Nearly a third of families say staff are not always available to care for young patients when needed, according to the first large-scale national survey of children’s hospital care.
Overall, the Care Quality Commission survey of nearly 19,000 under 16s treated in hospital painted a fairly positive picture with 87% of young people and 88% of parents or carers rating their overall experience as seven or more out of 10.
“Nationally, most young people and children said they were happy with their care”
But the survey, featuring results from 137 acute trusts, also found “marked variation” in the quality of care provided by different trusts and some key areas for improvement.
Young participants were either treated as inpatients or day cases. Questionnaires were sent to children aged eight to 15 with some extra questions for parents. For children under eight the survey was sent direct to their parent or carer.
Almost one in three – 32% – of parents or carers reported staff were not always available when their child needed attention.
Sixty-four per cent of parents and carers said staff were always available when their child needed attention but for 28% that was only sometimes and four per cent staff were not around when needed.
Meanwhile, 42% of parents of children aged eight to 11 years said staff did not play or do any activities with them while in hospital.
Forty-one per cent of parents and carers felt staff were not always aware of their child’s medical history before treating them, and 35% said they were not actively encouraged to be involved in decisions about care and treatment.
Forty-three per cent of 12- to 15-year-olds said they were not fully involved in decisions about their care.
“The trust is committed to continually improving services for our young patients”
Scores were less positive across the board among those families where a child had special need such as mental health condition, learning disability or physical disability.
Professor Edward Baker, the CQC’s deputy chief inspector of hospitals, said there was “much to celebrate” in this initial survey, but added variations in care must be addressed.
“Nationally, most young people and children said they were happy with their care, are able to understand the information given by staff following an operation or procedure and they have confidence staff are doing everything they can to manage their pain,” he said.
“However, there is marked variation between the results from different hospitals,” he said, adding that this pattern reflected results from hospital inspections.
“Hospitals should examine the results of this survey, together with our inspection reports and take steps to improve where necessary,” he said. “Children should not have different standards of care depending on which hospital they go to.”
Overall, the survey found nearly three quarters of parents and carers – 74% – said staff caring for their child worked well together. Twenty-two per cent said staff worked well together “to some extent”, while 2% said staff did not work well as a team.
A fifth of children and teenagers said staff definitely or “sort of” talked about them as if they were not there.
Three quarters of children and young people reported that if they had worries someone at the hospital talked to them about them but 18% said that only “sort of” happened and seven per cent said no one talked to them.
Seventy-nine per cent of parents and carers said they always had confidence and trust in the staff treating their child for 18% that was only sometimes and three per cent said “no”.
The survey – which covered children discharged from hospital between July and September last year – featured a range of questions covering areas like facilities, pain management, information given to young people and families and discharge, with each trust told whether they had performed better or worse than expected based on overall national results.
Among those to perform consistently well was Queen Victoria Hospital NHS Foundation Trust in East Grinstead, which did “better than expected” in 21 out of the 24 questions it participated in.
It scored better than expected on all the staff-related questions relevant to the trust including 10 out of 10 on staff agreeing a care plan, and looking after children well, 9.9 for confidence and trust in staff, 9.8 for staff working well together and 9.7 for staff availability.
These scores were based on the care of 111 children and young people.
North Middlesex University Hospital NHS Trust and Bradford Teaching Hospitals NHS Foundation Trust were pinpointed by the CQC for having performed “worse than expected” in 11 questions each.
North Middlesex did worse than expected in five questions relating to staff, including on whether staff were available when needed with scores based on the care of 88 children and young people.
“The survey looked at inpatient experience in the hospital last summer – between July and September – when we were midway through a major refurbishment programme of our children’s wards. There were a number of ward moves as a result and we were using old, un-modernised accommodation,” said a trust spokesman.
“Notwithstanding this, we are pleased that the vast majority of children and their parents and carers were pleased with our service,” he said. “We have since opened our new paediatric assessment unit and a new paediatric day assessment unit.
He added: “We have also had a great deal of success recruiting and retaining our paediatric nursing staff and we are undertaking work to develop and train all our nurses and encourage empowerment, career development and job satisfaction. We know that having happy, fulfilled staff improves the quality of care to our patients.”
Bradford did worse than expected on eight out of the nine staff questions, including when it came to staff being available when needed and staff knowing a child’s medical history. The scores were based on the care of 148 children and young people.
Clinical director for women and children Dr Des Ginbey said the trust would use the feedback and was “committed to continually improving services for our young patients”.
“We are currently investing £28m in a new hospital wing at Bradford Royal Infirmary,” he said. “This will house two paediatric inpatient wards and our current children’s surgical ward will undergo a full refurbishment and become a day-case facility for both surgical and medical day cases.”