Scottish Inpatient Patient Experience Survey 2014 Volume 1: National Results

5. Results - Care and Treatment

Summary

• Overall, patients responded positively to questions regarding their care and treatment. Where comparable, results had either stayed the same or improved from the previous survey.
• This is reflected in patients' overall rating of care and treatment, which rose by four percentage points from the 2012 survey to 89% positive.
• The least positive findings related to involvement in decisions about care and treatment. A significant number of patients were either not involved in decisions as much as they would like or felt that the people that mattered to them (e.g. friends and family) were not involved as much as they would like.
• 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 rating

5.1. Survey respondents were asked to provide an overall rating of the care and treatment that they received. 89% of respondents said that their treatment and care was either excellent or good, a four percentage point increase since the previous survey. Positive results for NHS Boards varied between 81% and 99%.

Chart 6 overall rating of care and treatment (%)

Care and treatment

5.2. Survey respondents were presented with a number of statements covering their health and treatment and asked the extent to which they agreed with them (Table 5).

5.3. The results for these statements were very favourable, with even the lowest ranked statement receiving a response of 85% positive. Six of the statements were comparable with the previous survey results and these had either grown more positive or stayed the same.

5.4. In each of the three questions regarding help from staff (around eating and drinking, going to the bathroom / toilet and washing and dressing), performance had improved. Most notably the question relating to help with eating and drinking shows a large improvement from previous surveys, rising by 16 percentage points since 2012. For the remaining two questions on help going to the bathroom / toilet and help for washing or dressing, there were smaller but still considerable rises (6% and 5% respectively).

5.5. Improvements on these three questions were seen across many Boards but were particularly high in several NHS Boards.

5.6. The results for care and treatment also showed an interesting contrast for the two statements relating to privacy. Patients rated privacy 'when being examined or treated' most positively of all seven statements (94% positive). However privacy when their condition and treatment were being discussed was rated seven percentage points lower at 87% positive.

5.7. This difference has been evident in even greater degrees in previous surveys^[8][9],. The discrepancy could be down to the fact that the standard method of creating privacy - drawing a sheet drawn around the bed - may effectively block patients from sight but does little to stop other patients from overhearing any discussions going on within.

Table 5 Summary of care and treatment questions (%)

Involvement with care and treatment

5.8. Patients were asked the extent to which they were involved in decisions about their care and treatment.

5.9. 3% of patients noted that they had not wished to be involved in decisions about their care and treatment

5.10. Of those that did want to be involved:

• 61% were definitely involved as much as they wanted to be
• 32% were involved to some extent
• 7% had not been involved

5.11. This suggests that a large proportion of patients (39%) were not involved as much as they wanted to be.

5.12. A similar question was asked regarding the involvement of friends and family in decisions about care and treatment. There was a similar pattern in responses. Although a larger proportion of people did not need the people that matter to them to be involved (33%), amongst those that did want them to be involved:

• 56% responded that the people that matter to them were 'definitely' involved as much as they had wanted them to be
• 33% responded that they had been involved 'to some extent'
• 11% responded that the people that matter to them had not been involved.

5.13. In both aspects therefore, a significant proportion of patients did not receive the involvement of themselves or the people that matter to them that they would have liked. In both cases the bulk of these had involvement 'to some extent', suggesting that the patient and those close to them are not being removed from the decision making process completely. However, the responses still indicate that more could be done to ensure that patients and those close to them are more fully involved in decisions about care and treatment.

Care Taken

5.14. This year patients were asked for the first time whether staff took adequate care when carrying out physical procedures.

5.15. Eighty per cent of patients felt that the staff 'definitely' did take adequate care. The remaining respondents were made up of 17% who felt adequate care was taken 'to some extent', and 4% who felt that adequate care was not taken. The responses suggest that more could be done to ensure that staff consistently take adequate care when carrying procedures.