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Content ArticlePositive results There are few results where the majority of people reported good experiences of mental health care. However, ‘organising care’ is an area where people were found to be more positive: 97% of people who have been told who is in charge of organising their care and services said they knew how to contact this person if they had a concern. 91% said the person that organised their care did so ‘very well’ (58%) or ‘quite well’ (33%). Another area where people were found to be more positive is ‘respect and dignity’: 73% reported that they were ‘always’ treated with dignity and respect. Key areas for improvement Crisis care 28% of people indicated that they would not know who to contact, out of office hours in the NHS, if they had a crisis. Of those who did try to contact this person or team, almost a fifth (17%) either did not get the help they needed or could not contact them (2%). Support and wellbeing 36% of people felt they had not had support with their physical health needs. 43% said they did not receive help or advice in finding support with financial advice or benefits. 43% of people did not get help or advice in finding support for keeping or finding paid or voluntary work, but would have liked this help. Accessing care 44% of people who had received NHS therapies in the last 12 months felt they waited too long to receive them. 24% of people felt they had not seen NHS mental health services often enough to meet their needs. 59% said they were ‘definitely’ given enough time to discuss their needs and treatment. Involvement 53% of those who had agreed with someone what care they will receive were ‘definitely’ involved as much as they wanted to be in the planning of their care. 52% of people who had been receiving medicines in the last 12 months were ‘definitely’ involved in making decisions about their medicines as much as they wanted to be. 50% of those who had received NHS therapies in the last 12 months were ‘definitely’ involved as much as they wanted to be in deciding which therapies to use. Communication 28% of people indicated that they had not been told who is in charge of organising their care. 24% of those who had been receiving medicines in the last 12 months for their mental health needs had no discussion about the possible side effects. 41% of people who had been receiving medicines had not had the purpose of discussed with them fully.
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Event
Tutorial on the AHRQ SOPS Data Entry and Analysis Tool
Patient Safety Learning posted a calendar event in Community Calendar
This webcast provides a tutorial on the AHRQ Surveys on Patient Safety Culture™ (SOPS®) Data Entry and Analysis Tool. Speakers will demonstrate how you can enter your SOPS survey data into the tool and it will automatically create tables and graphs to display your survey results. The tool allows healthcare organisations to compare results to the data in SOPS Databases. Register -
Content ArticleKey findings 45% of respondents have seen a permanent increase in the critical care capacity of their directorates. However, when asked if they consider any increase in capacity to be adequately staffed only 18% of respondents agreed. 60% of respondents reported that their units are still attempting to follow the Guidelines for the Provision of Intensive Care Services (GPICS) but 54% of respondents have seen some relaxation of those standards including to their medical staffing. 80% of respondents increased their working hours, and 71% report covering sick consultant colleagues. Future uncertainties affect the wellbeing of the Faculty’s fellows and members. How hospital structures support those working in critical care is vitally important for both recruitment and retention. 88% of respondents had leave cancelled. Work/life balance is extremely important. Whilst the vast majority of respondents were happy to deliver the needed increase in work in the first wave, to do this over subsequent waves of the pandemic becomes increasingly difficult for individuals and their family. Supporting professional activities and agreed job plans will be even more important in subsequent COVID-19 waves. Faculty fellows and members understood the impact the first wave of COVID-19 had on non-critical care staff, and hugely appreciated their response to the crisis. The flexible increase in staffing was so important for care, although the drop in GPICS standards underlines the need to increase the underlying critical care capacity, and the multi-disciplinary workforce. Key recommendations GPICS standards exist for reasons of best care, safety and governance. Units should be attempting to adhere to them or working towards achieving them. Inability to meet GPICS standards needs to be brought to the attention of management structures within hospitals and plans for addressing deficiencies identified and implemented. Supporting and maintaining the wellbeing of critical care staff is vitally important. Not only for recruitment by attracting multi-disciplinary team members in, but also for their retention in the specialty. Staff must not be taken for granted and listening to the voices from the frontline is only the start of this process. Enhanced Care recommendations, written and promoted by the Faculty, will allow for greater flexibility in future responses to surges in demand as well as safer care for those needing a higher level of care. Critical Care Directorates should make the case widely within their hospitals for enhanced surgical and medical care.
