Patient experience of NHS and social care services

In our latest update we look at trends in patients’ experiences of NHS and social care services.

Indicator update

Published: 25/11/2021

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. One of the ways that people can feed back is through national patient 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. Most of the latest data was collected since the beginning of the coronavirus (Covid-19) pandemic – notes on data quality and comparability can be found in the individual indicator pages.

Overall, there are broad signs that patient experience was maintained and even improved slightly during the Covid-19 pandemic. Although, it should be noted that the survey data does not take into account the experiences of patients who did not or were not able to access care. In general, overall experience of services (with the exception of NHS dental services), having confidence and trust in clinicians, and being treated with dignity and respect, were largely upheld. But there were differences in experiences across services, and in general practice there were variations in experience depending on whether a patient had a face-to-face, phone or online appointment.

Below is a summary of our patient experience indicators, with links to more detailed content and analysis.

Please note that a number of survey questions measure experience on a scale of 0 (very poor) to 10 (very good), and scores rated 0-2 and 8-10 have been totalled for descriptive purposes below.

Overall experience of services

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  • The 2021 GP Patient Survey reported that 83% of patients had a good overall experience of their GP surgery, a slight improvement from 82% in 2020 (a largely pre-pandemic survey).
  • GP Patient Survey respondents whose last appointment was face-to-face with a clinician were more likely to say that their needs were met during their last appointment. In 2021, 68% said that their needs were ‘definitely’ met, compared to 57% of respondents who had a telephone appointment.
  • In 2020, 75% of Adult Inpatient Survey respondents rated their experience as very good, but 4.1% rated their experience as very poor.
  • Cancer Patient Experience Survey respondents in 2019 tended to rate their overall experience highly, with 88% rating their experience as very good.
  • Only 51% of Community Mental Health Survey respondents in 2020 rated their overall experience of NHS mental health services in the last 12 months as very good, and 9% rated their experience as very poor.
  • In 2020-21, there was a statistically significant increase in the proportion of adult social care service users who reported that they were “extremely or very satisfied” with the care and support services they receive (68%). These results contrast with those from the Survey of Adult Carers in England.
  • The proportion of patients who had a good overall experience of NHS dental services decreased substantially, from 84% in 2020 to 77% in 2021.

Confidence and trust in clinicians

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  • In 2020, 84% of Adult Inpatient Survey respondents said that they ‘always’ had confidence and trust in the doctors treating them.
  • The proportion of GP Patient Survey respondents who ‘definitely’ had confidence and trust in the healthcare professional they saw or spoke to during their last general practice appointment increased from 68% in 2020 to 72% in 2021.

Respect and dignity

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  • 89% of Maternity Services Survey respondents in 2019 said they were ‘always’ treated with respect and dignity while they were being cared for during labour and birth.
  • In 2020, 85% of Adult Inpatient Survey respondents felt that they were ‘always’ treated with respect and dignity while they were in hospital.
  • 73% of Community Mental Health Survey respondents in 2020 felt that they were ‘always’ treated with respect and dignity, but 8% felt that they were not.

Do patients feel involved in decisions about their care?

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  • In 2019, 81% of Cancer Patient Experience Survey respondents said they were ‘always’ involved in decisions about their care and treatment. Only 53% of Community Mental Health Survey respondents in 2020 said that they were ‘definitely’ involved as much as they wanted to be in agreeing what care they would receive.
  • The proportion of GP Patient Survey respondents who were ‘definitely’ involved as much as they wanted to be in decisions about their care and treatment during their last general practice appointment remained constant at 61% for the last three years. In 2021, 7% of respondents were not involved as much as they wanted to be.
  • In 2020, 37% of Adult Inpatient Survey respondents said they were involved ‘a great deal, 44% said they were involved ‘a fair amount’, but 5% said they were ‘not at all’ involved in decisions about their care and treatment.

Supporting patients to manage their long-term condition(s)

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  • Between 2018 and 2021, the proportion of GP Patient Survey respondents who ‘definitely’ had enough support from local services or organisations to help them manage their long-term health condition(s) decreased from 43% to 37%.
  • Only 69% of patients aged 16 to 24 ‘definitely’ or ‘to some extent’ felt supported to manage their long-term condition in 2021, compared to 80% of respondents aged 75 to 84.

Carers’ views of social care quality

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  • 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.

Service users’ experience of community mental health services

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  • 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 2020, 59% of respondents felt they were ‘definitely’ given enough time.
  • In 2020, 72% of Community Mental Health Survey respondents said they knew who to contact out of hours within the NHS if they had a crisis.

Are patients told about medication side effects?

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  • In 2020, less than half (42%) of Urgent and Emergency Care Survey respondents said that a member of staff ‘completely’ told them about medication side effects to watch for. And less than half (43%) of Community Mental Health Survey respondents said that they were ‘definitely’ told about possible medication side effects.
  • Just 28% of Adult Inpatient Survey respondents in 2020 said they received an explanation of the side effects for medicines they were to take home.

Access to GP services

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  • At the start of the Covid-19 pandemic, the number of appointments in general practice fell by a third, from 24 million in March 2020 to 16 million in April 2020.
  • The number of appointments taking place on the same day as booking remained roughly constant during the first wave of the pandemic, while appointments taking place a week or more after booking fell considerably.
  • In July 2021, around 26 million appointments took place in general practice, almost back to pre-pandemic levels.
  • 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 worsened from 81% in 2012 to 65% in 2020, before improving slightly to 68% in 2021.
  • The proportion of patients who ‘always or almost always’ saw or spoke to their preferred GP when they would like to – a measure of continuity of care – decreased from 26% in 2018 to 22% in 2021.

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