Scottish Inpatient Patient Experience Survey 2011 Volume 1: National Results

10 Results - Other comparisons

Patient Characteristics

10.1 A more sophisticated analysis has been undertaken using the 2010 survey data to take into account all patient characteristics that influence the likelihood of a patient reporting a positive experience. The topic report was published on the same day as this publication ^[13].

Hospital Type

10.2 Last year's report found that there were differences in the experiences of patients in different types of hospital. This year a similar pattern was found. Patients in teaching and large general hospitals are less likely to report a positive experience compared to patients in general and community hospitals.

Comparisons with English Inpatient Survey

10.3 A number of the questions in the 2011 Scottish inpatient survey are broadly comparable to those in the 2010 English inpatient survey ^[14], a survey of inpatients in NHS hospitals in England. This section of the report compares the findings from both surveys where relevant. The wording of questions and response options are different and this has been discussed when reporting differences.

10.4 It is important to note that there are differences in the way that the English and Scottish results have been calculated. The English results are the unweighted mean result of all NHS Trusts. However the Scottish results have been calculated by weighting the results by the total number of eligible inpatients attending a particular hospital over the year to provide results more representative of the population. Giving NHS Boards equal weighting as was done for NHS Trusts in England would provide misleading results because it would give Greater Glasgow and Clyde's results (where there are over 80,000 inpatients annually) the same contribution to the national results as NHS Orkney' results (where there are less than 1,000 inpatients annually). The effect of this type of weighting for the Scottish results would be to inflate the national results because the smaller boards generally achieve higher positive scores. It is not clear what effect this weighting methodology has on the English results.

10.5 Other international comparisons with patient experience surveys proved more problematic for inclusion due to a mix of the level of comparability between the wording of questions posed and also the time period they related to. For example, the Commonwealth Fund International Health Policy survey in 2005 has ten broadly comparable questions; whereas the 2010 version of this survey did not have any questions that were similar to any of those asked in the Scottish inpatient survey.

10.6 Looking at comparisons between Scotland and England some questions have been compared in terms of the percentage of patients answering negatively. This has been done where the negative responses for the two surveys are more comparable than the positive responses.

Admission to hospital

10.7 Table 9 shows results from the English and Scottish inpatient surveys about patients' experience of admission to hospital.

Table 9 Comparative results for admission to hospital

English 2010 Inpatient Survey question	English 2010 Inpatient Survey question results		Scottish 2011 Inpatient Survey question	Scottish 2011 Inpatient Survey results
Was your most recent hospital stay planned in advance or an emergency?	Waiting list or planned in advance	41%	Was your most recent hospital stay planned in advance or an emergency?	Waiting list or planned in advance	41%
	Emergency or urgent:	57%		Emergency or urgent	59%
	Something else	3%
When you arrived at the hospital did you go to the A&E Department?	Yes	87%	When you arrived at the hospital did you go to the A&E Department?	Yes	72%
From the time you arrived at the hospital, did you feel that you had to wait a long time to get on to a bed on a ward?	Yes, definitely	13%	From the time you arrived at hospital, how did you feel about the time you had to wait to get to a bed on the ward	It was too long	13%

The hospital and ward

10.8 Table 10 shows results from the two surveys about patients' views and experiences of the hospital and ward.

10.9 A similar percentage of patients in Scotland and England disagreed that their hospital room or ward, and toilets and bathrooms were clean.

10.10 Scottish patients were less likely to have shared a room or bay with members of the opposite sex. The results are not directly comparable because the English survey only asked about when patients were first admitted. However the effect of this, if any, would be to reduce the English result so it is reasonable to conclude that there is a difference.

Table 10 Comparative results for the hospital and ward

English 2010 Inpatient Survey question	English 2010 Inpatient Survey question results		Scottish 2011 Inpatient Survey question	Scottish 2011 Inpatient Survey results
In your opinion how clean was the hospital room or ward that you were in?	Not very clean/ not at all clean	4%	The main ward or room I stayed in was clean	Strongly disagree/ disagree	3%
How clean were the toilets and bathrooms you used in hospital?	Not very clean/ not at all clean	6%	The bathrooms and toilets were clean	Strongly disagree/ disagree	7%
When you were first admitted to a bed on a ward, did you share a sleeping area with patients of the opposite sex?	Yes	14 %	During your most recent stay in hospital did you share a room or bay with members of the opposite sex?	Yes	10%

Care and treatment

10.11 Table 11 shows results from the two surveys about patients' views and experiences of care and treatment they received as an inpatient.

10.12 The results for care and treatment were similar for the English and Scottish surveys. The only major difference was for being involved as much as you wanted to be in decisions about your care and treatment, with 11 per cent of English patients answering that they were not involved enough compared to 15 per cent of Scottish patients.

Table 11 Comparative results for care and treatment

English 2010 Inpatient Survey question	English 2010 Inpatient Survey question results		Scottish 2011 Inpatient Survey question	Scottish 2011 Inpatient Survey results
Do you think the hospital staff did everything they could to help control your pain?	No	6%	I was able to get adequate pain relief when I needed it.	Strongly disagree/ disagree	5%
Were you given enough privacy when being examined or treated?	No	2%	I had privacy when being examined or treated	Strongly disagree/ disagree	3%
Were you given enough privacy when discussing your condition or treatment?	No	8%	I had privacy when my condition and treatment was discussed	Strongly disagree/ disagree	8%
Were you involved as much as you wanted to be in decisions about your care and treatment?	No	11%	How did you feel about being involved in decisions about your care and treatment?	I was not involved enough	15%

Staff

10.13 Table 12 shows results from the two surveys about patients' views of the staff they encountered during their most recent hospital stay.

10.14 Slightly more patients in England (7%) disagreed that doctors washed their hands than in Scotland (4%).

Table 12 Comparative results for staff

English 2010 Inpatient Survey question	English 2010 Inpatient Survey question results		Scottish 2011 Inpatient Survey question	Scottish 2011 Inpatient Survey results
As far as you know, did doctors wash their hands between touching patients?	No	7%	As far as I was aware doctors washed/ cleaned their hands at appropriate times	Strongly disagree/ disagree	4%
As far as you know, did nurses wash their hands between touching patients?	No	4%	As far as I was aware nurses washed/ cleaned their hands at appropriate times	Strongly disagree/ disagree	3%

Leaving hospital

10.15 Table 13 shows results from the two surveys about patients' views and experiences of leaving hospital.

10.16 There was a large difference in the percentage of patients that were not told of danger signals to watch for when they left hospital between Scotland (18%) and England (38%). Some of this difference is probably caused by Scottish patients not feeling that they required to be told about danger signals and answering "neither agree nor disagree". However only 11 per cent of patients in Scotland answered "neither agree nor disagree" so there still appears to be a large difference.

Table 13 Comparative results for leaving hospital

English 2010 Inpatient Survey question	English 2010 Inpatient Survey question results		Scottish 2011 Inpatient Survey question	Scottish 2011 Inpatient Survey results
Did a member of staff tell you about any danger signals you should watch for after you went home?	No	38%	I was told about any danger signals to watch for when I got home	Strongly disagree/ disagree	18%

Summary

10.17 Overall, the experiences of Scottish and English inpatients appear to be very similar.