Hospitals are getting better- but only very, very slowly

Patients’ experience of National Health Service hospitals is improving, but painfully slowly, according to findings in the annual survey conducted by the health service inspectorate.

There are also “striking variations” in performance between hospitals, the survey says, with some “struggling to deliver on some of the basics of hospital care” such as cleanliness and treating patients with dignity.

For the first time the Healthcare Commission has published the data, based on interviews with more than 75,000 patients, together with comparisons going back six years to the first such research in 2002. Since then spending on the NHS in England has risen from £55bn to £87bn in 2007, with staff numbers up by 115,000 over the same period.

In this year’s survey 92 per cent of patients rated their care as “good”, “very good”, or “excellent”, with the percentage rating it as only fair or poor down from 9 per cent in 2002 to 8 per cent in 2007.

But over the six years there has been only a 4 percentage point rise, to 42 per cent, in patients putting their care in the top category of “excellent” – in spite of all the extra spending.

A higher percentage of patients said that they had waited less than four hours in accident and emergency in 2007 than in 2002. However, the increase was only from 67 to 72 per cent. On some of the government’s key targets, performance has been less than impressive.

There has been a 3 percentage-point drop since 2002 to 53 per cent in the proportion describing their ward as “very clean”. But 12 per cent of patients complained that lavatories and bathrooms were dirty, the same figure as six years ago.

Forty six per cent of patients rated hospital food as only fair or poor, with a mere 1 percentage point rise over six years, to 19 per cent, in those saying the food was “very good”. In spite of the government’s emphasis on choice of hospital, precisely the same percentage recall being offered it in 2007 as in 2005 – just 27 per cent.

The survey also reveals dramatic differences in performance between hospitals.

More than 90 per cent of patients in top-performing hospitals, such as the Royal Marsden and Clatterbridge cancer centres, said they were always treated with respect and dignity.

The figure for the worst performers, such as Mayday and Ealing hospitals in London, was 80 per cent. At Ealing, just 58 per cent of patients said their care was very good or excellent, against 90 per cent and more at some specialist hospitals.

Anna Walker, chief executive of the Healthcare Commission, said it was good to see rising percentages of patients saying care was excellent but: “In some hospitals the NHS is struggling to deliver on some of the basics of hospital care.”

The diagnosis
*92 per cent of patients rated their care as ‘good’, ‘very good’, or ‘excellent’ (up from 91 per cent in 2002)
*72 per cent said they waited less than four hours in A&E; (67 per cent)
*46 per cent rated hospital food as only ‘fair’ or ‘poor’ (47 per cent)
*20 per cent did not get enough help eating meals (18 per cent)
*Spending on the NHS in England grew from £55bn in 2002 to £87bn in 2007


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