CQC - Care Quality Commission

11/21/2024 | Press release | Distributed by Public on 11/21/2024 02:49

Urgent and emergency care survey 2024

This survey looks at the experiences of people using type 1 and type 3 urgent and emergency care services.

Two questionnaires were used, tailored to each service type. Results are reported for each service type at trust and overall England level.

  • Type 1 services include A&E departments, and may also be known as casualty or emergency departments.
  • Type 3 services include urgent treatment centres, and may also be known as minor injury units. The survey only includes services directly run by an acute NHS trust.

The 2024 urgent and emergency care survey received feedback from 35,670 people who attended a Type 1 service in February 2024 and 10,325 people who attended a Type 3 service in February 2024.

What we found

Overall, results from this survey show people are having poor experiences of urgent and emergency care services. This applies more so for people using A&E services, with UTC patients generally reporting more positively.

Patients with long waits to initial assessment and those whose visits lasted more than 4 hours consistently report poorer care experiences for both A&E and urgent care services. Sixty-four percent of A&E attendances lasted more than 4 hours, with patients whose visit lasted more than 4 hours reporting worse than average experiences for all areas of care included in our analysis. Similarly, A&E patients who waited more than 60 minutes for their initial assessment (triage) also reported poorer experiences in the same areas. People's experiences of waiting for care whilst at A&E were especially poor, with 47% of A&E patients not able to get help with their conditions or symptoms. Of those who needed help with medication for a pre-existing medical condition in A&E, over a quarter (28%) were not helped by staff.

In addition, for the first time, this survey asks why respondents attended urgent and emergency care, rather than opting to receive care from another service. Results show that a lack of timely access to other services may be contributing to unnecessary attendances at urgent and emergency care services.

Positive findings

Medications

  • A high proportion of A&E (type 1) and urgent treatment centre (type 3) patients were given information about the new medication they were to take home. This included information about the purpose of the medication (A&E 75%; UTC 75%), how to take the medication (A&E 55%; UTC 62%), and the side effects (A&E 25%; UTC 28%).

Supporting patients to care for conditions at home

  • Of A&E respondents who were given information on how to care for their condition at home (67%; UTC 82%), nearly all understood the information 'very well' or 'fairly well' (97%; UTC 98%).
  • Over two-thirds of A&E patients (70%; UTC 77%) said they 'definitely' felt able to care for their condition at home.

Communicating about condition at urgent treatment centres

  • 76% of UTC respondents said they 'definitely' had enough time to discuss their condition and treatment.
  • 73% felt their treatment was 'completely' explained to them.
  • 80% felt health professionals 'definitely' listened to what they had to say.

Key areas for improvement

Waiting to be assessed

  • 61% of patients reported ambulance handovers happening within 15 minutes, 23% waited between 16 minutes to 1 hour and 17% waited more than 1 hour.
  • 28% of A&E patients said waited for more than 1 hour to be assessed by a nurse or doctor.
  • 49% of A&E patients and 40% of UTC patients waited more than 30 minutes for their initial assessment.
  • 47% of A&E patients and 54% of UTC patients were not able to get help with their condition or symptoms.

Meeting patients' needs

  • Just over a quarter of both A&E (27%) and UTC (26%) patients said staff did not help them to control their pain.
  • Eleven per cent of A&E respondents had at least one communication support need. Of those, more than a quarter (27%) said they were not given help with their needs. In addition, less than half (44%) said staff 'definitely' provided help. Support needs included translator or interpreter (3%); easy read materials (2%), large print materials (1%) or another type (6%).
  • 25% of A&E patients and almost 1 in 5 UEC patients (19%) report that their anxieties and fear were not discussed at all.

Reattending and discharge

  • Of respondents who felt they needed a conversation about any further health or social care, just over a third (31%) of A&E patients and nearly a quarter (23%) of UTC patients said staff did not discuss it with them, but they would have liked them to.
  • 28% of those who contacted any health and social care services after leaving A&E said they were not available when needed.
  • Of those who were discharged and sent home, 79% of A&E patients were told who to contact if they were worried about their condition or treatment; however, 21% were not. Similarly, 82% of UTC patients were told but 18% were not. Forty-four per cent of A&E patients and 45% of UTC patients said they were told to contact their GP.
  • Of the 30% who had been to A&E previously for the same condition, 13% said they did not get the help they needed on their previous visit.

How experience varies for different groups of people

People with different personal characteristics (demographics or long-term conditions) and care characteristics (such as waiting experiences) reported better or worse than average experiences for several questions.

Respondents who waited more than 60 minutes for their initial assessment reported poorer than average experiences for all the questions analysed in the survey for both Type 1 and Type 3 services. Similarly, those whose A&E visit lasted more than 4 hours consistently reported poorer than average experiences.

For Type 1 services, respondents aged 16 to 50, those with a disability or indicators of frailty reported poorer experiences of care for most questions we explored.

While for Type 3 services, respondents aged 16 to 35, those who waited more than 30 minutes or whose visit last more than 4 hours, all reported poorer experiences of care for over half the questions explored.

Results for NHS trusts

Results for NHS trusts

Type 1 survey results by NHS trust

Type 3 survey results by NHS trust

Each trust was provided with a benchmark report for type 1 services, and type 3 services where relevant, which provides more detail about the data.

Reports

Open data

Supporting information

How will results be used?

We will use the results from the survey to build an understanding of the risk and quality of services and those who organise care across an area. Where survey findings provide evidence of a change to the level of risk or quality in a service, provider or system, we use the results alongside other sources of people's experience data to inform targeted assessment activities.

Other organisations

NHS trusts

Trusts, and those who commission services, use the results to identify and make the changes they need to improve the experience of people who use their services.

NHS England and the Department for Health and Social Care

Information collected nationally in a consistent way is essential to support public and Parliamentary accountability. The results are used by NHS England and the Department of Health and Social Care for performance assessment, improvement and regulatory purposes