During the early part of 2014, the Care Quality Commission (CQC) interviewed almost 40,000 adults who attended large Accident and Emergency departments in January and February about their experiences.
A&E Performance – The Main findings
Perhaps the best news for the NHS to come out of the research was that the majority of patients were positive in their feedback. 79% of patients felt that they had been treated with dignity and respect. This does of course mean that a significant number – more than 1 in 5 – felt that they had not been treated in this way. Feedback about discharge procedures was also largely positive.
The report also found that A&E departments should be doing more to make sure they are offering a safe, effective and responsive service. Some patients arriving in A&E waited for lengthy periods in an ambulance before having their care transferred to A&E staff, and others waited too long to be given adequate pain relief.
The worrying variation in performance between hospitals
The report also flagged up wide variations in experiences between different patients, trusts and groups of patients. Chief Inspector of Hospitals, Professor Sir Mike Richards, said that they had found “significant variation” between different NHS Trusts.
The report also highlighted the fact that patients with learning disabilities or mental health problems should be given more support from A&E staff if they become distressed.
The report was also happy to publish lists of the best and worst A&E departments across the country. It won’t come as a surprise to our blog readers that some of the NHS Trusts whose A&E departments are listed as the poorest performing have been discussed previously for other patient failings too.
The worst Accident and Emergency departments in England and Wales
The “prize” for the worst A&E department goes to Tameside Hospital Foundation Trust in the North-West, with Medway Foundation Trust in Kent as a close runner-up. Both of these hospitals were put into special measures over a year ago over rising concerns about high death rates and failures in care.
Trusts Performing “Worse than Expected”
There are a number of Trusts which performed “worse than expected” in at least 20% of all the questions asked of respondents. Two Trusts were graded “worse” than other trusts in two out of three questions, and unsurprisingly these two are Tameside Hospital NHS Foundation Trust and Medway NHS Foundation Trust. Tameside was rated extremely poorly in questions regarding how well staff communicated with patients and the quality of information given, as well as the guidance given on discharge. Medway NHS Foundation Trust performed more poorly than had been expected on waiting times and staff interaction.
The full list of Trusts performing worse than expected is:
1. Tameside Hospital NHS Foundation Trust
2. Medway NHS Foundation Trust
3. Barking, Havering and Redbridge University Hospitals NHS Trust
4. North Middlesex University Hospital NHS Trust
5. Croydon Health Services NHS Trust
7. Milton Keynes Hospital NHS Foundation Trust
8. Barnet and Chase Farm Hospitals NHS Trust
9. Bradford Teaching Hospitals NHS Foundation Trust
10. University Hospitals of Leicester NHS Trust
Better than Expected Results For Some
The other side of the coin are the 12 NHS Trusts which were found to be performing “better than expected” in 20% of questions within the patient survey.
Dorset County Hospital NHS Foundation Trust topped the charts by performing better than had been expected in 69% of the survey questions, and was consistently strong in sections concerning communication between staff and patients and information given to patients when they were discharged.
The “better than expected” NHS Trusts are:
1. Dorset County Hospital NHS Foundation Trust
2. Salisbury NHS Foundation Trust
3. Taunton and Somerset NHS Foundation Trust
4. Royal Surrey County Hospital NHS Foundation Trust
5. Cambridge University Hospitals NHS Foundation Trust
6. South Tees Hospitals NHS Foundation Trust
7. Salford Royal NHS Foundation Trust
8.Epsom and St Helier University Hospitals NHS Trust
9. Frimley Park Hospital NHS Foundation Trust
10. South Warwickshire NHS Foundation Trust
11. Northumbria Healthcare NHS Foundation Trust
12. Harrogate and District NHS Foundation Trust
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