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: 25/11/2021

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 to 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? 20/01/2022

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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 88% rating their experience as 8, 9 or 10 and only 0.5% rating their experience as 0, 1 or 2. In contrast, only 48% of Community Mental Health Survey respondents rated their overall experience as 8, 9 or 10 and 10% rated their experience as 0, 1 or 2.

80% 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 8, 9 or 10 and 2.1% rated their experience as 0, 1 or 2. 75% of Adult Inpatient Survey respondents rated their overall experience as 8, 9 or 10, with 0.9% rating their experience as 0 (very poor). 72% of Urgent and Emergency Care Survey respondents who had attended type 1 departments rated their overall experience as 8, 9 or 10 and 4% rated their experience as 0, 1 or 2. 

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 undertaken in different time periods.


How has patients' overall experience of their GP practice changed over time? 23/09/2021

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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. The proportion of patients who had a poor overall experience (‘very poor’ or ‘fairly poor’) increased from 3.6% in 2012 to 5.3% 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 before increasing slightly to 83% in 2021. The proportion of patients who had a poor overall experience increased slightly from 6% in 2018 to 7% in 2021.


How does patients' experience of their last GP appointment vary by appointment type? 23/09/2021

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The GP Patient Survey asks respondents “Thinking about the reason for your last general practice appointment, were your needs met?”. In 2021, 65% of respondents said that their needs were definitely met, while 6% said that they were not met at all (data not shown).

Respondents are also asked what type of appointment their last general practice appointment was, such as a face-to-face appointment or phone appointment. While the majority of respondents in 2021 said that their last appointment was a face-to-face appointment, since the start of the Covid-19 pandemic there has been an increase in phone and online appointments. Respondents who had a face-to-face appointment were more likely to say that their needs were met, with 68% saying that their needs were ‘definitely’ met. This compares to 58% of respondents whose last appointment was an online appointment and 57% who had a phone appointment. Those who responded “Don’t know/Can’t say” have been excluded for comparison purposes.


How has patients' overall experience of NHS dental services changed over time? 23/09/2021

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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% where it remained roughly constant until 2021 when it fell to 77%. The proportion of patients who had a poor overall experience (‘very poor’ or ‘fairly poor’) fluctuated around 7% between 2012 and 2020, before increasing to 11% in 2021. The worsening of experience in 2021 likely relates to the disruption of NHS dental services during the Covid-19 pandemic, with patients reporting delays to treatment and difficulties accessing routine and emergency dental care.


How has adult inpatients’ overall experience changed over time? 25/11/2021

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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 8, 9 or 10 increased from 67% in 2012 to 73% in 2017, but decreased again slightly to 71% in 2019. The proportion who rated their experience as 0, 1 or 2 decreased slightly from 3.6% in 2012 to 3.0% in 2019.

In 2020, 75% of Adult Inpatient Survey respondents rated their overall experience as 8, 9 or 10, but 4.1% rated their experience as 0, 1 or 2. These results are not comparable to previous years due to changes in the 2020 survey. See ‘About this data’ for more information.


How has service users' satisfaction with adult social care services changed over time? 25/11/2021

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* The 2020-21 Adult Social Care Survey was voluntary for councils, and as not all councils took part care should be taken when comparing with previous years' data.

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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?”. In 2020-21, there was a statistically significant increase in the proportion of service users who reported that they were “extremely or very satisfied” with the care and support services they receive (68%). Conversely, there was a statistically significant decrease in those who reported that they were “quite satisfied” (23%). Note that the 2020-21 survey was voluntary for councils, and so caution should be taken when looking at the council average, which is not an England outcome.

Between 2014-15 and 2019-20, answers to the question remained largely stable. In 2019-20, 64% of service users reported that they were “extremely or very satisfied” with the care and support services they receive, 25% were “quite satisfied”, and 2.1% were “extremely or very dissatisfied”.

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 an increase in the volume of support provided is needed to improve the satisfaction of carers and the people they care for; however, for service users who do receive support the quality of care has largely been maintained.


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: 

  • trust weight to ensure that each trust contributes equally to the England average, and
  • 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.

For the 2020 Adult Inpatient Survey, patients aged 16 and over were eligible to take part if they were treated in hospital during November 2020. Fieldwork (the time during which questionnaires are sent out and returned) took place between January 2021 and May 2021. Participants were offered the choice of responding online or via paper-based questionnaires for the first time, and questions, terminology and methodology used in the survey were updated. Therefore, the 2020 survey results are not comparable with previous years.

Fieldwork for the 2021 GP Patient Survey took place between 4 January and 6 April 2021. In 2020, fieldwork took place between 2 January and 6 April 2020. Analysis conducted for the 2020 survey found that only 1.2% of responses were received after lockdown measures were implemented.

For the 2021 Community Mental Health Survey, people were eligible if they received treatment for a mental health condition between September 2020 and November 2020. Fieldwork took place between February 2021 and June 2021. Some questions asked participants to reflect on their care over the last 12 months, thus reflecting experiences of care throughout the pandemic.

For the 2020 Urgent and Emergency Care Survey, a sample of people aged 16 and over took part if they attended a Type 1 urgent and emergency care service provided by an acute trust in September 2020. Fieldwork took place between November 2020 and March 2021.

The 2020 Cancer Patient Experience Survey was run on a voluntary basis, and national level data was not produced because it was not possible to make comparisons with previous results. Therefore, the most recent data we present is from the 2019 survey.

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

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