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Content ArticleKey findings The more deprived the area that a person lives in, the less likely they are to report a positive experience of accessing general practice and a good overall experience of general practice. Older patients tend to report better access to general practice – they are more satisfied with their experiences making appointments and find it easier to get through to their practice by phone. However, they are less likely to have used online services. Asian patients report poorer experiences making appointments and more difficulty getting through to their GP practice by phone. Black patients are the least likely to have used any online services. Differences in experience of and access to general practice observed between demographic groups have been consistent over the past 3 years of survey data (changes in survey method mean that we can’t look any further back).
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Content ArticleKey findings Fear of catching and becoming seriously ill with COVID-19 outweighed concerns about respondents’ existing health conditions. Around 1 in 3 people said they had delayed healthcare and this was broadly consistent across all conditions. This rose to 2 in 5 for people with diabetes, lung disease and mental health conditions. People had switched to home therapy, delayed starting new treatments, avoided routine medication monitoring or self- managed. Some felt their health had deteriorated while they waited for the pandemic to abate.
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Content ArticleCAHPS surveys CAHPS surveys ask patients to report on their experiences with a range of health care services at multiple levels of the delivery system. Some CAHPS surveys ask about patients' experiences with providers, such as medical, groups, practice sites, and surgical centers, or with care for specific health conditions. Other surveys ask enrollees about their experiences with health plans and related programs. Finally, several surveys ask about experiences with care delivered in facilities, including hospitals, dialysis centers, and nursing homes. CAHPS databases For each survey, you can download formatted survey instruments, guidance for administering them, and information on analysing and using the results. Information in the guidance documents is based on the survey developers' extensive research into best practices in survey design and administration as well as analyses of data collected during the field testing of each instrument. AHRQ does not require the use of any surveys or the use of a specific methodology for sampling or survey administration. CAHPS Ambulatory Care Improvement Guide The CAHPS Ambulatory Care Improvement Guide is a comprehensive resource for health plans, medical groups, and other providers seeking to improve their performance in the domains of patient experience measured by CAHPS surveys of ambulatory care. Use this guide to help your organization: Cultivate an environment that encourages and sustains improvements in patient-centered care. Analyze the results of CAHPS surveys and other forms of patient feedback to identify strengths and weaknesses. Develop strategies for improving performance.
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Content ArticleThe results of the survey showed a high degree of confidence among patients about visiting GP premises in person, despite the ongoing COVID-19 pandemic. Two thirds of patients reported feeling very (35%) or somewhat (31%) confident about making such a visit. Measures such as having hand sanitiser and Perspex screens at reception would increase this confidence further, with relatively few patients concerned about them. They also confirmed that many patients had been offered remote consultations, and that phone calls were much more common than online appointments. Rachel Power, Chief Executive of the Patients Association, commented: “These results show that patients are keen to visit their GP’s premises in person, and feel confident about doing so. They also show that remote consultations have worked well for some patients, but that real-world access to premises is essential for others. In reopening its primary care services, the NHS must ensure that the options for accessing GP premises meet the needs of all patients, and build on the strong confidence in visiting their GPs that patients continue to hold.”
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Centre for Perioperative Care: What is perioperative care?
Patient Safety Learning posted an article in Surgery
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Content ArticleThe results paint a bleak picture of the massive toll on all patients of the coronavirus pandemic and the emergency measures taken in response to it. Despite the large scale celebration of the NHS over the spring and early summer, the emergency measures came at a huge cost to patients. In particular, access to services became very difficult, and many patients were left feeling unsupported, anxious and lonely. The relationship between patients and the NHS has been significantly disrupted. It was by no means all bad: some patients reported good ongoing care, and were impressed by the way their local communities came together to support them. This report uses what patients said to look to the future, both near and long-term. It contains recommendations for the next phase of the emergency response, and also a call for the health and care system to be built back better after the pandemic: the current emergency footing cannot be the basis for the ongoing relationship between patients and the NHS.
