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Many people experience good urgent and emergency care but some report waits and want better information when they are discharged

03/11/2017

CQC Findings from a survey of more than 45,000 people who received urgent and emergency services provided by 137 NHS trusts across England show positive results for many aspects of care and treatment.

The Care Quality Commission (CQC), survey reveals the responses from patients who attended either a major consultant-led accident and emergency department (Type 1) or a minor injury unit or urgent care centre (Type 3) run directly by an acute hospital trust during September 2016.

The majority of people who had attended a Type 1 department said they 'definitely' had confidence and trust in the doctors and nurses treating them (75%), felt they were treated with respect and dignity 'all of the time' (78%) and that they 'definitely' had enough time to discuss their medical problem with staff (73%).

People who had been treated at a Type 3 service were also very positive about their interactions with staff: 84% said that they were given the 'right' amount of information about their condition or treatment. Seventy-five percent rated their overall experience as '8' or above on a scale of 0 to 10 and nearly three quarters (74%) said they were definitely involved as much as they wanted to be in making decisions about their care and treatment.

However, over a quarter (29%) of those people who had requested pain relief medication in a Type 1 department said that they waited over 15 minutes before they received it and 7% said they did not receive any at all.
The results also reveal that just over half (53%) of people who were discharged home from a Type 1 department said they had not been made fully aware of important symptoms to look out for before being discharged. Over a quarter (27%) said they were not told who to contact if they were worried about their condition or treatment after they left and 45% of those who felt it was necessary, said that their family or home situation was not taken into account before they were discharged.

Responses to questions on waiting times showed that 33% of patients waited less than 15 minutes to speak to a doctor or nurse when they first arrived at a Type 1 department. Almost a third (32%) reported waiting over an hour before they were first examined and 4% said they waited more than four hours.

Around a third of patients (32%) were taken to a Type 1 Emergency department in an ambulance. Of these 16% said they waited over 30 minutes with the ambulance crew before they care was handed over to staff in the hospital and of these, 8% waited over an hour.

Professor Ted Baker, CQC's Chief Inspector of Hospitals, said: "This year's survey shows some very positive results. The fact that the majority of people reported a good overall experience is testament to the efforts and dedication of the frontline staff working in emergency departments across the country to ensure that people receive the care and treatment they need. Those staff should be proud of their achievements.

"The challenge of increased attendances puts huge pressure on emergency departments. The survey questions where patients responded less positively such as waiting times, discharge arrangements and access to timely pain relief are concerning at a time of increased demand when staff are at full stretch.

"I would like trusts to reflect on their survey results to understand what their patients really think about the care and treatment they provide. This will help them to identify where they may be able to take learning from other trusts to support improvements, particularly where that has involved collaboration with other local services to better manage capacity and improve discharge arrangements.

"Gathering feedback from people who use services is an important part of regulation. This year's survey findings will to feed into our future inspection activity and our ongoing monitoring of the quality of care."

The full results for England, as well as individual results for each trust are available on CQC's website: www.cqc.org.uk/emergencydepartmentsurvey

This is the sixth survey to gather patients' views on emergency department services. For the 2016 survey changes were made to the sampling approach and the method used to analyse the results. This means that it is not possible to make comparisons with previous years.

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