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INPATIENT SATISFACTION HIGH BUT IMPROVEMENT


HAS STALLED MOST inpatients in hospitals in England have confidence and trust in the doctors and nurses treating them but overall improvement has stalled, according to a CQC survey. The 2018 inpatient survey involved 144 NHS acute trusts in England


and over 75,000 adults who had stayed in hospital for at least one night during July last year. Less than half of people surveyed (48 per cent) rated their overall hospital inpatient experience as ‘nine or above’ out of 10. This is down from 50 per cent in 2017 and marks an end of year-on- year improvement previously seen for this question. The survey also found that 80 per cent of respondents felt they had


“always” been treated with dignity and respect during their hospital stay (82 per cent in 2017) and only two per cent said they were not given enough privacy when being examined (unchanged since 2017). Of those who had an operation while in hospital, 80 per cent said that


staff answered their questions in a way they could understand “completely” and 69 per cent said they “always” had confidence in the decisions made about their condition or treatment, a decrease from 71 per cent in 2017. Over a third (40 per cent) of patients surveyed left hospital without


written information telling them how to look after themselves after discharge (up from 38 per cent in 2017), and of those who were given medication to take home, 44 per cent were not told about the possible side-effects. Fewer people said they had discussions with staff about the need for further health and social care services after being discharged (80 per cent in 2018, compared to 81 per cent in 2017) and 24 per cent reported not enough support from health and social care professionals to manage their condition when discharged home. Responses were also less positive across many question areas for


younger patients (under 50-years old) and for those with a mental health condition. Professor Ted Baker, chief inspector of hospitals, said: “The need for


greater collaboration between local health and care services has never been more apparent.”


MHA CODE OF PRACTICE NOT


BEING USED AS INTENDED HEALTHCARE providers and staff are not using the Mental Health Act (MHA) code of practice as intended due to a lack of awareness and understanding of the statutory guidance, according to a new report by the Care Quality Commission (CQC). The report found variation in how the code has been used across


mental health services since last updated in 2015. The code is intended to help professionals interpret and apply the legislation in their day-to-day practice and to provide patient safeguards, particularly in regards to detaining people under the MHA. The CQC recommends that the Department of Health and Social


Care develop standardised resources, support and training for patients, carers and staff so that they understand how the code should be applied and promote use of the guiding principles to improve practice and enable meaningful engagement with families and carers.


It also calls for improved usability and access to the code in


“practical situations”, including how to make it digitally accessible, with links to other relevant guidance for quick support. CQC deputy chief inspector of hospitals Dr Paul Lelliott said:


“Use of the MHA to detain people in mental health services is more common than when the code of practice was first created 26 years ago. “That makes it even more important that the code is clear,


accessible and supports the legal safeguards that protect people’s human rights and autonomy.”


GMC UNCOVERS FACTORS IN


HIGH BAME REFERRALS INADEQUATE job induction and support along with isolating work patterns and poor feedback are all factors in higher GMC referrals for black, Asian and minority ethnic (BAME) doctors, new research suggests. The GMC commissioned the research in response to data showing


that employers and healthcare providers refer BAME doctors to the GMC at more than double the rate of their white counterparts. This means they have more chance of being investigated and, in turn, receiving a warning or sanction. The report Fair to Refer? concluded that some BAME doctors do


not receive adequate induction or support in transitioning to new social, cultural and professional environments. It also found that doctors from diverse groups do not always receive effective, honest or timely feedback which could prevent problems later. This is attributed to some clinical and non-clinical managers avoiding “difficult conversations”, particularly when they are with individuals from a different ethnic group. Working patterns also mean that some BAME doctors in isolated


roles lack exposure to learning experiences, mentors and resources. The report found that BAME doctors may be treated as “outsiders”, creating barriers to opportunities and making them less favoured than “insiders” who experience greater workplace privileges and support. The report also cites organisational leadership cultures with a “knock-on effect” where leadership teams are remote and inaccessible, and doctors struggle to approach them for advice and support and may not be listened to. The report made a number of recommendations around improved support and systems.


MDDUS medical adviser Dr Susan Gibson-Smith commented: “We


welcome the measures contained within this report and fully support the research recommendations that focus on the four key areas of support, working environments, inclusive leadership and delivery of these recommendations.”


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