Scottish Inpatient Patient Experience Survey 2014 Volume 2: Technical Report

This report provides technical information on the survey design, sampling, fieldwork and analysis for the Scottish Inpatient Patient Experience Survey 2014.

This document is part of a collection


3 Changes to the Survey

Introduction

  • Following the 2012 survey, a number of changes were made to the survey administration, questionnaire and reporting. Details of these changes are outlined below.
  • Information on the initial development of the survey is available in Chapter 3 of the technical report from the first survey carried out in 2010 at: http://www.gov.scot/Publications/2010/09/30111425/0

Changes to sampling

  • In previous surveys NHS Boards had appointed their own contractors to sample data. This year a central approach was taken whereby ISD selected the sample from the Scottish Morbidity Register database (SMR01).
  • ISD combined these data with a list of patients provided by NHS Greater Glasgow & Clyde. This was necessary as ISD do not hold data on the specific hospital of treatment for patients treated within a particular group of Greater Glasgow & Clyde hospitals including Beatson West of Scotland Cancer Centre, Drumchapel Hospital, Gartnavel General Hospital, Glasgow Homeopathic Hospital and Glasgow Western Infirmary.
  • This resulted in the production of a list of eligible patients.
  • Further information on sampling is available in Chapter 4.

Changes to the death checks procedures

  • Improvements were made to the death checking procedures. Prior to 2012, NHS Boards were responsible for undertaking their own checks of their sample using information provided by National Records of Scotland (NRS). In 2012 NHS Central Register[3] (NHSCR) undertook the death checks centrally. This year ISD Scotland coordinated death checking centrally, working with two separate organisations: NHSCR undertook the death checks for patients resident within Scotland and the Health and Social Care Information Centre (HSCIC) undertook death checks for patients resident in England.
  • In previous surveys it had not been possible to carry out sufficiently timely and reliable death checks on patients resident within England who were treated within NHS Borders, so these patients were excluded from the sample. Following consideration of various options and discussion with NHS Borders a system for death checking was put in place to allow these patients to be included in the survey without causing an unnecessary risk of questionnaires being sent to deceased patients.
  • NHS ISD provided detail of the sampled patients to NHSCR and NHSCR passed details of patients resident in England to HSCIC. Both organisations ran a death check the morning of a posting and supplied details of deceased patients to ISD by 10 am. ISD processed this information, supplied a list to the contractors (Quality Health) by 11 am and the contractor removed the relevant questionnaires from the mailing which was sent from 12 noon.
  • These new checks minimised the risk of sending surveys to people who were deceased by improving the process and minimising the lag between a death being registered and contractors receiving notification of it. Details on the number of deceased patients identified prior and during the survey are provided in Chapter 7.

Changes to the questionnaire

  • The 2014 questionnaire can be viewed in Appendix A.
  • There have been some substantial changes to the 2014 questionnaire as a result of consultation with Scottish Government (SG) health policy areas, Scottish NHS Boards, members of the general public, Health Improvement Scotland, and the Scottish Health Council.
  • A total of 33 new questions were introduced to the 2014 survey (see Table 1 below). Of these new questions, Q26, Q27, Q28 and Q32 allowed for multiple choice answers.
  • Many questions were carried over from 2012, receiving minor changes such as slight wording or rephrasing. 5 questions carried over from 2012 included an expanded number of answer categories, these were Q21, Q41, Q42, Q57 and Q71 (see Table 2).
  • A small number of questions were removed from the survey between 2012 and 2014. The was chiefly done to allow the inclusion of more relevant questions. These questions are detailed in Table 3.
  • The questions requesting free text 'comments' from respondents were all changed, with the number of such questions reduced from 6 to 3. Instead of asking for comments on each individual section of the questionnaire, we now ask patients for comments across their whole experience. This takes the form of asking patients to recount positive and negative aspects of their inpatient stay, with a third question: "Do you have any other comments" allowing for feedback on areas which may not have been raised within the questionnaire.