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Content ArticleImplementation of COVID-19 related safety measures such as social distancing, use of PPE and cleaning were strongly supported by most respondents. There was ambivalence around less certain measures such as regular staff antigen and antibody testing. Respondents were most likely to participate in research related to their own condition, COVID-19 research and vaccine research, but less likely to participate in healthy volunteer research, especially if suffering from a pre-existing comorbidity identified with increased risk or were female. There was general agreement that participants are comfortable with new ways of working, such as remote consultation, though women and BAME respondents were less comfortable. Findings raise concerns for health inequalities already impacting some groups in the pandemic. The role of clinical necessity and personal benefit support the reopening of services in line with clinical necessity. Moderate caution in respect of vaccine research relative to patient-participant research presents a challenge for pending recruitment demands, and would benefit from qualitative research to explore themes and concerns in more depth and support development and targeting of key messaging.
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Content ArticleKey findings The survey responses confirm that for the majority of respondents, the pandemic has been a very challenging experience. They indicated that their work and wellbeing has been worse or much worse than at normal times, during the survey period. Having to accept patients from hospitals with unknown COVID-19 status, being told about plans not to resuscitate residents without consulting families, residents or care home staff, lack of guidance on issues like personal protection and issues of poor access to pay if they became ill were some of the major issues the care home workforce faced during March and April 2020. While two thirds of respondents said they ‘always’ had access to appropriate personal protective equipment (PPE) and most others said that it was usually available, a small minority were not provided with PPE and had to improvise, by obtaining it themselves or by making it. The need for appropriate PPE in care homes is of critical importance in staff and resident safety: 21% of respondents said that their home accepted people discharged from hospital who had tested positive for COVID-19. The majority of survey respondents found it easy to access hospital care for their residents when this was required; however, a substantial minority found this difficult or very difficult. Additionally, a substantial number found it difficult to access District Nursing and GP services, which are universal parts of the National Health Service. In addition, many indicated that they were not able to access essential training from other health professionals at this time. Some respondents refocused work to consider how they could improve on their approach to end of life care. Worryingly, some who responded raised serious ethical and professional concerns, for example GPs, Clinical Commissioning Groups and hospital trusts making resuscitation decisions without first speaking to residents, families and care home staff or trying to enact ‘blanket’ ‘do not resuscitate’ decisions for whole groups of people.
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News Article
Surgeons told not to discuss lack of PPE
Patient Safety Learning posted a news article in News
Dozens of surgeons have reported being told by the NHS employer to stop discussing shortages of personal protective equipment (PPE) during the coronavirus crisis. The Confederation of British Surgery (CBS) said almost 70 surgeons working in major hospitals around the country had been warned off discussing a lack of PPE by their trust. A third of surgeons said the supply of PPE was inadequate at their hospital, with many complaining of inconsistent guidance, rationing of supplies and poor quality PPE when it was available. When asked if their concerns were dealt with satisfactorily, nearly a third said they were not addressed, or not effectively. A survey of 650 surgeons by the union found many were now considering changes to the way they worked as a result of the crisis – with more than half, 380, saying they would be avoiding face-to-face meetings with patients in the future. More than 40 surgeons, around 7%, said they were now considering leaving surgery altogether. Read full story Source: The Independent, 10 August 2020 -
News Article
Coronavirus (COVID-19) Infection Survey pilot: England, 24 July 2020
Clive Flashman posted a news article in News
Initial data from the COVID-19 Infection Survey. This survey is being delivered in partnership with IQVIA, Oxford University and UK Biocentre. Full article here Table of contents in the report: 1. Main points 2. Number of people in England who had COVID-19 3. Regional analysis 4. Incidence rate 5. Test sensitivity and specificity 6. COVID-19 Infection Survey data 7. Collaboration 8. Glossary 9. Measuring the data 10. Strengths and limitations 11. Related links -
