+4
Care and support after leaving hospital	83	+2

1.3. It is worth noting that there have been methodological changes to the survey, chiefly the shortening of the sampling window. However, exploratory analysis found that any effect of this was not statistically significant. These results are therefore likely to demonstrate genuine improvement in patients' experience.

Improvement in experiences of admission to hospital and in A&E

1.4. It is encouraging that patients were more positive about overall admission to hospital and about the care and treatment they received in A&E. However, the results show that more could be done to keep patients informed about the length of time to be seen by nursing or medical staff: 23 per cent of patients were not kept informed about how long they would have to wait.

Patient rate the hospital and ward environment more positively

1.5. There were considerable improvements in patients' rating of the overall ward and hospital environment. This improvement was seen across a number of NHS Boards and in some areas the rises were considerable. Nevertheless, a sizeable proportion of patients still found noise at night and food/meals to be problematic.

Encouraging results for staff

1.6. As in the previous survey, staff received the highest overall rating of all survey sections.

1.7. The statements that received the most positive findings for staff related to confidence and trust in the doctors and nurses treating them (both 91% positive) and whether both doctors and nurses washed their hands at appropriate times (91% and 93% positive respectively).

1.8. There were also particular improvements in the questions relating to nurses' knowledge of and explanations around patients' condition and treatment.

1.9. There were notable improvements in each of the three questions regarding help from staff: washing and dressing; going to the bathroom/toilet; and eating and drinking. In particular, the latter is now no longer one of the most negatively answered questions in the survey following a 16 percentage point rise.

1.10. Although patients were typically positive about the staff that they did encounter, around one in ten (9%) respondents felt that there were 'rarely or never ' enough nurses to treat them.

Leaving hospital the lowest ranked section

1.11. As in previous surveys, patients' departure from hospital continues to be viewed less positively than other aspects of their inpatient experience. Whilst still reasonably high (79% of patients rated it positively) , this area has the lowest overall rating of the aspects of care covered in the survey.

1.12. One potential explanation for the low relative rating may come from the finding that delays appear to be a problem for patients: two in five (39%) felt that they were delayed on the day that they left hospital. The most common reason for this was a delay in getting medication, which accounted for 55 per cent of delays. Indeed one of only two questions to have got worse since the previous survey was the statement 'I did not have to wait too long for my medication'.

1.13. Whilst there is considerable and understandable focus on delayed discharge from hospital, it is interesting that survey respondents were more likely to respond that their stay in hospital was too short rather than too long (8% vs 4%).

Questions on patient safety added to the survey

1.14. A range of new questions were introduced into this year's survey relating to issues around patient safety.

1.15. The survey found that around one in five patients (19%) felt that they had experienced harm or injury relating to their inpatient care such as infections, bed sores, reactions to medications, or falls.

1.16. Seven per cent of patients felt that they had experienced a clinical error during their stay in hospital, the most common being 'delayed or incorrect test results'.

1.17. The survey results further suggested that where patients felt that clinical errors occurred, they were not always dealt with to patients' satisfaction. In over a third of instances (36%) patients reported that staff did not discuss the error with them and in 40 per cent of cases patients were not happy with how the errors were dealt with.

1.18. There was also a specific question relating to drips and needles in patients' veins. This found that one in four patients felt that either: their drip was not checked regularly enough; their drip was not changed when required; or their drip was not removed quickly enough.

1.19. In all these patient safety matters it is worth noting that these results reflect the perceptions of the patients and are not formal assessments from health professionals.

Patient Centred Care

1.20. Collectively, the findings relating to aspects of patient-centred care were mixed. Patients were more positive about everyday aspects of patient centred care such as the way staff treated and listed to them, and the explanations provided about their care and treatment.

1.21. However, the results suggest that more could be done to take account of what matters to patients and involve them, and those that matter to them, in decisions about their care and treatment.

Board and hospital results available

1.22. The results presented in this publication focus on the national picture. Reports for individual NHS boards and hospitals are available at: http://www.careexperience.scot.nhs.uk/