“With winter approaching, this survey highlights problems in patients’ experiences of urgent and emergency care”

People attending accident and emergency (A&E) departments and urgent treatment centres, are reporting poor experiences of care, with long waits compounded by a lack of information, support, and communication.  

These are the findings of a major survey of people attending type 1 and type 3 urgent and emergency care departments – such as A&E departments, urgent treatment centres, minor injuries units, and urgent care centres. The survey, coordinated by Picker for the Care Quality Commission, gathered more than 45,000 responses from people who sought treatment last winter – mainly in February 2024.

According to the survey: 

• More than a quarter (28%) of people attending type 1 (A&E) departments waited for more than one hour for an initial assessment by a doctor or nurse. Only 29% had an initial assessment within the target time of 15 minutes (34% for walk-in patients visiting type 3 departments). 

• Most patients were not told how long they would wait to be examined or treated in type 1 (74%) and in type 3 departments (61%). Patients who spent the longest in A&E departments were less likely to get this information: only 21% of patients who spent more than four hours in the department were told how long they would wait. 

• The majority of patients who spent more than four hours in an A&E department said that they were not able to get help with their condition or symptoms whilst they waited (54%). 

• Almost two in five patients attending type 1 (A&E) departments said that they did not or only “to some extent” had enough time to discuss their condition with a doctor or nurse (39%).  

• Only 70% of patients attending type 1 departments and 81% attending type 3 departments said that they were treated with respect and dignity “all of the time”. 

The results also examine the relationships between different aspects of people’s care. There was a clear association between waiting times and people’s overall experiences of care: in both type 1 and type 3 departments, people who waited more than 30 minutes for an initial assessment and those whose visit lasted more than four hours overall reported significantly worse experiences across almost all other aspects of care. In type 1 departments, people aged under 50 years; people with frailty; and people with disabilities were also significantly less positive about their care across a wide range of measures. 

Commenting on the results, Chris Graham, Group CEO of Picker, said:

“Patient feedback provides significant cause for concern as to the quality of NHS urgent and emergency care services in 2024. Long waits in A&E and urgent care services have been well reported and are not surprising – but this survey demonstrates a clear link between timely access to care and people’s overall experiences.  

“People who wait longer for an initial assessment and who spend longer in urgent care departments overall have worse experiences of nearly all aspects of care. Long waits and associated problems are a barrier to providing the high quality, person centred care that the NHS aspires to offer. 

“The findings are particularly worrying as the NHS heads towards what is expected to be a challenging winter. A separate poll published this week by the Royal College of Emergency Medicine reported that 87% of A&E clinical leads are not confident that their departments will cope well this winter.  

“As it is likely that long waits will persist throughout the winter months, services should prioritise improving people’s experiences of waits – by communicating clearly about how long people can expect to wait; updating people as often as is practicable; and ensuring that support is available for people who are suffering with their conditions or symptoms as they wait.” 

– Ends –

Notes to editors

• The 2024 Urgent and Emergency Care Survey was coordinated by Picker on behalf of the Care Quality Commission (CQC). Picker (www.picker.org) is a health and care research charity with a vision of the highest quality person centred care for all, always. The Care Quality Commission (www.cqc.org.uk) are the independent regulator of health and adult social care in England. 

• Full results of the survey are available on the Care Quality Commission website at www.cqc.org.uk/publications/surveys/urgent-emergency-care-survey, and details of the survey methodology as well as trust-level benchmark reports are available at nhssurveys.org/surveys/survey/03-urgent-emergency-care/year/2024.  

• 120 NHS trusts providing urgent and emergency care services in England took part in the survey. Of these, 70 trusts had at least one type 3 department. A total of 172,025 people were invited to take part in the survey.   

• 35,670 people responded to the type 1 survey: this represents a response rate of 28.8% once undelivered surveys and ineligible recipients are accounted for.  

• 10,325 people responded to the type 3 survey: and this represents a response rate of 26.1% once undelivered surveys and ineligible recipients are accounted for.  

• The survey included people aged 16 years or older who attended a type 1 or type 3 urgent or emergency care centre in February 2024. For some trusts with smaller type 3 departments, people who attended in January 2024 were also included. Trusts with only a type 1 department selected a sample of 1250 patients. Trusts with both type 1 and type 3 departments selected a sample of 950 type 1 and 580 type 3 attendances (a total of 1,530 patients per trust). 

• The NHS Patient Survey Programme has included a number of previous urgent and emergency care surveys; the most recent was published in July 2023. The survey underwent significant methodological changes for 2024, including changes to the month when patients were selected for the survey and to the methods used to contact and collect responses from patients. As these changes affect the comparability of survey data, we do not present comparisons to previous surveys.   

• Type 1 and type 3 departments are defined below. Further details of the sampling methodology are available from nhssurveys.org/surveys/survey/03-urgent-emergency-care/year/2024

• Type 1 department: a major, consultant led A&E Department with full resuscitation facilities and designated accommodation for the reception of A&E patients which operates 24 hours a day, 7 days a week. 

• For all media enquiries please contact Lucy Pickard via email: pressoffice@pickereurope.ac.uk, or phone: 01865 632 235.