The Care Quality Commission, an executive non-departmental public body of the Department of Health and Social Care, has revealed the results of its Urgent and Emergency Care Survey 2024.
The survey aims to assess the quality of care provided by NHS urgent and emergency services, identify areas for improvement, and help NHS trusts enhance patient experiences.
For the first time, this survey asked why respondents attended urgent and emergency care, rather than opting to receive care from another service
Two questionnaires were used, tailored to each service type and results were 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.
The results
Overall, results from this survey showed people are having poor experiences of A&E services, while urgent treatment centre patients generally reported more positively.
Patients with long waits to initial assessment and those whose visits lasted more than 4 hours consistently reported poorer care experiences for both A&E and urgent care services.
64% of A&E respondents said their visit 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 the analysis.
Similarly, A&E patients who waited more than 60 minutes for their initial assessment (triage) also reported poorer experiences in the same areas.
Results showed that a lack of timely access to other services may be contributing to unnecessary attendances at urgent and emergency care services
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 asked why respondents attended urgent and emergency care, rather than opting to receive care from another service.
Results showed that a lack of timely access to other services may be contributing to unnecessary attendances at urgent and emergency care services.
Positive findings of the survey include:
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.
Those whose A&E visit lasted more than 4 hours consistently reported poorer than average experiences
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 conditions 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.
- 11% 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. 44% 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.
Respondents
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.
Respondents aged 16 to 50, those with a disability or indicators of frailty reported poorer experiences of care for most questions the survey explored
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 the survey explored.
While for Type 3 services, respondents aged 16 to 35, those who waited more than 30 minutes or whose visit lasted more than 4 hours, all reported poorer experiences of care for over half the questions explored.