NHS hospital services for children and young people improved in 2020 despite pandemic, survey finds.

Children and young people admitted to NHS hospitals during the second wave of the COVID pandemic in England reported good experiences of care. In fact, care experiences were often markedly better than in comparable surveys conducted before the pandemic, especially in the view of parents and carers.

The survey, coordinated by Picker on behalf of the Care Quality Commission, was conducted in 125 NHS acute trusts. More than 27,000 responses were received from children and young people admitted between November 2020 and January 2021 and/or their parent(s) or carer(s). These admissions were during the second wave of England’s COVID pandemic: this was a period of significant pressure for the NHS, with high levels of bed occupancy related to COVID meaning that many staff were redeployed outside of their normal roles. However, the volume of admissions for children and young people were much lower than normal: compared to the prior year, monthly admissions during the survey sampling period were down between 27% and 36%. Emergency admissions, in particular, were almost halved – 47% lower than the same period during the previous year [1].

Children, young people, and their parent(s) or carer(s) reported positive experiences in a number of areas of care:

Overall experiences of care:

• The proportion of parents or carers rating their child’s overall experience between 9 and 10 out of 10 rose from 61% in 2018 to 68% in 2020.
• There was a 3% point increase in the proportion of young people aged 8-15 who said that they were “very well” looked after in hospital (73% in 2020 vs 70% in 2018).

Clear information, communication, and support for self-care:

• The proportion of parents or carers who said hospital staff “definitely” kept them informed about what was happening whilst their child was in hospital rose 7% points from 70% in 2018 to 77% in 2020.
• Parents or carers of children aged 0-7 years were 5% points more likely to say that NHS staff communicated with children in a way that was “definitely” understandable to the child (70% in 2020 vs 65% in 2018)
• Seven in eight (88%) young people aged 8-15 years said that hospital staff talked with them about how they were going to care for them – a 3% point improvement compared to 2018.

Effective treatment from trusted professionals:

• Three quarters of parents or carers (74%) said that staff were “always” available when their child needed attention – an 11% point increase from 63% in 2018.
• Four in five (82%) young people aged 8-15 years said that staff “definitely” did everything that they could to help if they were in pain – a 3% point increase compared to 2018.

There were some areas where results declined, and these tended to be related to COVID restrictions. For example, parents or carers were far less likely to be able to prepare hot food for themselves or their children in hospital – the proportion who said that they could not do this rose from 36% in 2018 to 61% in 2020, a 25% point increase. This was likely down to changes intended to promote infection control in hospitals. Similarly, there was a threefold increase in the proportion of parents or carers of 0-7 year olds who said that there was not enough for their child to do in hospital – up from 7% in 2018 to 22% in 2020. There was a similar but much smaller increase in the proportion of 8-15 year olds who said that they did not have enough to do in hospital, which rose from 17% to 21% – mitigated, it would seem, by improvements in the standard of Wi-Fi in hospitals.

Commenting on the results, Chris Graham, CEO at Picker, said:

“Children and young people admitted to hospital during the second wave of the pandemic – and their parents or carers – may well have expected to encounter disruption. Instead, their feedback shows that a larger proportion of children and young people experienced high quality, person centred care – including clear communication and effective treatment from trusted professionals. This is something to be celebrated and NHS providers and staff working in children’s services should be proud of the standard of the care that they have been able to deliver in testing circumstances.

“The fuller context of the results and improvements will need some consideration, and it will be interesting to see if progress can be maintained. Providers may have benefited from reduced demand as far fewer children were admitted to hospital, especially in emergencies, during the second wave of the pandemic than would usually be expected. Equally it is undoubtedly the case that providers will have been forced to make changes to usual patterns of care, and in most areas these appear to have been successful. We call on all providers to review their results in light of their approach to care over the winter of 2020/21, reflecting on what changes benefited or undermined the experiences of young people and their families. In this way, the lessons of the pandemic can be used to maintain improvements in the quality of care into the future.”

[1] Source: NHS Digital https://digital.nhs.uk/data-and-information/publications/statistical/hospital-episode-statistics-for-admitted-patient-care-outpatient-and-accident-and-emergency-data/april-2021—june-2021.

View the summary infographic and children’s infographic.

Notes for Editors

• Picker is an independent health and care research charity specialising in measuring, understanding, and improving people’s experiences. Our vision is of the highest quality person centred care for all, always. Further details about the charity and our work can be found at www.picker.org.
• The survey is commissioned and published by the Care Quality Commission, the independent regulator of all health and social care services in England.
• People were eligible for the survey if they were admitted between the 1st November 2020 and the 31st January 2021 and were aged between 15 days and 15 years (inclusive) at the time of their discharge. This includes both children and young people who did and did not have overnight stays in hospital. However, children and young people were excluded if they were only admitted to a
• Neonatal Intensive Care Unit (NICU) or Special Care Baby Unit (SCBU); for a planned termination of a pregnancy; for psychiatric reasons; as private patients; or if they were known to be a current hospital inpatient.
• Three versions of the questionnaire were used depending on the age of the child or young person. For children aged 0-7 years, a questionnaire was sent to be completed by the parent(s) or guardian(s) of the child. Questionnaires for 8-11 and 12-15 year olds included sections for the young person and for their parent(s) or guardian(s) to complete.
• The survey was conducted between March and July 2021. 27,374 responses were received, representing a response rate of 24.2%.
• Full results from the survey are available at https://www.cqc.org.uk/publications/surveys/children-young-peoples-survey-2020.
• Details about how the survey was administered and full results are available at https://nhssurveys.org/surveys/survey/01-children-patient-experience/.