National Institute for Health and Care Excellence (NICE) guidance and recommendations identify person-centred care as being central to good quality health services. The NHS Long Term Plan is committed to giving people greater control over their own health and ensuring they have more personalised care when they need it.
A number of questions in the survey asked patients about their experience of making choices about their care and also the information made available to them to enable them to make well-informed choices.
Overall, views on person-centred care during the COVID-19 pandemic were good.
The majority of patients in hospital during March, April or May 2020 said they were involved ‘a great deal’ or ‘a fair amount’ in decisions made about their care and treatment, as well as in decisions made about their discharge. Patients were similarly positive about the emotional support that they received from staff during their stay. Information given about care and treatment, either while in A&E (for those admitted through that route), or during their stay in hospital, was also rated highly. In addition, most said they ‘always’ had confidence and trust in the staff treating them. However, COVID-19 patients, were consistently less positive than patients admitted for non-COVID reasons on all measures of person-centred care.
Patients’ involvement in decisions
The NHS Constitution states that patients have the right to be included in decision-making and planning their care along with their care provider. Research has found that, for patients, equal communication and involvement between themselves and treatment teams is important to give the patient a sense of control and responsibility, which in turn helps them to get better.
The majority of patients (77%) said that staff looking after them involved them in decisions about their care and treatment ‘a great deal’ or ‘a fair amount’. COVID-19 patients were significantly less positive about involvement in decisions about their care and treatment (73%).
Similarly, 73% of patients who wanted to take part in decisions about leaving hospital said staff involved them ‘a great deal’ or ‘a fair amount’ in these decisions. COVID-19 patients were slightly less likely to say this than patients without a COVID-19 diagnosis (71% vs 74%).
Provision of information about condition or treatment
Good patient information makes sure that patients are ‘prepared and fully aware of the next steps in their pathway so they are able to plan ahead’. NICE guideline CG138, Patient experience in adult NHS services: improving the experience of care for people using adult NHS services, adds that patients should be given information in a way that they can understand. It specifically notes that professionals should avoid using jargon and define unfamiliar words and terminology.
To improve the quality of information made available to patients, the Department of Health and Social Care (DHSC) have published The Information Standard.
Patients who were in hospital during the pandemic were positive about the information they were given in relation to their condition and treatment, both while in A&E (for those admitted via this route) and generally during their stay. However, views were slightly less positive about the level of information provided while in A&E. Seven in 10 (71%) said they were given ‘the right amount’ of information about their condition and treatment in A&E, while 77% said the same about the information provided during the rest of their stay. COVID-19 patients were significantly less positive about the information they received either during their time in A&E or during the remainder of their stay.
In addition to being provided with information, patients may also need emotional and psychological support during their time in hospital. Guidance from NICE encourages healthcare professionals to discuss concerns and fears with patients in a way that is sensitive and non-judgemental.
Patients who were in hospital during the pandemic generally reported receiving the support they needed. Seven in 10 (70%) said they ‘always’ received enough emotional support from hospital staff during their stay, and 19% said they ‘sometimes’ did. COVID-19 patients were less positive about the emotional support they received (65% said that they ‘always’ received enough emotional support compared with 71% of patients without a COVID diagnosis).
Confidence and trust in staff providing care
Research has found that patients who have confidence and trust in their healthcare professionals report having a higher quality of life, better health outcomes and are more satisfied with their treatment.
Most patients (83%) in hospital during the height of the first wave of the pandemic said they ‘always’ had confidence and trust in the staff treating them. Just 3% answered ‘no, never’. Again, however, COVID-19 patients were slightly less positive than those without a COVID-19 diagnosis.