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Eight of ten NHS Trusts bottom of a league table measuring patient experience across England are in London, according to new data released today by Macmillan Cancer Support, based on Department of Health research.[1]
The league table, based on the latest Patient Experience Survey, provides the first opportunity to compare the performance of NHS Trusts across the whole of England. The league measures patients’ experiences while being treated at hospital, for example: if there were enough nurses on duty; whether they were given enough support from health and social services when they left hospital; whether they were given the right emotional support or told about financial information. It does not cover the medical treatments they received, such as standards of chemotherapy or surgery.
Ciarán Devane, Chief Executive of Macmillan Cancer Support says:
'Cancer patients are being let down by many Trusts that are failing to give adequate levels of care. The experiences you have whilst in hospital can have a massive impact on your health and wellbeing and how well you cope once you leave hospital. We hope that the Trusts given a red card will work with community services and take urgent action to improve the care they offer cancer patients.'
According to the research, breast cancer patients in England have the best patient experience, while sarcoma patients have the poorest. [2]
The Trusts in the bottom 10 (from worst to best): 1) Imperial College Healthcare NHS Trust, 2=) Royal Free Hampstead NHS Trust, 2=) The Whittington Hospital NHS Trust, 4) Barts and the London NHS Trust, 5=) Royal National Orthopaedic Hospital NHS Trust, 5=) The Princess Alexandra Hospital NHS Trust, 7) Newham University Hospital NHS Trust, 8) Croydon Healthcare NHS Trust (formerly Mayday), 9) Ealing Hospital NHS Trust, 10) Portsmouth Hospitals NHS Trust.
Eight out of the top 10 Trusts, including Harrogate and District NHS Foundation Trust, and Barnsley Hospital NHS Foundation Trust are in the North of England.3
Philippa, 62, from London says:
'As my husband approached death in hospital the support I needed so desperately wasn’t there. I wanted to talk about stopping his suffering but the consultant was very rushed and unapproachable, and then went abroad. Other doctors had little time. 'His final week was awful. The Macmillan nurse we’d had at the start of his treatment had to leave after four months; she’d helped us with all the practical things like pain management, benefits and parking. She’d been the human face of the NHS but when she left there was a huge void of support and information.'
'As my husband approached death in hospital the support I needed so desperately wasn’t there. I wanted to talk about stopping his suffering but the consultant was very rushed and unapproachable, and then went abroad. Other doctors had little time.
'His final week was awful. The Macmillan nurse we’d had at the start of his treatment had to leave after four months; she’d helped us with all the practical things like pain management, benefits and parking. She’d been the human face of the NHS but when she left there was a huge void of support and information.'
Patient experience matters – Trusts should offer high standards of support as well as medical treatment. Even if a particular hospital offers excellent medical treatment, most patients are treated in more than one hospital and poor coordination can mean that people have a bad experience overall. Good patient care can help patients deal better with not only managing their own condition once out of hospital but also the emotional impact of cancer, and building confidence to return to work.
Macmillan is calling for the Government to put more focus on improving cancer patient experiences and to provide urgent support to the Trusts with the worst results in its league.
Through over 5,000 Macmillan professionals and over 100 information centres in the UK, Macmillan has a presence at all of the hospitals that came bottom in the league and will be working with them to improve patient experience.
Hannah Shannon, head of media, Macmillan Cancer Support 0207 091 2083 hshannon@macmillan.org.uk|
[1] Analysis by Macmillan Cancer Support based on Department for Health - National Cancer Patient Experience Programme – 2010 National Survey Report. London refers to the London Strategic Health Authority. For each of the 59 questions in the Survey the top and bottom 20% of Trusts have been identified (this excludes questions that could not be measured positive and negative).
Macmillan has further ranked the top and bottom 10 Trusts according to the number of questions in which Trusts appeared in the bottom 20% and further ranked this by the number of questions in the top 20%.
The best NHS trusts are those who never appear in the bottom 20% and are further ranked by the number of questions falling into the top 20% of all trusts. There may be other trusts not identified in the best 10 who had a higher number of questions falling into the top 20% of all trusts but are not identified in the top trusts as they also have questions falling into the bottom 20%. The remaining trusts have not been ranked.
The Survey results provide insights into the care experienced by cancer patients across England who were treated as day cases or inpatients during the first three months of 2010. 158 NHS Trusts providing cancer services identified patients and 67,713 patients chose to respond (the overall response rate was high at 67%).
The survey is based on patient experience, not treatment (therefore a hospital with excellent treatment could score badly if they do not offer a high level of patient care)
The full survey and trusts level reports can be found via the NCIN here: http://www.ncin.org.uk/cancer_information_tools/cancer_patient_experience.aspx|
[2] Analysis by Macmillan Cancer Support based on Department for Health - National Cancer Patient Experience Programme – 2010 National Survey Report. There were 32 questions which identified significant differences in responses for patients with different cancers (this excludes questions that could not be measured positive and negative). For each question tumour groups were ranked according to the highest positive score for that question (ranked 1 to 13). An average rank for all 32 questions was then calculated for each tumour group to determine an overall ranking. It should be noted that there are over 200 different cancers so within each tumour group identified in the survey there may be great variability in experience for patients with different cancer types.
[3] North of England refers to North West, North East and Yorkshire and the Humber Strategic Health Authorities.
Macmillan Cancer Support improves the lives of people affected by cancer, providing practical, medical, emotional and financial support. Working alongside people affected by cancer, Macmillan works to improve cancer care. One in three of us will get cancer. Two million of us are living with it. If you are affected by cancer Macmillan can help.
Call the Macmillan Support Line on 0808 808 00 00, Monday to Friday, 9am to 8pm. Calls are free, including from mobiles or visit www.macmillan.org.uk|