National Inpatient
Survey 2013
Homerton University
Hospital NHS Foundation
Trust
Lucas.Daly@pickereurope.ac.uk
Inpatient Survey 2013
Homerton University
Hospital NHS Foundation
Trust
National patient surveys
Part of the National NHS Patient Survey Programme
‒
Designed by Picker Institute Europe for CQC
 Questionnaire covers all aspects of the patient ‘journey’
 76 trusts contracted Picker to carry out this Survey
 Standard questions and survey methodology for all NHS trusts:
-
Sample of 850 patients aged 16+
-
Postal survey: initial mailing plus two reminders
-
Freephone and LanguageLine available
-
Patients discharged in August
-
Survey fieldwork between October 2013 and January 2014
 Picker report followed by national CQC findings & CQUIN
Inpatient Survey 2013
Homerton University
Hospital NHS Foundation
Trust
National NHS Surveys:
Structure
Care Quality
Commission
London
Co-ordination Centre
Picker Institute
Other Approved
Survey Contractors
Approved Survey
Contractor
eg Picker
76 Picker
Trusts
Trust
eg Your Trust
Inpatient Survey 2013
Homerton University
Hospital NHS Foundation
Trust
81 non-Picker
Trusts
Trust
Trust
Total of 161 Trusts
Trust
Room for
improvement
o A summary score to show where there is room for improvement
o HIGHER scores indicate a GREATER PROBLEM
o LOWER scores reflect fewer reporting a problem. BETTER performance
Example:
Did you have confidence and trust in the doctor examining and
treating you?
o
o
o
Yes, definitely
Yes, to some extent
No
75%
20%
5%
Room for improvement
Improved from last year (30%), but still not on a par with average (20%)
Inpatient Survey 2013
Homerton University
Hospital NHS Foundation
Trust
Significance of testing
The t-test
o To determine whether or not a statistically significant difference exists
between two datasets
P1 = Sample 1 problem score
P2 = Sample 2 problem score
N1 =Sample 1 base size
N2 = Sample 2 base size
o Accounts for whether the difference is due to chance or not (as with all
probability tests)
o Tests whether the means of two datasets are equal
o Employed to determine whether significant differences in problem scores
exist in your data (i.e. historical, specialty, Picker average)
Inpatient Survey 2013
Homerton University
Hospital NHS Foundation
Trust
Survey activity
o 247/828 eligible patients responded
o Trust response rate: 30% (average 46%).
o 68% were emergency or urgent admissions (average 57%)
Route of admission
Age
6% 4%
7% 15%
Emergency
Elective
22%
Something else
40-59
28%
60-69
32%
Not answered
68%
19%
Inpatient Survey 2013
Homerton University
Hospital NHS Foundation
Trust
16-39
70+
Not answered
Results
Inpatient Survey 2013
Homerton University
Hospital NHS Foundation
Trust
Using your summary
scores
Picker average:
Benchmarking
Average on 26
Better on 0
Worse on 36
Inpatient Survey 2013
Homerton University
Hospital NHS Foundation
Trust
Trends:
Same as 2012 on 58
Better on 0
Worse on 3
Using your summary
scores
Differences from the 'Picker Average'
All questions
Inpatient Survey 2013
Homerton University
Hospital NHS Foundation
Trust
Historical changes for all questions
Good results
63% rated care as 7+ out of 10
64% felt they were treated with respect
and dignity
72% always had confidence and trust in
their doctors
89% said hospital rooms/wards were
very or fairly clean
88% said they always had enough
privacy when being examined or treated
Inpatient Survey 2013
Homerton University
Hospital NHS Foundation
Trust
Admission to hospital
There are no significant differences by average:
There are no significant changes since 2012
Inpatient Survey 2013
Homerton University
Hospital NHS Foundation
Trust
Admission to hospital:
External Benchmarking
Inpatient Survey 2013
Homerton University
Hospital NHS Foundation
Trust
The Hospital and Ward
The trust is worse than average on 11 questions:
Inpatient Survey 2013
Homerton University
Hospital NHS Foundation
Trust
The Hospital and Ward:
External Benchmarking
Inpatient Survey 2013
Homerton University
Hospital NHS Foundation
Trust
The Hospital and Ward
The trust is significantly worse on 1 question since 2012:
Inpatient Survey 2013
Homerton University
Hospital NHS Foundation
Trust
Doctors
The trust is significantly worse than average on 3 questions:
Inpatient Survey 2013
Homerton University
Hospital NHS Foundation
Trust
There were no significant historical differences
Doctors: By Specialty
Inpatient Survey 2013
Homerton University
Hospital NHS Foundation
Trust
Nurses
The trust is significantly worse than average on 4 questions:
Inpatient Survey 2013
Homerton University
Hospital NHS Foundation
Trust
There were no significant historical differences
Nurses: By Specialty
Inpatient Survey 2013
Homerton University
Hospital NHS Foundation
Trust
Care and Treatments
The trust is significantly worse than average on 7 questions:
Doctors and nurses attitude towards
patients not enough compassion shown
from staff. Train you staff including
doctors on simple patient care i.e.,
communication, dignity and respect
Inpatient Survey 2013
Homerton University
Hospital NHS Foundation
Trust
Care and Treatments:
External Benchmarks
Inpatient Survey 2013
Homerton University
Hospital NHS Foundation
Trust
Care and Treatments
The trust is significantly worse on 1 question since 2012:
