Patient experience: do patients have confidence and trust in clinicians?

We look at how confidence and trust in clinicians has changed over time.

Qualitywatch

Indicator

Last updated: 14/12/2023

Background

Trust and confidence are key components of the clinician-patient relationship. There are many benefits that can accrue from a trusting relationship, including open communication of information, improved adherence to medical advice, improvement of health outcomes and better patient experience.

The national patient experience surveys ask service users whether they have confidence and trust in the doctors, nurses and other clinicians treating them, the results of which we explore here.


Several national patient surveys ask service users whether they have confidence and trust in clinicians. It is useful to compare people's responses to understand how patient experience varies across NHS services.

In 2020, 84% of parents with children aged 15 or under who had been admitted to hospital had the most favourable response and stated in the Children and Young People’s Survey that they always had confidence and trust in the member of staff treating their child. 81% of the 2022 Adult Inpatient Survey respondents said that they always had confidence and trust in the doctor treating them.

78% of Maternity Services Survey respondents in 2022 reported that they definitely had confidence and trust in the staff caring for them during their labour and birth. 71% of the 2022 Urgent and Emergency Care Survey respondents who had attended a type 1 department said that they definitely had confidence and trust in the doctors and nurses examining and treating them. Lastly, 64% of 2023 GP Patient Survey respondents stated that they definitely had confidence in the healthcare professional they saw or spoke to.

The differences in responses between the surveys may reflect the demographics of respondents, as well as their experience of services. For example, older people tend to respond more positively in surveys, and a higher proportion of inpatients are in older age groups compared with maternity service users. Additionally, while the most recent results for each survey are presented here, they were carried out at different times, with fieldwork for some taking place before the pandemic and some either during or after the pandemic.


Adult Inpatient Survey respondents are asked, ‘Did you have confidence and trust in the doctors treating you?’ Between 2009 and 2019, answers to this question remained largely stable. The proportion of respondents who ‘always’ had confidence and trust in the doctors treating them remained between 77% and 80%, and those who did not have confidence and trust fluctuated around 4%.

In 2020, 84% of respondents ‘always’ had confidence and trust in the doctors treating them, while 3% did not. By 2022, the proportion of respondents that ‘always’ had confidence and trust had decreased to 81%. A slightly higher record of confidence and trust in 2020 could have been due to factors related to the onset of the pandemic. These results are not comparable with the years preceding 2020 due to changes in the survey. See ‘About this data’ for more information.

The survey also asks about confidence and trust in nurses. The proportion of respondents who ‘always’ had confidence and trust in the doctors treating them is consistently slightly higher than the proportion who ‘always’ had confidence and trust in the nurses treating them (data not shown). 


GP Patient Survey respondents are asked, ‘During your last general practice appointment, did you have confidence and trust in the healthcare professional you saw or spoke to?’ The proportion of patients who ‘definitely’ had confidence and trust in the healthcare professional they saw or spoke to decreased from 69% in 2018 to 64% in 2023. The proportion who did not have confidence and trust increased from 4% to 7% between 2018 and 2023. Previous research has shown that one of the factors affecting trust in physicians is patients being given a choice of which physician they want to see. The decline in patient confidence and trust could be partly related to the decline in patients being able to see or speak to their preferred GP

About this data

These indicators draw on data from the Adult Inpatient Survey, the GP Patient Survey, the Children and Young People's Survey, the Emergency Department Survey and the Maternity Services Survey.

For each Care Quality Commission survey, two weights have been applied to the survey results data:

  • a trust weight to ensure that each trust contributes equally to the England average, and 
  • a population weight, to make sure each trust’s results are representative of their own sample and do not over-represent particular groups, such as older respondents. 

A combination of the two weights results in one single weighting which has been applied to enable comparisons between years.

The GP Patient Survey data was weighted to adjust for the differences between all patients at a GP practice and the subset of patients who actually completed the questionnaire. For more detailed information, please see the GP Patient Survey - Technical Annex.

In 2020, fieldwork took place between 2 January and 6 April. This means that some responses were collected after the Covid-19 pandemic began in England. Analysis was conducted to understand whether the pandemic had an impact on results and found that only 1.2% of responses were received after lockdown measures were implemented. Thus, the results of the survey and validity of comparisons with previous surveys were not impacted by the pandemic. 

For the 2020 Adult Inpatient Survey, participants were offered the choice of responding online or via paper-based questionnaires for the first time, and the questions, terminology and methodology used in the survey were updated. Therefore, the 2020 survey results are not comparable with previous years.

Note that data from the most recent survey publications were used for comparison. Our comparison across NHS services did not adjust for differences in survey populations; therefore, the results may not be directly comparable.

For more information please see NHS England, National Patient and Staff Surveys.

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