Patient safety

Privacy of care environment in rapid decline, patients warn

Patients have this week voiced increasing dissatisfaction with the privacy of care environments in hospitals across England.

In NHS Digital’s fifth annual Patient Led Assessment of the Care Environment (PLACE) report, it was revealed that 1,230 assessments were carried out by 279 organisations, and used 6,399 patient assessors to find the views of the public on Cleanliness, Food and Hydration, Privacy, Dignity and Wellbeing, and the Condition, Appearance and Maintenance of hospital wards.

Specifically, the report found that for Privacy, Dignity and Wellbeing, the national average satisfaction level stood at 83.7%, which was a 0.5 percentage drop from 2016 and a 4 percentage point decrease since 2014.

The Privacy, Dignity and Wellbeing domain includes infrastructural and organisational aspects such as the provision of outdoor and recreational areas, changing and waiting facilities, and access to television, radio, internet and telephones. It also includes the practicality of male and female services e.g. sleeping, bathroom and toilet facilities, bedside curtains sufficient in size to create a private space around beds and ensuring patients are appropriately dressed to protect their dignity.

In some sites, the score for this area dropped as low as 51%, meaning that nearly half of patients reported being dissatisfied with the care environment in this area.

Average national Privacy, Dignity and Wellbeing scores decreased for Acute/Specialist, Mixed Service and Treatment Centre site types between 2016 and 2017. The largest decline in score was for Mixed Service facilities, where there was a 3 percentage point decrease. These scores increased slightly for Mental Health and Learning Disabilities, Other Inpatient and Treatment Centre site types.

In other areas, there were some rises. For cleanliness, the national average stood at 98.4%, which amounted to a 2.6 percentage point increase since 2013.

And patients also reported being happy with the state of food and hydration in hospital trusts, as the national average went up by 0.9 percentage points since 2014 to 89.7%.

For Condition, Appearance and Maintenance, satisfaction also went up by 0.6 percentage points to 94%. Trusts were also found to have considerably improved in making hospitals more accessible, as national disability scores across England increased.

John Kell, head of policy at the Patients Association also told NHE that this year's PLACE report showed a further deteroiation in the Privacy, Dignity, and Wellbeing doman, further to that seen in 2016. 

"Given the pressures on the NHS, it’s not surprising that patients are observing worse performance in these aspects of care which, while not strictly medical, can make a big difference to their overall experience," he said.

"Providers may feel they need to let these areas slip somewhat in order to focus on getting the medical aspects right, which is not a choice they should be having to make. Unless and until the government commits appropriate levels of funding to the NHS, we would expect to see this trend continue.”

A DH spokesperson told NHE: "These figures are encouraging and show that putting patients in the driving seat when it comes to assessing their care is the best way for the NHS to maintain its high standards.

"PLACE helps increase transparency in the NHS and identifies areas of improvement; giving patients the power to speak up about the changes they expect to see in the environment.”

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