Changes to the Inpatient Survey 2014, compared with the 2012 Inpatient Survey

New questions

  • New questions in the 2014 Inpatient Survey are shown in Table 1 below:

Table 1: New questions for the 2014 Inpatient Patient Experience Survey

Table 1

Question Number

Question

Reason for new question

5

In A&E, once you had been seen by a nurse or doctor, were you kept informed about what was happening? [answer options: Yes, completely; Yes, to some extent; No; Don't know / can't remember]

In the 2012 survey, we asked only if patients were told how long they would have to wait to be seen in A&E. Feedback from the SG health policy area covering A&E suggested we needed to be asking more detailed questions to understand more fully the patient experience of A&E.

The question regarding privacy enables us to benchmark against England.

7

Were you given enough privacy when being examined in A&E? [answer options: Yes, completely; Yes, to some extent; No; Don't know / can't remember]

8

When you were in A&E, did you feel safe? [answer options: Yes, completely; Yes, to some extent; No; Don't know / can't remember]

16

Were hand wash gels available for patients and visitors to use? [answer options: Yes, always; Yes, some of the time; No; Don't know / can't remember]

This question was proposed by the SG policy area covering Hospital Acquired Infections. Wards are required to provide hand wash gels for patients and visitors to use in order to minimise the opportunity for spread of infections.

17

During your most recent stay in hospital, were you in a single room at any time? [answer options: Yes, and I was happy; Yes, but I would have preferred to be with other patients; No, but I would have preferred to be in a single room; No, and I was happy]

This question was proposed by the SG policy area covering single room occupancy whilst in hospital.

18

During your most recent stay in hospital, were you happy with the visiting hours? [answer options; Yes; No; Don't know / can't remember]

These two new questions were added in order to understand more fully the patient experience of visiting hours.

19

Did you feel that you were able to spend enough time with the people that matter to you? [answer options: Yes, definitely; Yes, to some extent; No; Don't know / can't remember]

23

Were the people that matter to you (e.g. family and friends) involved in decisions about your care and treatment as much as you wanted? ? [answer options: Yes, definitely; Yes, to some extent; No, and I would have liked them to be more involved; No, but they didn't need to be involved]

This question was proposed by Health Improvement Scotland and SG health policy area covering person centred care.

24

Did you feel that staff took adequate care when carrying out physical procedures? (e.g. injections or blood tests, inserting, checking or removing drips or catheters, moving you) [answer options: Yes, definitely; Yes, to some extent; No; Don't know / can't remember; Does not apply to me]

This question was proposed by SG health policy area covering patient harm/safety.

We also received a lot of comments from patients in the 2012 survey suggesting that this was an important question to include.

25

While you were in hospital, did your condition get worse at any time? [answer options: No; Yes, and staff responded quickly; Yes, and staff did not respond quickly; Don't know / can't remember]

These two questions were proposed by the SG health policy area covering patient safety/harm.

They were both well received by patients when we tested them in consumer panel groups and in cognitive testing sessions.

26

During your hospital stay, if you had a drip or needle in a vein to give you medicines or fluids, did the following occur [answer options: I didn't have a drip; I did not feel it was checked regularly enough; I did not feel it was changed when necessary; I did not feel it was removed quickly enough; Don't know / can't remember]

27

Did you experience any of the following problems during, or because of, your hospital stay? [answer options: Infection (e.g. urinary tract infection, surgical wound infection, MRSA, Cdiff, etc.); Blood poisoning/sepsis; Blood clot (e.g. Deep Vein Thrombosis [DVT], embolism); Bed sore (pressure sore); Injury from falling over; Adverse reaction to medication; Complication from surgery; Any other problems; None]

This question was proposed by the SG health policy area covering patient safety/harm.

It was well received by patients when tested in consumer panel groups and in cognitive testing sessions.

28

During your most recent hospital stay, did any of the following events occur? [answer options: Incorrect diagnosis; Wrong treatment; Incorrect medicines; Incorrect doses of medicines; Delayed or incorrect test results; None]

These three questions were proposed by the SG health policy area covering patient safety/harm.

They were introduced to understand if staff were discussing any errors with patients in a satisfactory way.

