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Hospital patients reveal the ups and downs of NHS in biggest survey

Independent, The (London), May 14, 2008 by Jeremy Laurance Health Editor

The biggest survey of patients admitted to hospitals in England has found a chasm separates the best NHS trusts from the worst.

On key measures of performance, including cleanliness, mixed-sex accommodation and the quality of food, patients' experiences differed dramatically depending on where in the country they were treated.

The variations are striking enough to suggest urgent action is needed by some trusts to improve their service, according to the Healthcare Commission, the NHS watchdog that ordered the survey.

The findings show that 77 per cent of patients rated their overall care as excellent in the best performing trust - the Robert Jones and Agnes Hunt Orthopaedic Trust in Oswestry - while only 24 per cent did so in Ealing hospital, the worst performer.

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In all, 76,000 in-patients were surveyed at 165 hospital trusts and asked to answer 72 questions about their experience. The results, released on the commission's website, enable patients to see the comparative scores for each trust for the first time.

Anna Walker, the chief executive of the commission, said: "The Government has made it absolutely plain that it wants the NHS to listen to the view of patients and respond to their concerns. That is why this survey is so important. It gives the most comprehensive picture available of how patients feel about NHS hospitals and, importantly, it allows comparisons between trusts across the country."

The findings show marginal overall improvements in some areas; quality of care, quality of food and waiting times - and marginal reverses in others; the availability of nurses and levels of cleanliness.

But it is the scale of the differences between trusts that is worrying. Ms Walker said: "There are striking variations in performance in key areas such as providing single-sex accommodation and giving people help when they need it. Those performing poorly must learn from those who perform well."

On mixed-sex wards - a key area of complaint for patients - the survey found one in four (24 per cent) said they had to share a room or bay with patients of the opposite sex when first admitted but that fell to one in 10 for those whose admission had been planned.

Commenting on the survey, the Health minister, Ann Keen, said: "The wide variation in patient experience across the NHS is unacceptable. Where hospital trusts and primary care trusts know that they have more to do, we have asked them to set specific local improvement goals. This commitment is in the operating framework for the NHS next year to ensure that it is at the top of their agenda. The NHS should be in no doubt about how seriously we take this issue."

Dominating the tables of survey results are small specialist trusts providing care in cancer, heart surgery, brain surgery and orthopaedics, which consistently outrank the rest on a range of measures.

At the bottom of the tables, the names of certain trusts also recur, though those are less easy to group together. The survey exposes the difference between good and poor management. A well-run trust can be sensed by patients the moment they step through the entrance - from the attitude of staff, the speed with which they are attended to, and the respect they are shown.

Managers are likely to protest that, in setting small specialist trusts against big district hospitals, the survey does not compare like with like. It is unfair, they may say, to contrast the 230-bed Robert Jones and Agnes Hunt Orthopaedic Hospital in Oswestry, Shropshire, with the 1,000-bed Norfolk and Norwich University hospital in Norwich, which it narrowly beat to top position for the quality of its overall care.

As a survey of patients' experiences, the findings are subjective and impressionistic and are not a complete measure of the quality of clinical care. But they provide an insight into what matters to patients - the customers of the NHS - and they form an important part of the drive to strengthen the patients' voice in healthcare.

Hospital patients reveal the ups and downs of NHS in biggest survey

Independent, The (London), May 14, 2008 by Jeremy Laurance Health Editor

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