Patients praise quality of care in A&E

The results of a survey, by the Healthcare Commission, have shown that the majority of patients are very satisfied with the treatment they receive in A&E, but concerns remain over pain control, information given at discharge, and the involvement patients have in making decisions about their care. The survey included responses from just under 50,000 patients over age 16, who had visited an A&E or emergency department between January and March 2008, and was carried out in 151 hospital Trusts. The report showed that 88% of patients rated the care they received in A&E as “excellent”, “very good” or “good”, while 69% of patients who travelled in an ambulance rated the care given by ambulance staff as “excellent”.

Communication
The survey has shown there have been improvements in communication since it was last carried out in 2003 and 2004. More patients said that they definitely had enough time to discuss their problem (69% up from 62% in 2003), and that they were definitely listened to by doctors and nurses (76% up from 73% in 2003). The survey also showed some improvement in provision of information on discharge. However, too many people said they left A&E without all the information they needed. Eighty-four per cent of respondents who were prescribed new medication before leaving the emergency department said the purpose of medication was fully explained to them, up from 82% in 2003 and 81% in 2004. Just over a third (37%) said they were given a complete explanation of possible side-effects of their medication (35% in 2003, and 36% in 2004). Of those who needed information about when to resume usual activities – such as going back to work or driving a car – only 37% said they definitely received it (35% in 2004). Almost two thirds of respondents (65%) said that a member of staff told them what danger signals to watch for after they went home, either completely, or to some extent. This leaves over a third of people who said they were not told what danger signs to look out for after they have left A&E (35%). The results also highlighted other key areas of concern. The survey showed that 59% of people said staff definitely did everything they could to help control pain, a further 27% said they did to some extent, and 14% said they did not. This shows some progress since 2003 and 2004, but the Commission said that further improvement is required in this area. Separately, the Healthcare Commission’s recent review of urgent and emergency care showed wide variations in whether A&E units met the guidance for the timescale within which pain relief should be given to children with a fractured limb.

Cleanliness
There were no significant improvements since 2004 in patients’ views on cleanliness of departments. Less than half of respondents (44%) rated the emergency department as very clean – no change since 2004 but a decrease from the 2003 survey (48%). Forty-seven per cent rated the emergency department as fairly clean (46% in 2004). Nine per cent rated the department overall as not very clean or not at all clean. Of those who used the toilets, 38% rated them as very clean, and 16% reported that they were not very clean or not at all clean. This shows no change since 2004, but is a decrease from the 2003 survey, where more respondents rated the emergency room toilets as very clean (43%) than fairly clean (42%). There were also areas where improvements could be made relating to respect and dignity. Although a majority (79%) said that they were definitely given enough privacy when being examined or treated, this decreased slightly from 80% in 2004. When booking in at reception, only 41% of patients said they were “definitely” given enough privacy to discuss their condition.