These questions were well received by patients when we tested them in consumer panel groups and in cognitive testing sessions.

29

Did a member of staff discuss any of these events with you ? [answer options: Yes, completely; Yes, to some extent; No; Don't know / can't remember]

30

Were you satisfied with how these events were dealt with? [answer options: Yes, completely; Yes, to some extent; No; Don't know / can't remember]

31

When you were in hospital, did you move wards? [answer options: Yes; No; Don't know / can't remember]

These two questions were introduced to understand more fully the experience of patients moving wards when in hospital.

32

What time did you move wards? [answer options: Morning / afternoon; Evening (6pm to 10pm); Middle of the night (10pm onwards); Don't know / can't remember]

35

During your most recent stay, did you have an operation or procedure? [answer options: Yes; No]

These six questions represent a newly created section in the 2014 survey related to operations and procedures.

The experience patients have when undergoing operations and procedures makes up an important part of their inpatient journey; therefore, it was felt to be important to add this new section of questions.

These questions tested well with patients and NHS Boards alike. In the 2012 survey, some of these questions were duplicated in the 'Staff' section.

These questions also enable us to benchmark against England with regards to the patient experience of operations and procedures.

36

Beforehand, did a member of staff explain the risks and benefits of the operation or procedure in a way you could understand? [answer options: Yes, completely; Yes, to some extent; No; I did not want an explanation]

37

Beforehand, did a member of staff explain what would be done during the operation or procedure? [answer options: Yes, completely; Yes, to some extent; No; I did not want an explanation]

38

Beforehand, were you told how you could expect to feel after you had the operation or procedure? [answer options: Yes, completely; Yes, to some extent; No; I did not want an explanation]

39

Beforehand, did a member of staff answer your questions about the operation or procedure in a way you could understand? [answer options: Yes, completely; Yes, to some extent; No; Don't know / can't remember]

40

After the operation or procedure, did a member of staff explain how it had gone in a way you could understand? [answer options: Yes, completely; Yes, to some extent; No; Don't know / can't remember]

43

Did you know which nurse was in charge or your care? [answer options: Yes, all or most of the time; Yes, some of the time; No, but I would have liked to know; No, but it didn't bother me]

This question was introduced as a result of patient feedback. We do have a question asking if patients knew which nurse was in charge of the ward; however, many people commented that it was important to know which nurse was in charge of their care.

44

In your opinion, were there enough nurses on duty to care for you in hospital? [answer options: There were always or nearly always enough nurses; There were sometimes enough nurses; There were rarely or never enough nurses; Don't know / can't remember]

This question has been added as a result of patient feedback. When answering questions in the survey, many patients commented that they felt nurses were very busy due to staffing pressures.

This question enables us to benchmark against England with regards to the patient experience of nursing levels.

46

Did you feel that staff took account of the things that matter to you? [answer options: Yes, definitely; Yes, to some extent; No; Don't know / can't remember]

This question was proposed by Health Improvement Scotland and SG health policy area covering person centred care.

47

Did you feel you got enough emotional support from staff during your stay? [answer options: Yes, definitely; Yes, to some extent; No; Don't know / can't remember]

This question was proposed by NHS Health Boards who commented that the 2012 survey asked about physical health but did not ask whether patients' psychological / emotional needs were being met whilst in hospital.

53

How did you feel about the length of time you were in hospital? [answer options: It was reasonable; It was too long; It was too short; Don't know / can't remember]

This question was introduced in response to patients' feedback that we were not asking any questions regarding whether or not they were happy with how long they were in hospital. We previously asked about delayed discharge but this did not enable patients to tell us if they thought they had been discharged too early.

57a

I was involved in decisions about leaving hospital [answer options: Strongly agree; Agree; Neither agree nor disagree; Disagree; Strongly disagree; Does not apply; Don't know]

This question was proposed by Health Improvement Scotland and SG health policy covering person centred care.

