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17.10.17

CQC: Quality of A&E care improving but waiting times still a concern

A CQC survey has revealed that most people receiving urgent and emergency care in England are happy with their doctors and nurses.

However, the 2016 Emergency Department Survey indicates serious concerns over long waiting times for treatment as well as problems with the speed at which pain medication was administered to patients.

The report analysed data from services across 137 NHS trusts related to both major consultant-led accident and emergency departments (Type 1) and minor injury and urgent care centres (Type 3).

Over a quarter (29%) of 41,000 people who requested pain relief in a Type 1 department reported waiting over 15 minutes to receive treatment, with a further 7% saying they did not receive any at all.

Conversely, 75% patients who visited the Type 1 facilities said they ‘definitely had confidence and trust in the doctors treating them while 78% felt they were treated with respect and dignity ‘all of the time’.

Results from 3,600 people using Type 3 services were similarly positive, as 75% of patients rated their experience as eight or above on a 0 to 10 scale, with 84% saying they were given the right amount of information about their condition or treatment.

“This year’s survey shows some very positive results,” commented Professor Ted Baker, CQC’s chief inspector of Hospitals. “The fact that the majority of people reported a good overall experience is testament to the efforts and dedication of the frontline staff working in emergency departments across the country to ensure that people receive the care and treatment they need. Those staff should be proud of their achievements.

“The challenge of increased attendances puts huge pressure on emergency departments,” he added. “The survey questions where patients responded less positively such as waiting times, discharge arrangements and access to timely pain relief are concerning at a time of increased demand when staff are at full stretch.”

In addition, the report brought up issues surrounding the information patients are given when they are discharged.

Just over half (53%) of those surveyed from Type 1 departments said they had not been made fully aware of important symptoms to look out for in future and over a quarter (27%) did not know who to contact with concerns about their condition.

There were also some slight concerns about ambulance times, with 16% of the people who needed to be driven to the hospital waiting over half an hour and a further 8% waiting an hour.

“I would like trusts to reflect on their survey results to understand what their patients really think about the care and treatment they provide,” Professor Baker continued.

“This will help them to identify where they may be able to take learning from other trusts to support improvements, particularly where that has involved collaboration with other local services to better manage capacity and improve discharge arrangements.”

In response to the report, NHS Providers stressed the positive results, specifically pointing to the work services are doing in spite of rapidly increasing demand.

“This survey provides further evidence of the skills and commitment shown by frontline NHS staff in providing urgent and emergency services, often in extremely difficult circumstances,” explained Amber Jabbal, head of policy for the members group.

“The CQC is right to say they should be proud of their achievements. Despite the relentless rise in demand and gaps in staffing, a large majority of patients were positive about their experience.”

However, NHS Providers also accepted that staff needed to continue to strive for the highest class of care, especially with the tough winter period approaching.

“But the findings also suggest the growing pressures may, at times, affect the quality of care,” Jabbal added.

“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.

“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.”

Although the survey was mostly positive, worries around waiting times come at a difficult time for the NHS, just days after the Royal College of Surgeons (RCS) warned the government about hospital standards slipping.

The RCS pointed to lengthening times for planned treatments in hospitals and the failure to reach the accepted 18-week mark for services.

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