Scottish Inpatient Experience Survey 2016 Volume 1: National Results

Results - Person-Centred Questions

Summary

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

Where they tended to be less positive was about the extent to which their personal preferences were taken into account and their involvement in decisions about care and treatment.

Introduction

An important element of the NHSScotland Quality Strategy is to support person-centred care. This is defined as 'mutually beneficial partnerships between patients, their families and those delivering healthcare services which respect individual needs and values and which demonstrates compassion, continuity, clear communication and shared decision-making' ^{[ 24]}

The Person-centred Health and Care Portfolio has been established to support people who use services to have their voices heard, and to support health and care services to listen, learn and improve to deliver more person-centred care.

A number of person-centred questions are reflected across the survey from admission to discharge and have been reported across several areas of the report. This section considers themes arising from the person-centred questions collectively.

Communication

An important element of person-centred care is the way staff communicate with patients and their families. In the main, the findings around communication were very positive.

• 89 per cent of people felt they were listened to by doctors if they had concerns and 90 per cent for nurses
• 90 per cent of people felt doctors discussed their condition/ treatment in a way they could understand and 84 per cent for nurses

As in previous years, an area where people were less positive was around staff talking in front of them if they were not there: one in 10 ( 10 per cent) indicated that doctors talked in front of them as if they were not there and eight per cent for nurses.

Other areas where people were particularly negative about communication are:

• being kept informed about the wait to be seen by a nurse or doctor in A&E - around one in four ( 23 per cent) indicated that they weren't kept informed, 33 per cent indicated that they were informed 'to some extent' and the remaining 44 per cent felt 'completely' informed
• around three in five ( 61 per cent) felt that they were kept informed about what was happening once they had been seen by a nurse or doctor in A&E
• over one in three ( 35 per cent) reported that staff did not discuss errors with them and 44 per cent had the event discussed with them 'to some extent'

An area for improved communication for those undergoing surgery is informing patients about how they would feel following their operation:

• only two out of three people ( 64 per cent) indicated that staff 'completely' provided information on this
• 25 per cent indicating that this happened 'to some extent'
• 11 per cent indicated not at all

Treated with compassion and understanding/personal preferences

People were generally positive about the way they were treated by staff:

• three out of four ( 75 per cent) indicating that staff 'always' treated them with compassion and understanding during their stay
• while 22 per cent indicated this was the case 'sometimes'

However people tended to be less positive about the extent to which their personal preferences were taken into account:

• less than two thirds ( 65 per cent) indicated that the things that mattered to them were 'definitely' taken into account,
• while one third ( 29 per cent) felt that this was only 'sometimes'

People were positive about being able to spend enough time with the people that mattered to them

• four in five ( 84 per cent) indicating that they were able to do so 'completely'
• 13 per cent indicating 'to some extent'

Involvement in care

A key aspect of person-centred care is patient and family involvement in decisions about care and treatment:

• around two in five ( 39 per cent) indicated that they were not always involved as much as they wanted to be in decisions
• a slightly larger proportion ( 43 per cent) indicated that the people that mattered to them weren't involved as much as they had wanted

In both cases, the bulk of those not fully involved were involved 'to some extent'. However, these results still suggest that there is scope for improvement

Overall

Taken together these findings are broadly similar to those from the previous Inpatient Experience survey ^{[ 25]} and the recent Health and Care Experience 2015/16 ^{[ 26]} survey which suggest that staff are generally good at the more everyday aspects of person-centred care such as listening to patients/service users, providing appropriate explanations and treating individuals well, all of which are important foundations for person-centred care.

As in the Health and Care Experience survey, the findings relating to the involvement of patients and families in their care and taking account of what matters to them suggest that these areas are being achieved to a lesser degree.

The question of what 'matters' is open to interpretation by the survey respondent. Further investigation would be required to establish the aspects of their situation that some respondents felt were not being taken account of. The free text comments left by respondents as part of the survey may offer some insight into this and these have been provided to NHS boards, and will be the subject of a separate national report.