Scottish Inpatient Patient Experience Survey 2014 Volume 1: National Results

11. Results - Person Centred Questions

Summary

• Collectively the findings relating to aspects of person-centred care were mixed. Patients were more 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.
• Patients tended to be less positive about the extent to which their personal preferences were taken into account and their involvement in decisions about care and treatment.

Introduction

11.1. 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'^[25]

11.2. 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.

11.3. A number of person-centred questions are reflected across the questionnaire 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

11.4. 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. There was high agreement that doctors and nurses listened to patients if they had concerns (90% for both doctors and nurses) and that doctors or nurses talked to patients in a way that helped them understand their condition and treatment (90% and 84% respectively).

11.5. As in previous years, an area where patients were less positive was around staff talking in front of them if they were not there: one in 10 patients indicated that doctors talked in front of them as if they were not there.

11.6. Another aspect of communication where patients were particularly negative was around being kept informed about the time to wait to see a doctor or nurse in A&E: nearly one in four indicated that they were not kept informed, while 33 per cent suggested they were kept informed 'to some extent' and 44 per cent they were 'completely' informed.

11.7. An area for improved communication for those undergoing surgery is informing patients about how they would feel following their operation: only 3 out of 5 patients indicated that staff 'completely' provided information on this, with the remainder indicating that this happened 'to some extent' (27%) or not at all (12%).

Treated with compassion and understanding/personal preferences

11.8. Patients were generally positive about the way they were treated by staff, with 74 per cent of patients indicating that staff 'always' treated them with compassion and understanding during their stay, while 23 per cent indicated this was the case 'sometimes'. However patients tended to be less positive about the extent to which their personal preferences were taken into account: less than two thirds (64%) indicated that the things that mattered to them were 'definitely' taken into account, while one third felt that this was only 'sometimes'.

11.9. Patient were positive about being able to spend enough time with the people that mattered to them, with 81 per cent indicating that they were able to do so 'completely' and 15 per cent 'to some extent'.

Involvement in care

11.10. A key aspect of person-centred care is patient and family involvement in decisions about care and treatment. Around 4 in 10 (39%) patients indicated that they were not always involved as much as they wanted to be in decisions and a slightly larger proportion of patients (44%) 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

11.11. Taken together these findings are broadly similar to those from the recent Health and Care Experience 2013/14^[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.

11.12. 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.

11.13. 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.