Big improvements in hospital cleanliness and mixed-sex accommodation, finds major NHS survey

But Care Quality Commission urges NHS to tackle lack of information about medicines
A major survey of 69,000 NHS hospital inpatients points to big improvements in cleanliness and a decline in mixed-sex accommodation, says the Care Quality Commission.

The Commission today published the results of the 2009 NHS Inpatient Survey coordinated by Picker on behalf of CQC, covering 162 hospital trusts in England.

CQC said many of the survey questions relate to essential standards of quality and safety that trusts must meet under the new registration system that came into operation on 1 April. The information is used to monitor performance in the NHS.

In 2009, 64% of patients rated their hospital room as “very clean”, up from 60% in 2008 and 56% in 2002. The Commission said this mirrored year-on-year improvements in all questions related to infection control, such as whether bathrooms were clean and if staff washed their hands.

In 2009, the proportion of patients who reported sharing accommodation with the opposite sex fell significantly. For emergency patients, 21% said they initially stayed in mixed-sex accommodation, down from 29% in 2008. The proportion of people admitted from waiting lists to mixed-sex accommodation also decreased, from 10% in 2008 to 8% in 2009.

But the Commission said progress was disappointing in some important aspects of care and in some cases the experience of patients had got worse.

The survey showed significant room for improvement around the information given to people about medicines. The proportion of patients who said they were not given enough information about the purpose of medicine they were given to take home has steadily increased, from 7% in 2002 to 8% in 2008 and 9% in 2009. In 2009, 45% of patients said they had not been given enough information about potential side effects of medication, up from 44% in 2008 and 2002.

The Commission said the NHS must address the lack of help for patients to eat. Almost one in five patients (18%) said they did not get enough help to eat their meals if they needed it – the same as in 2002. There was an increase in the proportion who said they “always” received enough help to eat, but a corresponding decrease in the proportion who said they “sometimes” received enough help.

Overall, 44% of people rated their care as “excellent”, 35% “very good”, 13% “good”, 5% “fair” and 2% “poor”. This shows improvement since 2002, when the figures were 38%, 36%, 17%, 7% and 2% respectively.

Cynthia Bower, CQC’s chief executive, said: “The survey results have shown year-on-year improvements in many important aspects of hospital care. Infection control and mixed-sex accommodation have been a big concern for patients, so it’s encouraging to see the substantial improvements in these areas.

“But there are also some persistent problems that the NHS is struggling to address. It is unacceptable that almost 50% of patients did not have the potential effects of medicine properly explained to them. I’m also concerned that some people who need help to eat are not getting enough assistance. These are fundamentals of care and it is time for the NHS to tackle these issues head-on.”

NHS trusts use the survey results to identify where improvements are needed and to track the experience of patients in hospital.

The Commission uses the survey results to monitor performance in the NHS. CQC analyses the survey results alongside a range of other information, such as findings from inspections, data on mortality and infection rates and intelligence from other organisations, to monitor compliance with the new essential standards of quality and safety and to help determine where further regulatory action is needed.

Ms Bower said: "We are using more and more information from patients to help identify where we need to focus our efforts as the regulator. Many of these questions relate to the registration standards and we will be using this information from patients when we assess and inspect trusts.

“We expect every NHS hospital trust to pay close attention to their results and plan how they can improve the experience of hospital patients.”