Almost half of all hospital inpatients want to be more involved in their care and treatment, survey shows

NHS patients in England continue to report high-quality care and communication from healthcare staff, including doctors and nurses. But almost half (45%) of England’s hospital inpatients want to be more involved in decisions made about their care and treatment, according to results from a survey of more than 75,000 people released today. The findings suggest a continuing need for improvement in the key principles of person centred care.

The survey, conducted by Picker on behalf of the Care Quality Commission, asked recent hospital patients about their experiences from admission through to care after their discharge. It is the latest in a long-running series of national surveys that have tracked trends in NHS performance since 2001. The survey was conducted prior to the Covid-19 pandemic, meaning that the results reflect the service’s performance in its normal context.

Some of the most positive results in the survey were related to experiences with NHS staff. The proportions of respondents describing good communication with doctors and nurses continued to trend upwards, and similarly, the vast majority said they “always” had confidence and trust in their doctors (79%) and nurses (78%). Despite these positive results, only 36% said they “definitely” found someone on the hospital staff to talk to about their worries and fears (down from a high of 40% in 2015) and only half (53%) felt they “always” got enough emotional support (down from 57% in 2015).

Patients were also more likely to report problems with planned appointments in 2019 compared to prior years. Only one in four (25%) who were referred to a specialist were offered a choice of hospital for their first appointment, continuing a decline from 31% in 2010. More than one in five (21%) said their admission date was changed by the hospital, and 28% said they should have been admitted “a bit” or “a lot” sooner – an increase of two percentage points compared to 2017.

Chris Graham, Picker’s CEO, said:

This survey shows the NHS frequently offering excellent personal care but all too often struggling with demand. Patients are finding that they have less choice and more delays as they navigate their way through hospital care – and these problems are likely to be significantly worsened given the huge numbers of routine procedures cancelled due to Covid-19 in 2020.

More broadly, readers will find few big changes from a quick glance at the survey results compared to 2018. However, this masks some important trends. Last year’s survey saw unusually sharp declines in a number of areas, including patients being given clear information about their care and medicines post-discharge as well as being asked for their views and being shown how to make a complaint. Results for these questions have not recovered – and although the changes this year are less dramatic they continue a worrying downward trend. This shows how important it is for NHS providers to take a strategic approach to monitoring and improving patient experience – and we encourage all NHS organisations to look closely at how their own results have changed over recent years.

Notes to editors

• The Adult Inpatient Survey 2019 was conducted by Picker on behalf of the Care Quality Commission.
• A total of 143 NHS Trusts across England took part, with 76,915 patients responding to the survey (45% response rate).
• Full details of the survey methodology, questions, and results are available on the dedicated survey website.