Report release: Service user experiences of Croydon University Hospital Accident and Emergency Department
Healthwatch Croydon are pleased to release our report on patient experiences of Croydon University Hospital Accident and Emergency department. Between August and November 2019, Healthwatch Croydon asked those who had recently used Croydon University Hospital’s Accident and Emergency department what their experience of services was like as well as their expectations of services. These are our findings based on the survey of 79 service users:
• High overall satisfaction: The department scored highly for overall satisfaction with over 50% scoring it as excellent and a further 29% stating it was good; friendliness scored highest with 88% scoring excellent or good; 81% waiting areas 64; 70% communication with staff; 69% that what they came for was made better scored excellent or good 54 and 50% were satisfied with waiting times.
• Being assessed more than one or speaking to two or more staff was not a concern: Very few patients were assessed once, but no-one found this negative. Most found the experience positive increasing if they had three or more assessments.
• Waiting times could be communicated better: When we asked for improvements, many said that they would like to have better communication of waiting times to manage their expectations.
• Facilities are not so good if patients have a long wait: Some people found the seats uncomfortable and toilets untidy, as well as limited access to food and drink facilities.
• An inconsistent approach with staff and processes: While many found staff friendly and helpful and information good, there were a number of instances were staff did not meet expectations, and information and processes were not as clear as they could be.
• Some expectations of waiting times varied with age: Bearing in mind the small sample, for the very young and over 65s the time they had to wait vs expected time was lower, irrespective of how long they wanted to wait. Other groups were likely to have higher expectations of less time in A&E than what happened.
These are our recommendations:
• Better communication of waiting times: Patients understand they have to wait but would really welcome information on how long they will have to wait. This would make a big difference in their experience of waiting. Some advance communication of expected waiting times maybe on the website may also help visitors consider whether to visit then or even at all. Using big data may help in giving a prediction of waiting time.
• Better explanation of the expected journey that patients will need to take: Some patients were not clear on what was going to happen to them and how this would develop. While significant effort has been made to give information at each stage, this still needs some emphasis.
• Ensure waiting room and toilets are always comfortable: While A&E has been designed for a swift turnover of patients, some are sitting there for hours. More comfortable seating could be considered and reserved for those who have waited longer. More regular checks of the toilets in busier part of the hospital will also help avoid disappointment with the hospital environment and improve patient experience.
• Better food options and free water on-site: While the facility was built to deliver a swift service, it is clear that some people are waiting a long time with only limited food and no easy access to water. A small café facility and free water would do much to improve the waiting experience.
• Improve consistency of processes: Patients found the overall experience generally good but found some aspects that could have been better. This included gaining prescriptions, having x-rays taken, reason for coming not being resolved and a concern on the triage process.
• Staff consistency and training: While staff friendliness and helpfulness scores were high, some patients had concerns about how they were approached and that they might not have enough training with palliative care or some cultural issues.
Gordon Kay, Healthwatch Croydon Manager said: “Accident and Emergency is one of the most used services in Croydon, so it is important to know how patients experience this service. It is good to see that patients had high satisfaction with the overall service and the friendliness of staff. Waiting times and communication were the main issues of consideration. Waiting longer also impacts the quality of experience particularly in the comfortability of facilities. Part of this is also of about understanding and then managing expectations. We are pleased to see that Croydon Health Services Trust has made the commitment to improvements in line with our recommendations. We offer to repeat the survey at some time in the future to measure the impact of these changes and inform future developments.”
Matthew Kershaw, Croydon Health Services Chief Executive and Place-Based Leader for Health said:
“We welcome the findings of this report and are committed to responding to the feedback we receive from patients to improve the care we provide. Since this important work took place, we have implemented a number of changes. Working with our digital partner Patienteer, we’re now able to provide live updates on waiting times for both areas of the Emergency Department, as well as communicating clearly what our patients can expect from their visit. We recognise that some patients may have to wait longer than they would like and we are working hard to respond to this, whilst facing additional demand. As well as recruiting an addition 17 nurses to the department at the end of 2019, we have also implemented a multi-skilled team who can provide efficient ‘see and treat’ services, so that our patients can be triaged as quickly as possible. We strive to provide a welcoming environment for all of our patients and acting on this feedback, we have installed comfortable “care chair” seating for patients who require ongoing assessment. We have also employed additional support staff to ensure that all facilities are clean and tidy and that refreshments are available when required.”