Most people seen in accident and emergency in England are positive about the care they receive from nurses and doctors, despite the huge pressures on departments, suggests a large-scale survey.
The national survey showed three quarters of people who attended a major A&E department said they “definitely” had confidence and trust in the nurses and doctors who cared for them.
“The challenge of increased attendances puts huge pressure on emergency departments”
Meanwhile, 78% of patients felt they were treated with dignity and respect “all of the time” and 73% said they “definitely” had enough time to discuss their clinical problem with staff.
Those treated at minor A&Es and urgent care centres run by acute trusts were also positive about the care they received, with three quarters rating their overall experience at eight or more out of 10.
The survey involved more than 45,000 people who received urgent and emergency services at 137 trusts during 2016. It was carried out by the Picker Institute for the Care Quality Commission.
However, the research also revealed perceptions of delays among patients, including when it came to getting pain relief, and a lack of information for those discharged from hospital.
“As we head towards winter, there are real concerns over whether we have the capacity to deal with the pressures ahead”
Responses on waiting times showed a third – 33% – of those who went to a major A&E department waited less than 15 minutes to speak to a nurse or doctor when they first arrived. But 18% said they waited for more than an hour.
Almost a third – 32% – said they waited over an hour before they were first examined by a nurse or doctor, with 4% waiting more than four hours.
Of those respondents who were in pain and requested pain relief, 29% waited over 15 minutes before they received it, and 7% said they did not receive pain relief at all.
They survey, published today by the Care Quality Commission, also suggested there were gaps in the amount of emotional support staff were able to provide.
For example, 16% of respondents who had anxieties or fears about their condition or treatment said a doctor or nurse did not discuss them, while 27% felt staff had discussed them “to some extent”.
Of those who felt distressed while they were in the emergency department, less than half – 48% – said that a member of staff “definitely” helped to reassure them.
“The results highlight the good patient centred care being practiced around the country, despite continual pressures”
When it came to being discharged from A&E, more than half – 53% – of people said they had not been made fully aware of symptoms to look out for before being sent home.
Meanwhile 27% said they were not told who to contact if they were worried about their condition or treatment, and 45% said their family or home situation had not been taken into account when they were discharged when it should have been.
The CQC said the fact that the majority of people reported a good overall experience was testament to hard-working and dedicated frontline NHS who “should be proud of their achievements”.
However, CQC chief inspector of hospitals Professor Ted Baker said some of the findings were cause for concern.
“The challenge of increased attendances puts huge pressure on emergency departments. Survey questions where patients responded less positively – such as waiting times, discharge arrangements and access to timely pain relief are concerning at time of increased demand when staff are at full stretch,” he said.
edward ted baker
He urged trusts to reflect on their individual survey results and learn from best practice – such as successful partnership work – in order to improve the way they managed capacity and discharge.
The NHS Providers organisation said the survey demonstrated the skills and commitment of staff in urgent and emergency care, who were often working in “extremely difficult circumstances”.
“Despite the relentless rise in demand and gaps in staffing, a large majority of patients were positive about their experience,” said head of policy Amber Jabbal.
“But the findings also suggest the growing pressures may – at times – affect the quality of care,” she said. “It is vital that staff are able to take time to discuss treatment, offer adequate pain relief, and ensure that patients have the information they need after they have been discharged.”
She added: “Trusts are doing their level best to ensure this happens. But as we head towards winter, there are real concerns over whether we have the capacity – including beds and staff – to deal with the pressures ahead.”
Dr Taj Hassan, president of the Royal College of Emergency Medicine, said: “I am delighted to see that a majority of patients who took part in the survey felt they were treated with dignity and respect, and felt that they had confidence and trust in the doctors and nurses treating them.
“Emergency department staff continuously aim to provide a high-quality patient centred service,” he said. “The results highlight the good patient centred care being practiced around the country, despite continual pressures.
“However, the findings of the survey also allude to what we have been saying for some time: we do not have enough resources to match demand,” he added.