Lengthy waiting times remain a problem in A&E

The Care Quality Commission has reported that a significant number of NHS trusts across England continue to report long waits, particularly those attending major A&E departments.

Based on the findings from a survey of more than 50,000 people who received urgent and emergency care from services provided by 132 NHS trusts, the survey reveals that 75 per cent of patients who had attended a Type 1 department, deemed a major consultant-led A&E department, said they ‘definitely’ had enough time to discuss their condition with the doctor or nurse, compared to 73 per cent who said the same when the survey was last carried out in 2016.

Similarly, 76 per cent of Type 1 respondents said they ‘definitely’ had confidence and trust in the staff examining and treating them (up from 75 per cent in 2016), and 79 per cent felt they were treated with respect and dignity ‘all of the time’ (up from 78 per cent in 2016).

People who had been treated at a Type 3 service, deemed an urgent care centre or minor injury unit, were also positive about their interactions with staff, with 85 per cent feeling that the staff they saw ‘definitely’ listened to what they had to say and 57 per cent said that they were ‘definitely’ given enough privacy when discussing their condition with the receptionist, compared to 51 per cent who said this in 2016.

While the majority of responses reflect a positive experience, the 2018 survey results also identified some areas where NHS trusts could improve. Most obviously, responses to questions on waiting times showed that 32 per cent of patients waited 15 minutes or less to speak to a doctor or nurse when they first arrived at a Type 1 department, while 33 per cent reported waiting over an hour before they were first examined, including five per cent who said they waited more than four hours. Additionally, 41 per cent of respondents said that their visit to A&E lasted for more than four hours and results show that this group had a worse than average experience across most question areas.

The majority of people who visited a Type 3 service also reported waiting longer than recommended - 57 per cent who had attended with a pre-booked appointment and 65 per cent without an appointment said they waited more than 15 minutes before they first spoke to a health professional. Furthermore, less than half of those discharged from a Type 1 service said that a member of staff ‘definitely’ told them when they could resume their usual activities and 26 per cent, said they were not told who to contact if they were worried about their condition or treatment after they left.

Across both service types, just over half (55 per cent of Type 1 respondents and 56 per cent of Type 3 respondents) felt that staff ‘definitely’ did everything they could to help control their pain.

Professor Ted Baker, CQC’s Chief Inspector of Hospitals, said: “It is disappointing that in some areas people’s experience continues to fall short. We cannot ignore the increasing impact of lengthy waiting times particularly for those patients attending A&E departments. Patients who are seriously ill and need urgent care should be consistently identified in a timely way, so it is concerning that such a low proportion say they waited 15 minutes or less for an assessment.

“Information provision when leaving hospital and help from staff with pain control were also areas where people were less positive, pointing to the impact of increased demand and pressures on staff who are at full stretch.

"We know there are huge challenges in managing demand for urgent and emergency care services. Emergency departments are under considerable and increasing pressure and need the support of the whole hospital and surrounding local health and social care system to manage the workload. I would like trusts to reflect on their survey results to understand what their patients really think and help identify what individual changes they can make to drive improvements, particularly where more effective integration with other services may be of benefit.”