Patients’ overall experience of NHS and social care services

We explore how overall patient experience of NHS and social care services has changed over time.

Indicator

Last updated: 15/10/2020

Patient experience
Primary and community care Hospital care Emergency care Mental health Social care Children and young people

Background

To understand the quality of services that the NHS and social care deliver, it is important to know what people think about their care and treatment. The NHS Constitution includes a pledge to encourage and welcome feedback from patients on their experiences of health and care and use this to improve services. The national patient experience surveys ask service users how they rate the care they have received overall.


How does overall patient experience compare across NHS services? 15/10/2020

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A number of national patient surveys ask service users to rate their overall experience on a scale of 0 (very poor) to 10 (very good). It is useful to compare people's responses to understand how experience varies across NHS services.

Patients with a primary diagnosis of cancer admitted to hospital as an inpatient or day case for cancer treatment were asked in the Cancer Patient Experience Survey how they felt about their overall experience. They responded most favourably of all the patient groups, with 39% rating their experience as 10 (very good) and only 0.1% rating their experience as 0 (very poor). In contrast, only 17% of Community Mental Health Survey respondents rated their overall experience as 10 (very good) and 3% rated their experience as 0 (very poor).

37% of Children and Young People’s Survey respondents (parents or carers of children aged 0 to 15 who had been admitted to hospital) rated their child’s experience as 10 (very good) and 0.7% rated their experience as 0 (very poor). 28% of Urgent and Emergency Care Survey respondents who had attended type 1 departments rated their overall experience as 10 (very good) and 1.5% rated their experience as 0 (very poor). 27% of Adult Inpatient Survey respondents rated their overall experience as 10 (very good), with 0.9% rating their experience as 0 (very poor).

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 community mental health service users. Further to this, although the most recent survey results are displayed here, they were distributed in different time periods.


How has patients' overall experience of their GP practice changed over time? 14/08/2020

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All GP Patient Survey respondents are asked "Overall, how would you describe your experience of your GP practice?". The proportion of patients who had a good overall experience (‘very good’ or ‘fairly good’) of their GP practice decreased from 88% in 2012 to 85% in 2017. Changes to the 2018 GP Patient Survey resulted in this question not being directly comparable with previous years (see ‘About this data’ for more information). In 2018, 84% of patients had a good overall experience and this decreased to 82% in 2020. The proportion of patients who had a poor overall experience (‘very poor’ or ‘fairly poor’) increased from 3.6% in 2012 to 5.2% in 2017, and increased from 6.1% in 2018 to 7% in 2020.


How has adult inpatients’ overall experience changed over time? 15/10/2020

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Adult Inpatient Survey respondents are asked how they rate their overall experience, on a scale of 0 (a very poor experience) to 10 (a very good experience). The proportion of respondents who rated their overall experience as 10 increased from 23% in 2012 to 28% in 2017, but has since decreased slightly to 27% in 2019. The proportion who rated their experience as 0 has remained steady over time at 1%.


How has service users' satisfaction with adult social care services changed over time? 15/10/2020

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Adult Social Care Survey respondents are asked “Overall, how satisfied or dissatisfied are you with the care and support services you receive?”. Answers to this question have remained largely stable over time. In 2018-19, 64% of service users reported that they were “extremely or very satisfied” with the care and support services they received and 25% were “quite satisfied”. Between 2016-17 and 2017-18, there was a statistically significant increase in the proportion of service users who were “extremely or very dissatisfied”, from 1.7% to 2%, and in 2018-19 this proportion remained constant at 2%.

These results contrast with those from the Survey of Adult Carers in England, which asks how satisfied carers are with the support they and the person they care for have received from social services in the last 12 months. In 2018-19, only 39% of carers said that they were “extremely” or “very” satisfied, and this number has declined since the first survey in 2012-13.

One interpretation of this data is that, despite funding constraints which have led to a fall in the volume of care provided, the quality of care for those that do receive it has been maintained.


How has patients' overall experience of NHS dental services changed over time? 14/08/2020

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The GP Patient Survey asks people who have tried to get an NHS dental appointment in the last two years, "Overall, how would you describe your experience of NHS dental services?". Between 2012 and 2016, the proportion of patients who had a good overall experience (‘very good’ or ‘fairly good’) increased from 83% to 85%, then remained constant until 2020 when it fell slightly to 84%. In 2012, 7.5% of patients had a poor overall experience (‘very poor’ or ‘fairly poor’) and this decreased slightly to 7% in 2020.


About this data

These indicators draw on data from the Adult Inpatient Survey, the GP Patient Survey, the Personal Social Services Adult Social Care Survey, the Children and Young People's Survey, the Emergency Department Survey, the Community Mental Health Survey, and the Cancer Patient Experience Survey.

For each CQC survey, two weights were 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 groups, such as older respondents.

A combination of the two weights resulted in one single weighting which was applied to enable comparisons between 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.

In 2018, two key changes were made to the GP Patient Survey:

  • the content of the questionnaire was changed significantly to reflect changes in the delivery of primary care services in England.
  • the sample frame was extended to include 16-17-year-olds for the first time to improve the inclusivity of the survey.

Analyses were carried out by Ipsos MORI to measure the impact of these changes on the comparability of trend data. These analyses found that the question “Overall, how would you describe your experience of your GP practice?” was subject to context effects as a result of changes to the questionnaire and/or the inclusion of 16-17-year-olds. Therefore, results presented for this question from GP Patient Surveys carried out from 2018 onwards are not comparable with results from previous surveys.

The data was weighted to adjust for differences between all patients at a GP practice and the subset of patients who actually completed the questionnaire.

For more information please see NHS England, National Patient and Staff Surveys and NHS Digital, Personal Social Services Adult Social Care Survey.

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