NATIONAL SURVEY OF HOSPITAL PATIENTS

Objective-To Survey patients' opinions of their experiences in hospita l in order to produce data that can help managers and doctors to ident ify and solve problems. Design-Random sample of 36 NHS hospitals, stra tified by size of hospital (number of beds), area (north, midlands, so uth east, south west), and type of hospital (teaching or non-teaching, trust or directly managed). From each hospital a random sample of, on average, 143 patients was interviewed at home or the place of dischar ge two to four weeks after discharge by means of a structured question naire about their treatment in hospital. Subjects-5150 randomly chosen NHS patients recently discharged from acute hospitals in England. Sub jects had been patients on medical and surgical wards apart from paedi atric, maternity, psychiatric, and geriatric wards. Main outcome measu res-Patients' responses to direct questions about preadmission procedu res, admission, communication with staff, physical care, tests and ope rations, help from staff, pain management, and discharge planning. Pat ients' responses to general questions about their degree of satisfacti on in hospitals. Results-Problems were reported by patients, particula rly with regard to communication with staff (56% (2824/5020) had not b een given written or printed information); pain management (33% (1042/ 3162) of those suffering pain were in pain all or most of the time); and discharge planning (70% (3599/ 5124) had not been told about warni ng signs and 62% (3177/5119) had not been told when to resume normal a ctivities). Hospitals failed to reach the standards of the Patient's C harter-for example, in explaining the treatment proposed and giving pa tients the option of not taking part in student training. Answers to q uestions about patient satisfaction were, however, highly positive but of little use to managers. Conclusions-This survey has highlighted se veral problems with treatment in NHS hospitals. Asking patients direct questions about what happened rather than how satisfied they were wit h treatment can elucidate the problems that exist and so enable them t o be solved.