“We have to get better” – RCEM responds to CQC report on inpatient experiences

Wednesday 21 August 2024

We have to get better at involving and supporting inpatients to leave hospital as soon as they are able to.

That’s the response of the Royal College of Emergency Medicine (RCEM) to the Care Quality Commission’s (CQC) latest annual survey of hospital inpatients published today (21 August 2024) about their discharge experiences.

The 2023 adult inpatient survey captured the views and experience of more than 63,500 people who stayed in one of 131 acute and specialist NHS trusts in England for at least one night during November last year.

The survey asked people to give their opinions on the care they received, including quality of information and communication with staff.

It found:

• Only 33% of respondents said they were involved ‘a great deal’ in decisions about their discharge – a notable drop from the 37% who said this in 2022.
• Less than half (44%) said they ‘definitely’ knew what would happen next in their care after leaving hospital (down from 45% in 2022).
• Fewer people said that staff discussed the need for further support from health and social care services with them before they were discharged (77% in 2023 compared to 79% in 2022 and 81% in 2020).

Dr Adrian Boyle, President of The Royal College of Emergency Medicine said: “This is an important piece of patient-centred work. It is vital that we have an independent regulator able to conduct such research, and to ensure the patients’ voice is heard.

“While the focus of this report is on inpatient experiences there are key elements which directly impact Emergency Medicine and can influence the demands experienced there.

“Especially the ability to discharge people in a timely manner. In July in England there was a daily average of 12,315 people in hospitals who were well enough to go home but couldn’t because the support needed for them to do so was not there.

“Meaning those beds were not available to people who needed to be admitted from A&Es slowing the system down and contributing to overcrowding in the Emergency Department.

“But discharging people has to be done in the right way and in consultation with patients, and where appropriate, their carers and family.

“This report shows that often this is not happening. As a health care system and as a society we must get better, and work to ensure that people can leave hospital as soon as possible and that they feel informed and supported when they do.”

The report also revealed that 42% of respondents who were in hospital for elective care in 2023 said they would have liked to have been admitted sooner (compared to 39% who said this in 2022). Additionally, 43% said their health deteriorated while waiting to be admitted (up from 41% in 2022). Of those who reported a decline in their condition, a quarter (25%) said it got ‘a bit worse’ and just under a fifth (18%) said it got ‘much worse’.