Inpatient Survey 2013
Homerton University
Hospital NHS Foundation
Trust
Care and Treatments: By
Specialty
Inpatient Survey 2013
Homerton University
Hospital NHS Foundation
Trust
Operations and Procedures
The trust is significantly worse than average on 1 question:
Inpatient Survey 2013
Homerton University
Hospital NHS Foundation
Trust
Operations and Procedures:
By Specialty
Inpatient Survey 2013
Homerton University
Hospital NHS Foundation
Trust
Leaving Hospital
The trust is significantly worse than the average on 8 questions:
Inpatient Survey 2013
Homerton University
Hospital NHS Foundation
Trust
Leaving Hospital: External
Benchmarks
Inpatient Survey 2013
Homerton University
Hospital NHS Foundation
Trust
Leaving Hospital
The trust is significantly worse on 1 question since 2012:
Inpatient Survey 2013
Homerton University
Hospital NHS Foundation
Trust
Reasons for Delay in
Discharge
8%
14%
Wait for medicines
Wait to see doctor
12%
55%
11%
Inpatient Survey 2013
Homerton University
Hospital NHS Foundation
Trust
Wait for an ambulance
Something Else
Not answered
Overall
The trust is significantly worse than the average on 2 questions
There were no significant historical differences
Inpatient Survey 2013
Homerton University
Hospital NHS Foundation
Trust
Overall
10 - I had a very good experience
9
8
7
6
5
4
3%
3 2%
2
3%
1 2%
0 - I had a very poor experience 1%
0%
Inpatient Survey 2013
Homerton University
Hospital NHS Foundation
Trust
19%
17%
14%
13%
9%
9%
5%
10%
15%
20%
Improvement Map
67
1.0
Picker Improvement Map
TM
17
25
28
35
39
27
33
37
32
36
44
8 64
0.5
Importance 
31
42
58 60 61
49
3
50 4
48
43
20 16
26
9
45
22
47 19
66
54
40
23
57 18
24
34
55
29 30 63
59
62 56
21
15
70
69
65
51
6
14
53
11
13
Inpatient Survey 2013
0.0
Homerton University
-22.0
Hospital NHS Foundation
Trust
7

Low problem score
0.0
High problem score

22.0
High Problem Score – High Importance
1.0
not treated with respect
Priorities Plot
Importance 
0.9
0.8
low confidence in nurses
room not clean
low confidence in doctors
not enough emotional support
wrong amount of info on
condition
0.7
unclear answers from nurses
not enough privacy when
examined
not told how to take medication
toilets not clean
0.6
not involved in decisions
could not find staff member to
discuss concerns
unclear answers from doctors
slow response to call button
not enough help to eat meals
not told purpose of medication
Specialist didn't have
surgery questions not answered information
Inpatient Survey 2013
0.5
Homerton
University
0.0NHS Foundation
1.0
2.0
Hospital
Trust
poor pain control
surgery risks and benefits not
staff contradict each other
not enough nurses
explained
social care not discussed home situation not taken into
family
not given information home adaptation not discussed
no clear printed info about
account
3.0
medicine
4.0
5.0
6.0
7.0
 Low problem score
8.0
9.0
10.0
11.0
12.0
13.0
14.0
15.0
16.0
High problem score 
17.0
Patient comments
Positive
The A&E doctors were very compassionate
and interested in what I know about my
rare/unusual condition and keen to listen
and learn. The A&E nurses were
compassionate and supportive and provided
holistic care despite huge workloads.
The food was very good, there was
a choice and it was very appetising
and also looked attractive
My surgeon and his team are fantastic and I
have nothing but praise for their care and
continued after care.
Inpatient Survey 2013
Homerton University
Hospital NHS Foundation
Trust
Patient comments
Negative
There were mix up with
medications. Also nurse was a bit
rough and had a poor attitude. It
was difficult to get the nurses
attention whilst on ward.
The food was dreadful, clearly all
microwaved within an inch of its
nutritional value. There were no fresh fruit
and vegetables. I was left to get my own
breakfast after a major operation, my
lunches/dinners were forgotten. Overall
this was the worst aspect of my care.
One doctor later in my stay was extremely poor,
talking about his take on my earlier diagnosis on the
ward within earshot of me but refusing to answer
questions in relation to this when asked, shrugged or
gave misinformation in response.
Inpatient Survey 2013
Homerton University
Hospital NHS Foundation
Trust
Summary
• 36 questions significantly worse than average, and
better on none.
• Lower than average response rate at 30%.
• Higher than average emergency or urgent admissions
at 68%
• By speciality, General medicine showing high problem
score areas, while General Surgery has poorer
performances in confidence in Nurses and Staff
contradicting information.
• Trust significantly worse than average across all areas
apart from admissions; particularly poor performances
for Hospital and Ward, Care and Treatment, Doctors
and Nurses.
Inpatient Survey 2013
Homerton University
Hospital NHS Foundation
Trust
Picker Institute Europe
Buxton Court
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Oxford OX2 0JB
Tel: +44 (0)1865 208100
Fax: +44 (0)1865 208101
Email: info@pickereurope.ac.uk
Charity registered in England and Wales: 1081688
Company limited by guarantee registered in England and Wales: 03908160
Registered office: Buxton Court, 3 West Way, Oxford OX2 0JB
Inpatient Survey 2013
Homerton University
Hospital NHS Foundation
Trust