Scottish Inpatient Patient Experience Survey 2011 Volume 1: National Results

2 Introduction

Introduction

2.1 The Better Together Scottish Patient Experience Inpatient Survey is a postal survey, first conducted in early 2010, with the aim of establishing the experience of a sample of people aged 16 years who had a recent overnight hospital stay. The survey covers the areas of: admission to hospital; the hospital and ward; care and treatment; hospital staff; and arrangements for leaving hospital. A copy of the survey can be found in Annex A.

2.2 This report presents the detailed national findings of the second Better Together Inpatient Patient Experience Survey. Key findings are presented at national level as well as by NHS Board.

2.3 Details of the survey design, fieldwork and analysis are available in the Scottish Inpatient Patient Experience Technical Report ( http://www.scotland.gov.uk/inpatientsurveytechnicalreport).

Background to the Better Together Programme

2.4 Better Together, Scotland's Patient Experience Programme, has been designed to support NHSScotland to deliver high quality, equitable, person-centred care by focusing on improving the quality of the experiences of those people using NHS services. The programme is key to the NHSScotland Quality Strategy and provides a basis for measuring the progress against one of the six healthcare quality outcomes; Everyone has a positive experience of healthcare.

2.5 The results of this survey are used to calculate the patient experience quality indicator for the Quality Measurement Framework in addition to providing data for the national performance indicator on improving healthcare experience. The revised value based on the 2011 data of the quality indicator is presented in this report. Further information about the Quality Strategy can be found http://www.scotland.gov.uk/Topics/Health/NHS-Scotland/NHSQuality

2.6 The programme, in partnership with NHS Boards, GP practices, Information Services Division ( ISD) of National Shared Services Scotland, Scottish Government Health Directorates and other national improvement programmes and initiatives, aims to provide staff with the information, tools and techniques to embed experience into the design and delivery of continuous quality improvement and to provide a range of opportunities for patients to share their experiences of healthcare in Scotland.

2.7 The initial focus of the programme has been on three areas:

• Inpatients (reported for the first time in September 2010);
• GP services (reported for the first time in July 2010); and
• Long term conditions ^[1]

2.8 Specific areas of focus for the Better Together programme include:

• Building on and spreading existing good practice;
• Demonstrating local and national improvements;
• Contributing to measurable progress in Scotland-wide person-centred healthcare;
• Testing new approaches that use patient experience for designing and planning services and improving existing healthcare services; and
• Integrating and aligning these approaches with the other national improvement programmes and initiatives supported and informed by the Healthcare Quality Strategy for NHSScotland.

2.9 Further information about the Better Together programme and results to date from the inpatient and GP surveys can be found at: http://www.bettertogetherscotland.com.

Aims of the Better Together Inpatient Survey

2.10 The survey's specific aims are to:

a) Gain a fuller understanding of the experiences of adult patients receiving inpatient services at NHS hospitals in Scotland;

b) Provide comparable national data on the quality of the patient experience across NHSScotland;

c) Provide NHS Boards and NHS hospitals with information about areas of best practice and areas for improvement;

d) Determine the key drivers for positive inpatient experience within Scotland;

e) Explore if and how differences exist in terms of experiences between patients of different ages groups, genders, ethnic groups, religious groups, sexual orientation, and disability status;

f) Assess if and how the level of positive and negative experiences change over time; and

g) Examine whether positive experiences benefit patients in terms of their clinical outcome.

2.11 Additional topic reports will be published during the life of the programme and the first topic report to be published is "Variations in the experiences of inpatients in Scotland " which explores the variations in the experiences of different groups of patients and is based on the 2010 Inpatient Survey results ^[2].

Survey design

2.12 Minor changes were made to the questionnaire and survey materials following the first survey in 2010 and in response to feedback from NHS boards. These changes were approved by North West Ethics Committee. Details of the changes made to the survey materials are contained in Chapter 3 of the technical report.

Survey fieldwork and response

2.13 The patient sample was designed to provide results for individual hospitals as well as for the 14 NHS Boards and the National Waiting Time Centre ( NWTC) and nationally across Scotland. The survey was sent to a sample of adult inpatients (aged 16 years old or above on discharge) who had an NHS inpatient hospital stay (at least one overnight stay) between October 2009 and September 2010.

2.14 Fieldwork was undertaken by approved contractors ^[3] on behalf of NHS Boards beginning on 24 January 2011 on a rolling basis. NHS Boards started at different times; the last NHS Board distributed their surveys on 22 February 2011 and the survey closed at the end of April 2011. In total, 59,341 survey packs were sent to patients and 31,048 were returned, giving an overall response rate of 52%.

2.15 Of those patients who provided information about themselves: 7 per cent were aged 16-34, 14 per cent were aged 35-49, 28 per cent were aged 50-64, 24 per cent were 65-74 and over and 28 per cent were 75 and over; 42 per cent were male and 58 per cent were female.

2.16 In addition, 37 per cent did not have any limiting illness or disability. Also, 98 per cent indicated that they were heterosexual / straight whilst 2 per cent indicated that they were gay / lesbian, bisexual or other.

2.17 Patients were also asked to self-report their general health as good, fair or poor: 47 per cent rated their health as good, 41 per cent as fair and 13 per cent as poor.

Data analysis and interpretation

2.18 The survey data was collected and then entered by Approved Contractors. Anonymised data was then securely transferred to Information Services Division ( ISD) who carried out the analysis.

2.19 Prior to data analysis, hospitals which were identified as private using the Scottish Health Service Costs Book were excluded for the purposes of reporting national NHS results for Scotland. A total of 256 cases from private hospital were excluded from national NHS results.

2.20 In general, results are presented as the percentage of patients reporting a positive experience. The percentages are calculated excluding any patients from the denominator who did not answer the question or answered "not relevant" or "don't know". Annex B shows which answers have been classed as positive for each question.

2.21 Throughout the report, weighted percentages have been presented unless otherwise stated. Weights were applied to all cases within the data file based on the number of eligible inpatients at each hospital. This means that the contribution of each hospital to the NHS Board and Scotland results is proportional to the number of patients that were eligible for the survey. Further information on how weights were calculated and applied can be found in Chapter 8 of the technical report.

2.22 Differences from last year's results are only discussed if they are statistically significant. Further information on this is available in Chapter 8 of the technical report.

2.23 These statistics have been independently assessed by the UK Statistics Authority and are designated as National Statistics subject to meeting the requirements set out in the assessment report: http://www.statisticsauthority.gov.uk/assessment/assessment/assessment-reports/assessment-report-131---statistics-on-scottish-patient-experience.pdf

Other outputs from this survey

2.24 This report focuses on the national results for the Scottish Inpatient Patient Experience Survey 2011. More detailed results for NHS Boards and individual hospitals are available at: http://www.bettertogetherscotland.com/bettertogetherscotland/982.28.521.html

2.25 The survey asked patients if there was anything else that they would like to tell us about their experience in hospital. These comments will be provided to NHS Boards and details that could identify patients or members of staff will be removed.

2.26 For further information on the survey development, design, sampling and analysis please refer to the technical report: http://www.scotland.gov.uk/inpatientsurveytechnicalreport