65

Did you see, or were you given, any information explaining how to give feedback or make a complain to the hospital about the care you received? [answer options: Yes; No; Don't know / can't remember]

This question was added to assess patients' experience of providing feedback or making complaints about their treatment and care. The 2011 Patient Rights Act requires that NHS Boards actively encourage and welcome feedback from patients. The introduction of this question also enables us to benchmark against England.

66

Overall… (please circle a number) [scale ranges from 0 : I had a very poor experience to 10: I had a very good experience]

This question was introduced to gain an understanding of the patients' overall experience in their hospital stay. The introduction of this question also enables us to benchmark against England.

Changed questions

  • Changes to existing questions were made for similar reasons to those that led to the inclusion of new questions. In addition, where possible, questions were reduced in complexity and in some cases we changed the format of questions in order to make them more easily understood.
  • Questions that were changed from the 2012 to the 2014 Inpatient Survey are shown in Table 2 below:

Table 2: Questions changed in the 2014 Inpatient Patient Experience Survey

Table 2

Question Number 2014 Survey

Question

Question Number 2012 Survey

Question

Reason for change

6

When you were in the A&E department, did a nurse or doctor discuss your condition with you in a way you could understand? [answer options: Yes, completely; Yes, to some extent; No, but I would have liked them to; No, but I did not want to discuss it]

4

In A&E, I was told what was happening in a way I could understand [answer options: Strongly agree; Agree; Neither agree nor disagree; Disagree; Strongly disagree; Does not apply; Don't know / can't remember]

This question has been reworded in a more person centred way reflecting the more collaborative approach the NHS is working to achieve with patients.

3

In A&E, were you kept informed about the length of time you would have to wait to be seen by a nurse or doctor? [answer options: Yes, completely; Yes, to some extent; No; Don't know / can't remember]

3

In A&E, I was told how long I would have to wait [answer options: Strongly agree; Agree; Neither agree nor disagree; Disagree; Strongly disagree; Does not apply; Don't know / can't remember]

In the 2014 survey, we split the 2012 question so that we could understand the patient experience before and after they were seen by a doctor or nurse in A&E.

4

In A&E, how did you feel about the length of time you had to wait to see a nurse or doctor? [answer options: I didn't have to wait; It was reasonable; It was too long; Don't know / can't remember]

10

How did you feel about the length of time you waited to be admitted to hospital after you were referred? [It was reasonable; It was too long; It was too short]

6

If your hospital visit was planned in advance how did you feel about the length of time you waited to be admitted to hospital after being referred? [It was reasonable; It was too long; It was too short]

Some text has been removed from this question to simplify it.

14c

I was bothered by noise at night from other patients [answer options: Strongly agree; Agree; Neither agree nor disagree; Disagree; Strongly disagree; Does not apply; Don't know / can't remember]

11c

I was bothered by noise at night [answer options: Strongly agree; Agree; Neither agree nor disagree; Disagree; Strongly disagree; Does not apply; Don't know / can't remember]

Feedback from patients and NHS Boards suggested that it was important to understand whether noise at night was being generated by other patients or by hospital staff. By splitting this question, we can now benchmark against England.

14d

I was bothered by noise at night from hospital staff [answer options: Strongly agree; Agree; Neither agree nor disagree; Disagree; Strongly disagree; Does not apply; Don't know / can't remember]

14e

I was happy with the food / meals I received [answer options: Strongly agree; Agree; Neither agree nor disagree; Disagree; Strongly disagree; Does not apply; Don't know / can't remember]

11e

I was happy with the food and drink I received [answer options: Strongly agree; Agree; Neither agree nor disagree; Disagree; Strongly disagree; Does not apply; Don't know / can't remember]

Patients provided feedback that their experience in hospital could be very different for food and for drinks; therefore, we have split the 2012 question in order that the results are more meaningful for NHS Boards. We can now benchmark against England with regards to patients' satisfaction with food.

