The results of the latest annual survey of hospital inpatients published by the Care Quality Commission

The results of the latest annual survey of hospital inpatients published today (12 September) by the Care Quality Commission (CQC) show patient satisfaction levels have remained largely static since 2021, but indicate a longer term decline in most areas compared to previous years. They also highlight growing frustration with waiting times and reveal that four in ten people scheduled for planned treatment said their health deteriorated while waiting to be admitted.

The 2022 adult inpatient survey captures the views and experience of more than 63,000 people who stayed in one of 133 acute and specialist NHS trusts in England for at least one night during November* last year. It has been carried out annually since 2002.

The survey asked people to give their opinions on the care they received, including quality of information and communication with staff, whether they were given enough privacy, the amount of support given to help them eat and drink, and on their discharge arrangements.

In 2022, over a third of respondents who were in hospital for elective care (39%) said they would have like to have been admitted sooner (compared to 35% who said this in 2021 and 32% in 2020) and around four in 10 (41%) said their health deteriorated while waiting to be admitted, with 24% saying it got ‘a bit worse’ and 17% said their health got ‘much worse’ respectively.

A significantly higher proportion of people felt they waited longer to access a bed on a ward after arriving in hospital in 2022 when compared to both 2021 and 2020. Those that said they ‘had to wait far too long’ increased to 18% in 2022 (compared to 15% in 2021 and 8% in 2020), while those that said they ‘had to wait a bit too long’ increased to 16% (compared with 15% in 2021 and 12% in 2020).

The majority of respondents were still positive about their interactions with doctors and nurses - as has been the case in previous years. Most people surveyed (81%) said they ‘always’ had confidence and trust in doctors treating them (unchanged from 2021) and more than four fifths (82%) felt they were ‘always’ treated with dignity and respect (unchanged from 2021).

Furthermore, responses to questions about the support provided by staff to meet people’s fundamental needs – most of which saw a significant decline in 2021 – remained generally unchanged in 2022. Seventy per cent of respondents reported ‘always’ getting help to wash or keep themselves clean (unchanged from 2021, but still down from 75% in 2020), and 75% said they were ‘always’ offered food that met any dietary needs or requirements they had (up from 74% who said this in 2021).

Most respondents felt they were given ‘the right amount’ of information about their condition or treatment (77%) unchanged from 2021, though lower compared with 80% in 2020.

However, despite limited change in a number of question areas, when asked to rate their overall inpatient experience, the proportion of people who gave a score of nine or higher out of ten declined to 50% in 2022 down from 52% in 2021 and 56% in 2020.  The latest survey results also highlight a deterioration in relation to waiting times, staffing levels, and access to previously prescribed medications while on a ward.

Just over half of survey respondents (52%) felt there were ‘always’ enough nurses on duty to care for them in hospital - compared to 55% in 2021, and 62% in 2020. And almost two in three (62%) said that they were ‘always’ able to get a member of staff to help when they needed attention (down from 63% in 2021 and 67% 2020).

Although most people surveyed (70%) said they were ‘always’ able to take their previously prescribed medication while on a ward, that proportion has fallen from 72% in 2021 and 75% in 2020. Thirteen per cent said they were ‘never’ able to take their medication (in both 2022 and 2021), up from 12% previously (2020).

In common with previous years, people’s experience at discharge also showed scope for improvement. Only 38% of respondents said they were involved ‘a great deal’ in decisions about their discharge (same as in 2021 and down from 40% in 2020), and less than half (45%) said they ‘definitely’ knew what would happen next in their care after leaving hospital (consistent with 2021 though down from 46% in 2020).

Responses to the 2022 survey show that people admitted for emergency care, those who were considered frail, have Dementia, Alzheimer’s or a neurological condition and younger people (age 16-50) all reported poorer than average experiences for either all or most questions analysed. In contrast, older people, people who were in hospital for an elective admission, and those who stayed in hospital for only one night were generally more positive about their care.

As well as a report of the national findings, CQC has published the results for each of the 133 individual trusts that took part, and a report identifying those trusts that have performed better or worse across the survey overall, so that people can see how their local services performed.

Dr Sean O’Kelly, Chief Inspector of Healthcare said: 

“However, the lack of improvements in areas such as discharge arrangements and in people feeling like they were given enough information is disappointing and highlights the need for us to do more. I would like NHS trusts to reflect on their individual survey results to help them pinpoint what changes are within their power to make to drive further improvement. 

“The NHS is struggling with a large elective care backlog, and these survey results reflect the impact of that backlog on people who need treatment, with an increasing number reporting that they waited too long to be admitted and four in ten saying their health deteriorated while waiting for planned treatment. The results also indicate growing public awareness of the difficulties staff face in meeting demand due to workforce shortages.

“We know that trusts are doing all they can to see patients as quickly as possible and to manage the flow of patients from admission through to discharge to maximise capacity. But as pressures continue to mount, ensuring the best possible experience throughout the entirety of the patient journey is a task that needs input from all parts of the health and care system. It also needs to be supported by the effective delivery of measures set out in the recently published workforce plan to help address staff shortages and harness the skill and commitment we have on the frontline going forward.” 

The survey findings have been shared with each participating trust so that they can review their individual results and take steps to address any areas where improvements are needed. CQC will continue to use the findings as part of its wider monitoring of the quality of hospital services and to plan and target its inspections.