Graphic: the best and the worst

Patients experience wide variations in cleanliness and “striking” differences in some areas of patient care while in hospital, a national survey by the country's health watchdog shows.

The Healthcare Commission found that patients treated in NHS hospitals are generally satisfied with their care, and a growing proportion rate it as excellent. But there are increasing concerns about cleanliness, and fewer patients than in previous surveys believed that doctors and nurses always washed their hands between patients.

The biggest variations came in how long patients were kept waiting for admission to hospital, their experience of mixed-sex wards, the quality of food and the help they were given in eating it. The survey, which has been carried out annually since 2002, questioned 75,000 adult patients at 165 trusts. In general, the results show that patient satisfaction is inching up.

Those rating their overall care as “excellent”, for example, went up from 41 per cent in 2006 to 42 per cent in 2007. In 2002, the first year of the survey, it was 38 per cent. The Robert Jones and Agnes Hunt Orthopaedic and District Hospital NHS Trust in Shropshire ranked top last year with 77 per cent reporting excellent care, and Ealing Hospital NHS Trust in London bottom, with 24 per cent.

Patients also reported slight improvements in how long they waited in accident and emergency before being admitted to a ward. In 2007 73 per cent said that they waited up to four hours, compared with 72 per cent in 2006 and 67 per cent in 2002.

The number of patients reporting that their hospital was “very clean” fell from 56 per cent in 2002 to 53 per cent in 2006, and the same figure in 2007. Among the best performing trusts, around 80 per cent said their room or ward was “very clean”.

But fewer than half of patients reported that lavatories and bathrooms were very clean. In the best trusts this figure was as high as 81 per cent but in the worst was as low as 22 per cent.

The survey found that 68 per cent of patients said that, as far as they knew, doctors “always” washed their hands between patients, down 1 per cent on last year. At the worst-performing trust, Maidstone and Tunbridge Wells, only 45 per cent said yes. At the best, Queen Victoria Hospital NHS Foundation Trust in East Grinstead, 88 per cent said yes.

About a quarter of people reported being in a mixed-sex ward when first admitted to hospital, and a fifth when they moved wards, both figures showing slight improvements compared with last year.

More than a fifth of patients (22 per cent) complained that nurses “often or sometimes” talked over their heads as if they weren'tthere, and that a similar proportion of doctors did the same.

Food was rated as good or very good by 55 per cent of respondents, up 1 per cent since 2006. In the highest-scoring trust for food, Robert Jones and Agnes Hunt Orthopaedic and District Hospital, 62 per cent of patients rated it “very good” while in the worst, Royal Liverpool and Broadgreen University Hospitals NHS Trust, only 8 per cent said it was very good.

Ann Keen, the Health Minister, said: “This survey gives a real insight into what patients think about their care, with many reporting high levels of trust in NHS staff, high standards of care and high rates of cleanliness during their stay in hospital.

“But we are not complacent. We will continue to listen to patients and work on those areas where improvements need to continue.”

Anna Walker, chief executive of the Healthcare Commission, said: “This survey gives the most comprehensive picture available of how patients feel about NHS hospitals. And, importantly, it allows comparisons between trusts across the country.

“Overall, it's encouraging that a steadily increasing percentage of patients say care is ‘excellent'. But the survey also shows that in some hospitals the NHS is struggling to deliver on some of the basics of hospital care. There are striking variations in performance in key areas such as providing single-sex accommodation and giving people help when they need it. Those performing poorly must learn from those who perform well.

“It's crucial that trusts take this information on board. The patient voice must be heard loudly on the boards of trusts across the country.”

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