14f

I was happy with the drinks I received [answer options: Strongly agree; Agree; Neither agree nor disagree; Disagree; Strongly disagree; Does not apply; Don't know / can't remember]

15

Did you know which nurse was in charge of the ward? [answer options: Yes, all or most of the time; Yes, some of the time; No; Don't know / can't remember]

11h

I knew who was in charge of the ward [answer options: Strongly agree; Agree; Neither agree nor disagree; Disagree; Strongly disagree; Does not apply; Don't know / can't remember]

This question was changed to a different format in order to make it easier for patients to answer.

21a

I was able to get adequate pain relief when I needed it [answer options: Strongly agree; Agree; Neither agree nor disagree; Disagree; Strongly disagree; Does not apply; Don't know / can't remember]

14a

I was able to get adequate pain relief [answer options: Strongly agree; Agree; Neither agree nor disagree; Disagree; Strongly disagree; Does not apply; Don't know / can't remember]

This question has been shortened slightly to simplify it.

21b

I had enough privacy when being examined or treated

14b

I had privacy when being examined

These five questions had minor wording changes to make them more person centred. We can benchmark against England to understand whether patients felt their pain was controlled; whether patients felt they were given enough privacy when they were being examined or treated; and whether patients felt they were given enough privacy when discussing their condition and treatment. [All questions had the following answer options: Strongly agree; Agree; Neither agree nor disagree; Disagree; Strongly disagree; Does not apply; Don't know / can't remember]

21c

I had enough privacy when my condition and treatment was discussed

14c

I had privacy when my condition and treatment were being discussed

21d

I got enough help with washing and dressing when I needed it

14d

I got help with washing and dressing when I needed it

21e

I got enough help with eating and drinking when I needed it

14e

I got help with eating and drinking when I needed it

21f

I got enough help with going to the bathroom or toilet when I needed it

14f

I got help with going to the bathroom or toilet when I needed it

21g

I was kept as physically comfortable as I could expect to be [answer options: Strongly agree; Agree; Neither agree nor disagree; Disagree; Strongly disagree; Does not apply; Don't know / can't remember]

29

I was as physically comfortable as I could expect to be [answer options: Strongly agree; Agree; Neither agree nor disagree; Disagree; Strongly disagree; Does not apply; Don't know / can't remember]

In response to feedback from NHS Boards, this question was reworded slightly in order to make implicit the staff's role in ensuring patients comfort.

22

Were you involved as much as you wanted to be in decisions about your care and treatment? [answer options: Yes, definitely; Yes, to some extent; No, and I would have liked to have been; No, but I didn't want to be involved]

15

How did you feel about being involved in decisions about your care and treatment? [answer options: I was more involved than I wanted to be; I was involved as much as I wanted to be; I was not involved enough]

The wording of this question was simplified in order to make it easier for patients to answer. This question enables us to benchmark against England.

33

In your opinion, was moving you between wards managed well? [Yes, definitely; Yes, to some extent; No; Don't know / can't remember]

14h

Moving wards was managed well [answer options: Strongly agree; Agree; Neither agree nor disagree; Disagree; Strongly disagree; Does not apply; Don't know / can't remember]

This question was changed to a different format in order to make it easier for patients to answer.

40

After the operation or procedure, did a

member of staff explain how it had gone in a way you could understand?

[Yes, completely; Yes, to some extent; No; Don't know / can't remember]

18g

Doctors told me how my operation or procedure had gone in a way I could understand. [answer options: Strongly agree; Agree; Neither agree nor disagree; Disagree; Strongly disagree; Does not apply; Don't know / can't remember]

This question was changed so that not only doctors were included in the staff who could have talked to the patient about their procedure or operation. The scale was changed to be consistent with other questions.

41b

Doctors discussed my condition and treatment with me in a way I could understand [answer options: Strongly agree; Agree; Neither agree nor disagree; Disagree; Strongly disagree; Does not apply; Don't know / can't remember]

18e

Doctors talked in a way that helped me to understand my condition and treatment [answer options: Strongly agree; Agree; Neither agree nor disagree; Disagree; Strongly disagree; Does not apply; Don't know / can't remember]

These questions have been reworded in a more person centred way reflecting the more collaborative approach the NHS is working to achieve with patients.

