Patient experience is a key element of quality, along with safety and clinical effectiveness. The NHS Constitution pledges to encourage patients to give feedback on their experience and use this to improve services. The coronavirus (Covid-19) pandemic has led to considerable changes in the way care is provided, with more appointments taking place by telephone or online and increased waiting times for elective care. The care of people with long-term health conditions has been disrupted, and feedback from patients reinforces the importance of focusing on individual needs and experiences.
Data covering the impact of the pandemic on trends in patient experience is not yet available. In this QualityWatch indicator update, we’ve used data from national patient surveys to look at patient experience prior to the pandemic. All surveys included here were carried out in 2019 or earlier, except the 2020 GP Patient Survey that took place between 2 January and 6 April. However, analysis found that the results were unlikely to have been affected by the pandemic as only a small percentage of responses were received after the lockdown began. A summary of our patient experience indicators is shown below. Click on the links for more detailed content and analysis.
Patients’ overall experience of NHS and social care services
- Patients receiving cancer treatment tend to rate their overall experience highly, with 88% of respondents rating their experience as ‘8’, ‘9’ or ‘10’ (very good).
- Only 48% 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).
- The proportion of patients who had a good overall experience (‘very good’ or ‘fairly good’) of their GP surgery decreased from 88% in 2012 to 85% in 2017; between 2018 and 2020, the proportion fell from 84% to 82%.*
- Adult inpatients’ overall experience has improved over time, with the proportion of survey respondents rating their experience as ‘10’ (very good) increasing from 23% in 2012 to 28% in 2017. However, it has since decreased slightly to 27% in 2019.
- Service users’ satisfaction with adult social care services has remained stable over time, with 64% of respondents saying they were ‘extremely or very satisfied’ in 2018-19.
- Between 2012 and 2016, the proportion of patients who had a good overall experience of NHS dental services increased slightly from 83% to 85%, then remained constant until 2020 when it fell slightly to 84%.
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 65% in 2020. Those who found it ‘not at all easy’ increased from 5% to 13% over the same time period.
- Between 2018 and 2020, the proportion of patients who found it ‘very easy’ or ‘fairly easy’ to use their GP practice’s website to look for information or access services decreased slightly from 78% to 75%.*
- The proportion of patients who said that their appointment took place ‘on the same day’ as initially trying to book remained constant between 2018 and 2020 at 35%. Those who said it took place ‘a week or more later’ increased from 25% to 28%.*
- 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 preferred decreased from 42% to 33%. Between 2018 and 2020, the proportion fell from 26% to 22%.*
Confidence and trust in clinicians
- 84% of Maternity Services Survey respondents ‘definitely’ had confidence and trust in the staff caring for them during their labour and birth. This contrasts with 68% of GP Patient Survey respondents who ‘definitely’ had confidence and trust in the healthcare professional they last saw or spoke to.
- Between 2009 and 2019, the proportion of Adult Inpatient Survey respondents who ‘always’ had confidence and trust in the doctors treating them fluctuated between 77% and 80%.
Respect and dignity
- 89% of Maternity Services Survey respondents said they were ‘always’ treated with respect and dignity while they were being cared for during labour and birth.
- 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 81% in 2019.
- Between 2014 and 2019, the percentage of Community Mental Health Survey respondents who said that they were ‘always’ treated with respect and dignity decreased from 74% to 71%. The proportion who felt that they were not treated with respect and dignity increased slightly from 7% to 8% over the same time period.
Do patients feel involved in decisions about their care?
- In 2019, 81% of Cancer Patient Experience Survey respondents said they were ‘always’ involved in decisions about their care and treatment. Only 52% of Community Mental Health Survey respondents said that they were ‘definitely’ involved as much as they wanted to be in agreeing what care they would receive.
- Between 2018 and 2020, the proportion of patients who were ‘definitely’ involved as much as they wanted to be in decisions about their care and treatment during their last general practice appointment decreased slightly from 61% to 60%.*
- The percentage of Adult Inpatient Survey respondents who said they were ‘definitely’ or ‘to some extent’ involved as much as they wanted to be in decisions about their care and treatment remained stable at around 89% between 2009 and 2019.
Supporting patients to manage their long-term condition(s)
- Between 2012 and 2017, the proportion of patients who ‘definitely’ had enough support from local services or organisations to help them manage their long-term health condition(s) decreased from 54% to 51%; between 2018 and 2020, the percentage fell from 43% to 40%.*
- Only 70% of patients aged 16 to 24 ‘definitely’ or ‘to some extent’ felt supported to manage their long-term condition in 2020, compared to 84% of respondents aged 65 to 74.
- In 2018/19, a smaller proportion of people from the most deprived areas (52%) felt supported to manage their long-term condition compared to people from the least deprived areas (63%).
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.
Service users’ experience of community mental health services
- The Community Mental Health Survey asks service users to rate their overall experience from 0 (very poor) to 10 (very good). In 2019, 17% rated their experience as very good and 3% rated it as very poor.
- The proportion of Community Mental Health Survey respondents who ‘definitely’ felt they were given enough time to discuss their needs and treatment has decreased over time, from 65% in 2014 to 57% in 2019.
- In 2019, 69% of Community Mental Health Survey respondents said they knew who to contact out of office hours within the NHS if they had a crisis.
Are patients told about medication side effects?
- In 2018, less than half of Urgent and Emergency Care Survey respondents said that a member of staff ‘completely’ told them about medication side effects to watch for. And in 2019, less than half of Community Mental Health Survey respondents said that they were ‘definitely’ told about possible medication side effects.
- Between 2009 and 2015, the percentage of Adult Inpatient Survey respondents who said they were ‘completely’ told about medication side effects to watch for increased from 36% to 39%, but this has since decreased to 37% in 2019.
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 (MSA) breaches remained low at less than 500 breaches per month, until 2016 when they began to slowly increase again to 2,156 in January 2020.
- In February 2020, there were 4,929 MSA breaches, which is equal to 3 breaches per 1,000 finished consultant episodes. However, this figure should be treated with caution as 53% of these breaches were reported by one NHS trust which had previously incorrectly reported data to the national collection.
* Note that these results from GP Patient Surveys carried out from 2018 onwards 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, so some survey questions are comparable over time.