Abstract
ObjectiveTo examine trends in patient experience and consistency between hospital trusts and settings.MethodsObservational study of publicly available patient experience surveys of three hospital settings (inpatients (IP), accident and emergency (A&E) and outpatients (OP)) of 130 acute NHS hospital trusts in England between 2004/05 and 2014/15.ResultsOverall patient experience has been good, showing modest improvements over time across the three hospital settings. Individual questions with the biggest improvement across all three settings are cleanliness (IP: +7.1, A&E: +6.5, OP: +4.7) and information about danger signals (IP: +3.8, A&E: +3.9, OP: +4.0). Trust performance has been consistent over time: 71.5% of trusts ranked in the same cluster for more than five years. There is some consistency across settings, especially between outpatients and inpatients. The lowest-scoring questions, regarding information at discharge, are the same in all years and all settings.ConclusionsThe greatest improvement across all three settings has been for cleanliness, which has seen national policies and targets. Information about danger signals and medication side-effects showed least consistency across settings and scores have remained low over time, despite information about danger signals showing a big increase in score. Patient experience of aspects of access and waiting have declined, as has experience of discharge delay, likely reflecting known increases in pressure on England’s NHS.
Highlights
Trust performance has been consistent over time: 71.5% of trusts ranked in the same cluster for more than five years
Information about danger signals and medication sideeffects showed least consistency across settings and scores have remained low over time, despite information about danger signals showing a big increase in score
The Dr Foster Unit is affiliated with the Health Research (NIHR) Imperial Patient Safety Translational Research Centre
Summary
Patient experience is increasingly seen as an important aspect of healthcare, both as an ‘intrinsically important dimension of care quality [1], and stimulus for improvement [2], and the last 20 years have seen a proliferation of national patient experience surveys in many countries[3]. Patient experience scores have shown associations with several outcomes including adherence to medication [4], good clinical process measures [5] and fewer inpatient care complications [6], some dispute the link’s causality [7]. In a Diagnostic Tool [9] published by the Department of Health (DoH) the questions in the three main hospital surveys are partitioned into five key domains (Box 1). The DoH suggest the tool shows how scores vary across NHS healthcare providers for both NHS managers and the general public
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