42b

Nurses discussed my condition and treatment with me in a way I could understand [answer options: Strongly agree; Agree; Neither agree nor disagree; Disagree; Strongly disagree; Does not apply; Don't know / can't remember]

19d

Nurses talked in a way that helped me to understand my condition and treatment [answer options: Strongly agree; Agree; Neither agree nor disagree; Disagree; Strongly disagree; Does not apply; Don't know / can't remember]

41f

I had confidence and trust in the doctors treating me [answer options: Strongly agree; Agree; Neither agree nor disagree; Disagree; Strongly disagree; Does not apply; Don't know / can't remember]

29d

I trusted the people looking after me [answer options: Strongly agree; Agree; Neither agree nor disagree; Disagree; Strongly disagree; Does not apply; Don't know / can't remember]

Patients' feedback helped us to understand that experiences with regards to doctors and nurses whilst in hospital were often very different. In the 2012 survey, the question did not enable patients to tell us about their experiences of doctors and nurses independently; and it did not enable NHS Boards to understand if there was a difference. In 2014, we have asked about confidence and trust for doctors and nurses separately. These questions enables us to benchmark against England.

42f

I had confidence and trust in the nurses treating me [answer options: Strongly agree; Agree; Neither agree nor disagree; Disagree; Strongly disagree; Does not apply; Don't know / can't remember]

29d

I trusted the people looking after me [answer options: Strongly agree; Agree; Neither agree nor disagree; Disagree; Strongly disagree; Does not apply; Don't know / can't remember]

45

Did you think that staff worked well together in organising your care? [answer options: Yes, definitely; Yes, to some extent; No; Don't know / can't remember]

20

How much do you agree or disagree that staff worked well together in organising your care? [answer options: Strongly agree; Agree; Neither agree nor disagree; Disagree; Strongly disagree; Does not apply; Don't know / can't remember]

This question was changed to a different format in order to make it easier for patients to answer.

48

Did you feel that staff treated you with compassion and understanding during your stay? [answer options: Yes, definitely; Yes, to some extent; No; Don't know / can't remember]

29a

I was treated with respect [answer options: Strongly agree; Agree; Neither agree nor disagree; Disagree; Strongly disagree; Does not apply; Don't know / can't remember]

In response to patient feedback, we replaced three questions from the 2012 survey which with a new question in the 2014 survey. The question regarding religious and spiritual needs tested poorly in previous surveys and feedback from patients helped us to understand that this may have been because many patients did not feel it was relevant.

29b

I was treated with care [answer options as above]

29g

My religious and spiritual needs were respected [answer options as above]

50

On the day you left hospital, were you delayed for any reason? [answer options: Yes; No]

22b

I was happy with how long I had to wait around when I was told I could go home [answer options: Strongly agree; Agree; Neither agree nor disagree; Disagree; Strongly disagree; Does not apply; Don't know / can't remember]

In the 2012 survey, the question regarding the length of time in hospital on the day of discharge was not clear. We therefore have replaced it with three questions which seek to understand if the patient was delayed on the day of discharge, how long they were delayed, and also the reason for the delay. The introduction of these three questions enables us to benchmark against England.

51

What was the main reason you were delayed? [answer options: I had to wait for medicines; I had to wait to see a doctor; I had to wait for hospital transport; I had to wait for my discharge letter; Something else]

52

How long was the delay? [answer options: Up to 1 hour; Longer than 1 hour but less than 2 hours; Longer than 2 hours but less than 4 hours; Longer than 4 hours; Don't know / can't remember]

54

Were you confident you could look after yourself when you left hospital? [answer options: Yes; No]

29

I was confident I could look after myself when I left hospital [answer options: Strongly agree; Agree; Neither agree nor disagree; Disagree; Strongly disagree; Does not apply; Don't know / can't remember]

This question was changed to a different format in order to make it easier for patients to answer.

55

Before leaving hospital, were you confident that any help you needed had been arranged for you? [answer options: Yes, completely; Yes, to some extent; No; I didn't need any help arranged]

22g

I was confident that any help I needed had been arranged for when I left hospital [answer options: Strongly agree; Agree; Neither agree nor disagree; Disagree; Strongly disagree; Does not apply; Don't know / can't remember]

This question was changed to a different format in order to make it easier for patients to answer.

