Ensuring that people have a positive experience of healthcare is a key outcome for the NHS, alongside clinical effectiveness and safety. The NHS Patient Experience Framework outlines the elements which are critical to patients’ experience of services, such as access to care, respect and dignity, and continuity of care.
The NHS Constitution pledges to “encourage and welcome feedback on your health and care experiences and use this to improve services”. One of the ways that people can feed back is through national patient experience surveys. Information from these surveys enables us to understand what service users think about their care and treatment, and to track the quality of care over time.
This QualityWatch update uses data from national patient surveys to compare the experience of different NHS and social care services. Overall, access to GP services has worsened, experience of inpatient services has improved, and satisfaction with adult social care services has remained stable. In general, people report their experiences of children and young people’s services and maternity services more positively than their experiences of emergency departments and community mental health services. Unfortunately, there is limited data available about patients’ experience of community services.
Below is a summary of our patient experience indicators, with links to more detailed content and analysis.
Overall experience
- Parents with a child who had been admitted to hospital tended to rate their child’s overall experience highly, with over 80% of respondents rating their child’s experience as ‘8’, ‘9’ or ‘10’ (very good).
- Only 52% of Community Mental Health Survey respondents rated their overall experience of NHS mental health services in the last 12 months as ‘8’, ‘9’ or ‘10’ (very good), and 10% rated their experience as ‘2’, ‘1’ or ‘0’ (very poor).
- Adult inpatients’ overall experience has improved over time, with the proportion of survey respondents rating their experience as ‘8’, ‘9’ or ‘10’ (very good) increasing from 67% in 2012 to 73% in 2017. However, overall experience declined slightly to 71% in 2018.
- The proportion of GP Patient Survey respondents who had a good overall experience (‘very good’ or ‘fairly good’) decreased from 88% in 2012 to 85% in 2017. In 2018, 84% of patients had a good overall experience and this declined slightly to 83% in 2019.*
- Service users’ satisfaction with adult social care services has remained stable over time, with 65% of respondents ‘extremely or very satisfied’ in 2017-18.
- Between 2012 and 2019, the proportion of patients who had a good overall experience (‘very good’ or ‘fairly good’) of NHS dental services increased from 83% to 85%.
Confidence and trust in clinicians
- Over 82% of Maternity Services Survey respondents ‘definitely’ had confidence and trust in the staff caring for them during their labour and birth. This contrasts with 69% GP Patient Survey respondents who ‘definitely’ had confidence and trust in the healthcare professional they last saw or spoke to.
- 6% of Emergency Department Survey respondents who had attended type 1 departments did not have confidence and trust in the doctors and nurses examining and treating them.
Respect and dignity
- 8% of Community Mental Health Survey respondents felt that they were not treated with respect and dignity by NHS mental health services in the last 12 months.
- The proportion of Adult Inpatient Survey respondents who felt that they were ‘always’ treated with respect and dignity while they were in hospital increased slightly from 78% in 2009 to 80% in 2018.
Patients' involvement in decisions
- In 2018, 76% of Maternity Services Survey respondents were ‘always’ involved enough in decisions about their care during labour and birth.
- Only 54% of Adult Inpatient Survey respondents and 53% of Community Mental Health Survey respondents were ‘definitely’ involved as much as they wanted to be in decisions about their care.
- One in 10 Adult Inpatient Survey respondents and Emergency Department Survey respondents were not involved as much as they wanted to be.
Medication side effects
- A higher proportion of Emergency Department Survey respondents were told about medication side effects to watch for compared to Adult Inpatient Survey respondents.
- In 2016, 44% of Adult Inpatient Survey respondents and 37% of Emergency Department Survey respondents said that they were not told about medication side effects to watch for when they went home.
Access to GP services
- The proportion of patients who found it easy (‘very easy’ or ‘fairly easy’) to get through to someone at their GP surgery on the phone fell from 81% in 2012 to 68% in 2019. Those who found it ‘not at all easy’ increased from 5% to 11% over the same time period.
- In 2019, one third of patients stated that their appointment took place ‘on the same day’ as initially trying to book, but one quarter said that it only took place ‘a week or more later’.
- Continuity of care in general practice has worsened over time. Between 2012 and 2017, the proportion of patients who ‘always or almost always’ saw or spoke to the GP they prefer decreased from 42% to 33%. And between 2018 and 2019, the proportion fell from 26% to 24%.*
Carers’ views of social care quality
- In 2018-19, 39% of carers were ‘extremely’ or ‘very’ satisfied with the support or services they and the person they care for received from social services, but 7% of carers were ‘extremely’ or ‘very’ dissatisfied.
- This contrasts with 43% of carers who were ‘extremely’ or ‘very’ satisfied in 2012-13, and 4% who were ‘extremely’ or ‘very’ dissatisfied. However, the results are not directly comparable.
Mixed-sex accommodation breaches
- The number of occurrences of unjustified mixing of genders in sleeping accommodation decreased by over 90% between April 2011 and August 2012. Following this, the number of mixed-sex accommodation breaches remained low at less than 500 breaches per month, until 2016 when they began to increase again.
- In June 2019, there were 1,363 mixed-sex accommodation breaches, which is equal to 0.8 breaches per 1,000 finished consultant episodes.
* Note that these results from the 2018 and 2019 GP Patient Surveys are not directly comparable with previous surveys. This is due to changes in the questionnaire and the inclusion of 16-17-year-olds. Not all time trend data was affected at a national level.