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News ArticleThere has been a sharp rise in the number of nurses considering quitting the profession compared to this time last year, suggest results from a new survey. The research also found that “existing tensions” among the workforce appeared to have been “exacerbated” by the COVID-19 crisis. The survey findings feature in a new report published by Royal College of Nursing and cover the views of almost 42,000 of its members across the UK and Channel Islands. Of those who responded to the survey, 36% of nurses were thinking of leaving the profession, an increase from 27% reported in a similar piece of research carried out at the end of last year. When considering the reasons for quitting, 61% of staff indicated that the level of pay was the “main driver”, while others said they were dissatisfied with the way nursing staff had been treated during the pandemic (44%). Meanwhile, 43% of nurses cited low staffing levels and 42% a lack of management support as key reasons for wanting to leave nursing. Read full story Source: Nursing Times, 17 July 2020
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Hospital ratings often depend more on nice rooms than on health care
Patient Safety Learning posted a news article in News
A study of 50,000 patients throughout the United States showed that those who were the most satisfied with their care (the top quartile) were 26% more likely to be dead six months later than patients who gave lower ratings to their care. The study, “The Cost of Satisfaction,” appeared in JAMA Internal Medicine. The researchers looked at Centers for Medicare and Medicaid Services (CMS) hospital data and patient surveys at more than 3,000 US hospitals over three years. The hospitals where fewer patients died had only a 2% point edge in patient satisfaction over the others. Cristobal Young, associate professor of sociology at Cornell University and lead author of the study, calls it “the halo effect of hospitality.” Young found that what mattered most to patients in ratings were the compassion of nurses and amenities like good food and quiet rooms. It’s why hospital managers are being recruited from the service industry and we’re seeing greeters in the lobby and premium TV channels in rooms, he says. Patients tend to value what they see and understand, but that can be limited, Young continues. They give hospitals good cleanliness ratings when they observe waste baskets are emptied and sheets are changed. “They can’t see a virus or tell you how clean the room is in ways that matter,” he says. Read full story Source: 4 July 2020, Washington Post -
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Third of frail hospital leavers in England find post-discharge care lacking
Patient Safety Learning posted a news article in News
Problems with hospital discharges in England, highlighted in the largest annual patient survey, reinforce the need for greater integration between health and social care, the sector regulator has said. The Care Quality Commission inpatient survey found that a majority of patients were positive about their hospital care but a significant minority experienced problems on discharge. A third of respondents who were frail said the care and support they expected when they left hospital was not available when they needed it. Three in 10 frail people said they had not had discussions with staff about the need for further health and social care services they might require post-discharge. Four in 10 of all patients surveyed left hospital without printed or written information about what they should or should not do after discharge, and the same proportion said their discharge was delayed. Read full story Source: The Guardian, 2 July 2020 -
Content ArticleKey findings Most questions on the theme of being treated in a respectful and dignified manner continued a trend of sustained improvement over the last 3-6 years. Results show communication between staff and patients before and after operations is improving. Patients continue to report positively when asked about the cleanliness of the hospital environment, the choice of food available to them and hydration. Confidence in doctors and nurses also remains high this year. However, this year’s results indicate that there are areas in need of improvement: Patients consistently reported less positive experiences for the themes of: communication at the point of discharge and consideration of the support they will need after leaving hospital. Results for information sharing in relation to medicines, including: explaining the purpose, being told about possible side effects and being given written or printed information all declined this year. The percentage of people experiencing shortages in nursing staff remains high. Certain groups of patients consistently reported poorer experiences of their time in hospital, including patients with dementia or Alzheimer’s, younger patients (aged 16 to 35) and patients who were admitted in an emergency.