56

If your condition meant you were eligible for hospital transport to take you home, were you happy with how this was arranged? [answer options: Not applicable to me; Yes; No]

22c

I was given help with arranging transport [answer options: Strongly agree; Agree; Neither agree nor disagree; Disagree; Strongly disagree; Does not apply; Don't know / can't remember]

This question was changed to a different format in order to make it easier for patients to answer.

57c

I knew who to contact if I had any questions after leaving hospital [answer options: Strongly agree; Agree; Neither agree nor disagree; Disagree; Strongly disagree; Does not apply; Don't know / can't remember]

22d

I understood who to contact if I had any questions after leaving hospital [answer options: Strongly agree; Agree; Neither agree nor disagree; Disagree; Strongly disagree; Does not apply; Don't know / can't remember]

This question's wording was amended to make it easier for patients to answer.

57d

I was told about danger signs to look out for when I left hospital [answer options: Strongly agree; Agree; Neither agree nor disagree; Disagree; Strongly disagree; Does not apply; Don't know / can't remember]

22e

I was told about danger signals to look out for when I left hospital [answer options: Strongly agree; Agree; Neither agree nor disagree; Disagree; Strongly disagree; Does not apply; Don't know / can't remember]

We made a minor wording change in this question. We now use the more familiar 'danger signs' instead of 'danger signals'. Thischange also enables us to benchmark against England.

59d

I understood the possible side effects of my medicines [answer options: Strongly agree; Agree; Neither agree nor disagree; Disagree; Strongly disagree; Does not apply; Don't know / can't remember]

23d

I understood the possible side effects of my medicines and what to do if I had any concerns [answer options: Strongly agree; Agree; Neither agree nor disagree; Disagree; Strongly disagree; Does not apply; Don't know / can't remember]

We have removed some words from this question to simplify it. In the 2012 survey, it was essentially two questions in one which made it a little more difficult to answer. This question enables us to benchmark against England.

Removed questions

  • Several questions which were in the 2012 questionnaire have been removed from the 2014 questionnaire. These are shown in Table 3 below:

Table 3: Questions removed for the 2014 Inpatient Patient Experience Survey

Table 3

Question Number 2012 survey

Question 2012

Reason for removing the question

8

Were you transferred to or from another hospital?

This question provided limited useful information in and of itself and was not used in secondary analysis of results.

11d

I was bothered by noise during the day

Feedback from patient groups and NHS Boards suggested that noise through the day was not an issue in the way that noise through the night is; therefore, we removed the question regarding noise during the day from the 2014 questionnaire.

12

During your most recent stay in hospital, did you share a room or bay with members of the opposite sex?

This question was removed because almost all complaints about shared rooms or bays come from patients who have been housed in wards or hospital areas that are excepted from the policy for single sex wards.

16

When you were in hospital, were you in a High Dependency Unit (HDU) or Intensive Care Unit (ICU)?

This question provided limited useful information in and of itself and was not used in secondary analysis of results.

18a

Doctors introduced themselves to me

These four questions were removed in order to reduce the number of questions specifically dedicated to doctors and nurses. We were then able to ask more questions in the staff section relevant to patient experiences of staff in general.

18b

There was enough time to talk to doctors

19a

Nurses introduced themselves to me

19b

There was enough time to talk to nurses

22f

I was given advice on how to look after myself

This question was removed as the questionnaire now includes other, more relevant, questions about leaving hospital.

29c

I got the best treatment for my condition

This question was removed as we ask questions in the 'operations and procedures' and 'staff' sections which adequately cover discussions about conditions and treatment.

41

NHS Boards will be conducting further research in order that they can learn more about the experiences of patients. Would you like to be considered as a participant in this future research?

This question was removed because NHS Boards already have mechanisms in place locally to engage with their patients.

