A survey of over 45,500 people have found that those who used NHS urgent and emergency care (UEC) services in 2024 show that many were broadly positive about their interactions with staff. Common complaints included lengthy waiting times and ineffective pain relief to manage their symptoms. As part of the NHS Patient Survey Programme (NPSP), this survey is conducted every two years, but because of changes made to methodology and sampling, direct comparisons with findings from previous years is not possible.

Published yesterday (Thursday 21st November) by the Care Quality Commission (CQC), the survey reveals the response from patients who attended either a major consultant-led A&E department (Type One) or an urgent treatment centre (Type Three) run directly by one of 120 acute hospital trusts in England during February 2024.

Most urgent treatment centre (UTC) respondents were positive about their interactions with staff. 80 per cent felt the doctors and nurses they saw were ‘definitely’ listened to what they had to say and 76 per cent felt that they ‘definitely’ had enough time to discuss their condition and treatment with the staff treating them.

People who had been seen by A&E were less positive about their interactions with staff. While 60 per cent said they felt that doctors or nurses ‘completely’ explained their condition or treatment to them clearly, 28 per cent said this only happened ‘to some extent’ and 11 per cent said it didn’t happen at all.

More than a third (38 per cent) of people who attended a Type One department and over half (54 per cent) who had visited a Type Three department treated their overall experience as nine or higher out of ten, though responses to questions about specific areas of patient experience such as ambulance handovers, waiting times, and pain management were less favourable.

Of the 27 per cent of survey participants who arrived at A&E by ambulance, 61 per cent said they were handed over to A&E staff within 15 minutes, but 17 per cent reported waiting more than an hour. Over a quarter of Type One patients (28 per cent) responding to the survey said they waited for more than an hour to be assessed by a nurse or doctor after arriving at A&E and 47 per cent said they were unable to get help with their condition or symptoms while waiting.

For those waiting in A&E, only 26 per cent were told how long they would have to wait to be seen. 64 per cent of patients said they waited more than four hours to be admitted, transferred or discharged at A&E, and patients whose visit lasted more than four hours reported worse than average experiences for all areas of care analysed.

Of those attending a UTC department with an appointment, 64 per cent were assessed within the 30-minute target. However, not everyone surveyed had a pre-booked appointment, and 19 per cent of those said they had waited more than an hour to be seen be a healthcare professional.

26 per cent of UTC respondents and 28 per cent of A&E respondents said that they did not receive help with medications for a pre-existing medical condition.

42 per cent of survey responders attending an A&E and 47 per cent of responders attending a UTC who needed help with pain relief felt that the staff ‘definitely’ help them control their pain. More than a quarter in both Type One (27 per cent) and Type Three (26 per cent) services said that they were not given any help with pain relief.

The results also show the potential for improvements at discharge. 67 per cent of people discharged from A&E said they were given information on how to care for their condition at home, leaving 33 per cent who were not. 21 per cent of people discharged from an A&E department said they were not told who to contract if they were concerned about their condition or treatment after leaving A&E. Of those respondents who felt they needed a conversation about any further health or social care after leaving A&E, 31 per cent of staff did not discuss it with them, but they would’ve liked them to. 28 per cent of people who tried to contact any health and social care services after leaving A&E were unable to because they were unavailable.

Younger people aged 16-35 were more likely to give negative feedback on urgent and emergency care services, as were patients with a disability, and frail patients (A&E only). Frail and disabled patients reported worse experiences surrounding being listen to and were less likely to feel that they were treated with dignity and respect while in A&E.

Responses this year indicate that not being able to get a GP appointment quickly enough and wanting to be seen on the same day were both factors directly influencing people’d decision to seek treatment at a UEC service. Of those who went A&E directly, 20 per cent (UTC 21 per cent) went because they thought their GP practice would not be able to help, and 26 per cent wanted to be seen on the same day (UTC 34 per cent). Of those who contacted another service, 36 per cent contacted a GP, but 28 per cent of those said the practice did not provide the help they needed (UTC 44 per cent).

Chris Dzikiti, CQC’s interim chief inspector of healthcare, said: “The results demonstrate how the stream of demand is continuing to drive lengthy waits, and cause difficultly for some patients in accessing information, emotional support and adequate pain relief. They also show the impact for staff when the number of people seeking urgent and emergency care is so high and resources are stretched. 

“With pressures on services only likely to increase as we head into winter, ensuring the best possible experience throughout the entirety of the patient journey is a task that needs input from all parts of the health ad care system. Over a third of people surveyed went to A&E before contacting another services and of those that did seek help elsewhere first, many said they were directed to A&E. We must support services in their efforts to collaborate locally, ensure a joined-up approach and help people to access the care they need, when they need it from the service that is best able to deliver it.”

CQC has also published the results for each of the 120 individual trusts that took part in the survey, alongside a report on findings across England, so people can see how their local services performed, and a report identifying those trusts that have performed better or worse across the survey overall.

CQC will continue to use the findings as part of its wider monitoring of the quality of hospital services to plan and target its inspections.