Is the NHS really that bad – what does the evidence show?:
The Care Quality Commission's annual inpatient survey suggests that the negative press is by no means all justified
Judging by recent media coverage, you might be forgiven for thinking that the NHS has become a patient's nightmare, with doctors and nurses routinely mistreating or ignoring those in their care, leading to thousands of unnecessary deaths in hospitals across the country.
What does the evidence say? The
Care Quality Commission's annual inpatient survey – looking at the experiences of more than 64,500 people admitted to NHS hospitals in England in 2012 – got precious little media coverage. But it paints a very different picture.
Most of its survey questions give patients the choice of answering "yes, always", "yes, sometimes or to some extent" or "not at all".
In 2012, 80% of patients said they were always treated with dignity and respect in hospital, with only 3% saying they weren't. 80% said they always had confidence in the doctors treating them and 76% always had confidence in the nurses treating them, with only 3% not having confidence in either case. Ninety percent of the patients surveyed said they were always given enough privacy when being examined or treated; only 1% said they weren't.
When asked the key summary question – to rate their overall experience on a scale of 0 to 10 – 93% rated the experience at or above the average score of 5 and only 7% rated the experience below 5.
The 2012 survey shows a range of small year on year changes (usually 1 or 2% up or down) but it's more instructive to look at the 10-year sweep. The period 2002-12 shows substantial and demonstrable improvements across a range of areas that we know are important to patients.
Hospitals are now a lot cleaner: 68% of patients stated that their ward was very clean in 2012, up from 57% in 2002 (and another 33% in 2012 thought they were fairly clean). 92% of patients didn't have to share a ward with the opposite sex, up from 75% in 2002. The proportion of patients who felt that doctors often talked in front of them as if they weren't there decreased from 23% to 5% in 2012.
We all recognise how crucial it is to integrate our health and social care systems for good health outcomes. The survey shows that trusts are forging these important links within their local communities. Since 2002 there has been a marked decrease in the proportion of patients who felt there was a need to discuss further health or social care arrangements after leaving hospital and who would have liked to discuss this with staff but were unable to. The percentage went down from 33% in 2002 to 16% in 2012. Delayed discharges are also on a downward trend with the percentage of patients whose discharge was delayed falling from 48% in 2002 to 41% in 2012.
It's not a uniformly positive picture; there are a number of areas where the NHS needs to do better. No one can be satisfied that 20% of patients didn't feel they were given enough information about their treatment or that 48% of patients felt that they had to wait three minutes or longer for their call button to be answered.
But, overall, this evidence confirms the view that poor pockets of care are exactly that – pockets – and that poor care is not widespread, universal or endemic. We should, therefore, celebrate the successes of the NHS with the same enthusiasm and regularity as we, rightly, criticise the places where care has failed.
Guardian
