The results of the latest annual survey of hospital inpatients published by the Care Quality Commission (CQC) show patient satisfaction levels are largely unchanged since 2022 but remain significantly worse than pre-pandemic.
They also highlight continued frustration with waiting times and an increase in the number who felt their health worsened while waiting to be admitted for elective care.
The 2023 adult inpatient survey captures the views and experience of more than 63,500 people who stayed in one of 131 acute and specialist NHS Trusts in England for at least one night during November last year.
It has been carried out annually since 2002 and is the longest running survey in CQC’s NHS Patient Survey Programme (NPSP). The survey asked people to give their opinions on the care they received, including quality of information and communication with staff, whether they were given enough privacy, the amount of support given to help them eat and drink, and on their discharge arrangements.
Results covering waiting times have continued to decline. Forty-two per cent of respondents who were in hospital for elective care in 2023 said they would have liked to have been admitted sooner (compared to 39% who said this in 2022). Additionally, 43% said their health deteriorated while waiting to be admitted (up from 41% in 2022). Of those who reported a decline in their condition, a quarter (25%) said it got ‘a bit worse’ and just under a fifth (18%) said it got ‘much worse’.
Seventy per cent of respondents reported ‘always’ getting help to wash or keep themselves clean (unchanged from 2022, but still down from 75% in 2020). And the proportion of people who needed help from staff to eat their meals that said they ‘always’ got that help fell slightly from 65% in 2022 to 64% in 2023 – and remains significantly lower than in 2020 when it was 69%.
People’s experience of being discharged from hospital also remained poor. Only 33% of respondents said they were involved ‘a great deal’ in decisions about their discharge - a notable drop from the 37% who said this in 2022.
Less than half (44%) said they ‘definitely’ knew what would happen next in their care after leaving hospital (down from 45% in 2022) and fewer people said that staff discussed the need for further support from health and social care services with them before they were discharged (77% in 2023 compared to 79% in 2022 and 81% in 2020).
However, the majority of respondents were still positive about their interactions with doctors and nurses - as has been the case in previous years. Most people surveyed (75%) said they ‘always’ felt included by doctors in conversations about their care (up from 74% in 2022) and over four fifths (82%) felt they were ‘always’ treated with dignity and respect by hospital staff (unchanged from 2022).
More than three-quarters of respondents (78%) said that they were given the right amount of information about their care and treatment and a large majority (90%) felt they were able to talk to hospital staff about their worries and fears (59% ‘always’ and 31% ‘sometimes’).
Furthermore, satisfaction with staffing levels showed some slight improvement in 2023. Fifty-six per cent felt there were ‘always’ enough nurses on duty to care for them in hospital – an increase on the 52% who said this in 2022, although still lower than in 2020 (62%). And 63% of respondents said that they were ‘always’ able to get a member of staff to help when they needed attention, an increase from 2022 (62%), although remaining 3 percentage points lower than 2020.
Despite the limited change in a number of question areas, when asked to rate their overall inpatient experience, just over half (51%) gave a score of nine or higher out of ten – compared to 50% in 2022.
Responses to the 2023 survey show that people admitted for emergency care, those who were considered frail, and those with Dementia, Alzheimer’s or a condition affecting their mobility all reported poorer than average experiences for most questions analysed. In contrast, older people, people who were in hospital for an elective admission, and those who stayed in hospital for only one night were generally more positive about their care.
As well as a report of the national findings, CQC has published the results for each of the 131 individual Trusts that took part, and a report identifying those trusts that have performed better or worse across the survey overall, so that people can see how their local services performed.
Nicola Wise, CQC’s Director of Secondary and Specialist Healthcare, said: “It’s disappointing that we haven’t seen more improvement in patient experience since the last time the survey was carried out. Overall, satisfaction rates remain far lower than they were pre-COVID with delays in accessing care and poorly coordinated discharge from hospital both clear factors impacting on the quality of people’s hospital stay.
“It’s also concerning that we’ve seen an increase in the number of people who feel their health deteriorated while they waited for elective care – further evidence that the current imbalance between patient demand and treatment capacity is putting people at risk.
“What is encouraging is that the majority of people surveyed continue to report positively about their interactions with staff - we know that staff and leaders are doing all they can to minimise delays, manage the flow of patients from admission through to discharge and provide compassionate person-centred care.
“But as pressures persist, ensuring the best possible experience throughout the entirety of the patient journey is a task that needs input from all parts of the health and care system. It also needs to be supported by continued efforts to address staff shortages, improve retention of our highly skilled workforce and ensure recognition of the commitment and dedication from frontline staff.”
For further information about the 2023 adult inpatients survey, including the national summary of results, please visit: https://www.cqc.org.uk/publications/surveys/adult-inpatient-survey