Aims of consultation

  • The Scottish Inpatient Patient Experience Survey ran in 2010, 2011 and 2012. Whilst there were minor updates to the 2012 survey, a more detailed review of the survey was carried out in 2013 to assess its efficacy in assessing the experience of an inpatient stay in hospital.
  • This substantial review had the following aims:
    • To ensure the questions we are asking reflect the end-to-end experience of an inpatient stay in hospital
    • To ensure the questions cover key SG health policy patient experience priorities
    • To ensure the questions cover patient experience priorities identified by Scotland's NHS Boards
    • To ensure the questions are easy to understand and simple to answer
    • Where possible, to benchmark against England for key patient experience areas, either with the introduction of new questions, or through reformatting of existing questions

Consultation process (Sept - Dec, 2013)

Phase 1: consultation with SG health policy areas

  • Members of the patient experience team met with SG health policy areas in September 2013. The purpose of these meetings was to review the questions included in the 2012 version of the questionnaire to consider:
    • Did the questions represent SG health policy priorities?
    • Were there any 'gaps' in the question set?

Phase 2: consultation with NHS Boards

  • Once feedback from SG health policy areas had been taken into account, an updated version of the Inpatient Survey was circulated to all Scottish NHS Boards for their review and comment in October 2013. We specifically asked them to consider:
    • Did the questions cover NHS Boards' patient experience priorities
    • Whether there were any 'gaps' in the question set
    • Overall usability of the questionnaire

Phase 3: consultation with members of the general public

  • Once feedback from NHS Boards had been taken into account alongside that received from SG health policy areas, consultation with members of the general public took place in November 2013.
  • Consultation with members of the general public occurred in two ways: 1. through patient group meetings; and 2. through cognitive testing sessions. Participants for the patient group meetings and cognitive testing interviews were recruited by the Scottish Health Council.

Consumer panel group meetings

  • Patient group meetings were comprised of members of the general public, most of whom had had an inpatient experience (maximum 10 participants per group meeting). In these meetings, group panel members were asked to complete the updated Inpatient Survey and then a discussion about the survey was facilitated by members of the SG patient experience team. These group meetings were specifically focussed on ensuring that the questions covered all areas of inpatient experience that patients considered to be important to them. We held three patient group meetings in Edinburgh, Glasgow and Inverness.

Cognitive testing sessions

  • Once we had taken into account the feedback from the patient group meetings, cognitive testing of the Inpatient Survey was conducted via interviews with members of the general public. In the two weeks spanning 4th to the 14th of November 2013 members of the SG patient experience team carried out 18 interviews with members of the general public who had previously had an inpatient stay in a Scottish hospital.
  • During the one-to-one interviews participants were asked to complete the questionnaire whilst the interviewer observed their progress, specifically looking for any points within the questionnaire which appeared to cause confusion. The participant and interviewer then discussed the experience of completing the questionnaire and the interviewer probed any areas which seemed to be difficult for the participant. This allowed us to be sure that questionnaire was useable, and that the final questions were easy to understand and simple to answer.
  • The interviews were scheduled to ensure adequate time between rounds to allow for discussions around findings and amendments made to the questionnaire. Interviews were conducted in Arbroath, Dundee, Kirkcaldy and Galashiels.
  • Participants who took part in cognitive testing interviews consisted of:
    • 12 females and 6 males
    • 17 people describing themselves as 'white' and 1 described themselves as 'mixed or multiple ethnicity'
    • Ages ranging from 28 to 85

Changes to the introductory letter and reminder letters

  • The introductory and reminder letters are available in Appendices C-E.
  • We made minor text changes to the introductory and reminder letters for the 2014 survey in order to simplify them.

Changes to NHS board and hospital reporting

  • The local NHS Board and hospital reports had generally been well received. However, it was decided that more extensive and comprehensive reports should be provided. The reports were reformatted to more closely resemble those produced within the Health and Care Experience Survey as feedback had indicated that this format was useful to local policy makers. Additional sections were added to compare current and previous surveys' results, show variation at the NHS Boards or hospital level across Scotland and to include more information on trends in the results.

Contact

Email: Andrew Paterson

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