What the 2024 Adult Inpatient Survey reveals about NHS patient experience
The Adult Inpatient Survey is the longest-running component of the NHS Patient Survey Programme (NPSP) and has been conducted annually since 2002. Its findings are vital for assessing NHS performance: the Care Quality Commission uses the results for regulatory oversight, while Trusts apply them to monitor service quality and drive improvements. The government is clear that reducing waiting lists and times is a priority, but what do the 2024 survey results tell us about patient experience in inpatient services?
Waiting times: a lingering concern
Reducing waiting times sits at the core of the Elective Reform Plan, which aims to improve access, outcomes, and patient experience in elective care¹. However, the 2024 Adult Inpatient survey results offer a sobering reminder that while policy may be shifting in the right direction, the lived reality for many patients still falls short of expectations.
When asked how they felt about the length of time they were on the waiting list, nearly half (42%) of patients said they would have liked to be admitted ‘a bit’ or ‘a lot sooner’. As delays in treatment can lead to complications, prolonged recovery periods, and increased pressure on services further down the line, it is concerning that 43% of respondents also reported that their health got worse while waiting to be admitted. At a time when waiting is a common experience for patients, it is, however, reassuring that the majority (75%) said that the quality of information they received while waiting was ‘good’. These findings underscore the importance of not just reducing waiting times but also improving triage and prioritisation to ensure those at risk of deterioration are seen sooner.
Transparency in virtual wards information
The NHS 10 Year Plan aims to broaden the use of virtual wards and hospital-at-home services, reflecting a broader move from hospital-based care to more community-focused healthcare delivery². One of the plan’s fundamental shifts includes moving care from hospitals into communities. This will facilitate remote monitoring of patients, with aspirations to seamlessly integrate data into the NHS App and a Single Patient Record, enabling more proactive and coordinated care. Making this a reality, requires seamless communication and information processes.
The 2024 Adult Inpatient survey gathers feedback from patients who have been placed on a virtual ward as part of a ‘step-down’ approach following their inpatient hospital stay³. The results show that while 55% of patients said hospital staff ‘definitely’ gave them information about the risks and benefits of continuing treatment on a virtual ward, 19% said they were not informed of the risks and benefits. Of those patients treated on a virtual ward, 60% said that they were ‘completely’ informed about the care and treatment they would receive there, but 14% said that they were not given this information. NICE guidance recommends that patients receiving care through virtual wards, along with their families or carers when appropriate, should be provided with clear, consistent, and evidence-informed information tailored to their individual needs throughout every stage of their care journey⁴. This includes, but is not limited to, details about their health condition(s) and available treatment options.
These findings show that while a majority of patients feel well-informed, there is still room for improvement. Further research could explore why some patients felt less informed, which would help to refine patient engagement strategies and avoid a ‘one size fits all’ approach.
Patient involvement in discharge process
Only 34% of patients reported being actively involved in decisions about their discharge, a figure that reflects a significant decrease since 2021. Encouragingly, 29% of patients noted that their family or carers were involved in the process, showing a modest increase from 27% the previous year. However, just 49% of patients received clear notice of their discharge date, while 37% were given only partial information, showing a downward trend since 2020, and underscoring the need for more consistent and transparent communication.
Tackling health inequalities
It is essential that diverse voices are included and heard to help tackle health inequalities. People with disabilities or frailty consistently reported worse inpatient care experiences across all areas of care assessed in the subgroup analysis⁵ of the 2024 survey data, while respondents with mental health, neurological, or mobility conditions reported negative experiences in over half the areas assessed, including having confidence and trust in the doctors and nurses treating them, and being treated with respect and dignity.
Positive developments
Despite ongoing challenges, the 2024 survey indicates a modest improvement in patient experience. Notably, 37% of respondents felt staff involved them ‘a great deal’ in decisions about their care and treatment, up from 35% in 2023. Discussions about post-discharge health or social care needs were reported by 79% of patients, compared to 77% in 2023. Overall, 52% rated their experience as very good (score of 9–10), marking a significant increase from both 2022 and 2023.
Supporting transformation for better person centred care
The 2024 findings offer valuable insights into the experiences of individuals using NHS inpatient services, revealing some encouraging improvements compared to 2023. However, they also show persistent challenges within the healthcare system. As the 10 Year Plan seeks to drive transformative changes in care delivery, it is essential to listen to diverse patient voices and act on their feedback. Prioritising person-centred care and ensuring that patients and carers are actively involved in decision-making are critical to delivering services that truly meet their needs.
References
¹ NHS England » Reforming elective care for patients
² 10 Year Health Plan for England: fit for the future – GOV.UK
³ NHS England » Virtual wards operational framework
⁴ Supporting the health and care system to implement virtual wards | NICE
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