People who are mentally ill experience inferior care in acute hospitals

CQC points to evidence of continued inequality in care if patients have a mental health condition

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People with mental ill health face continued inequality in acute hospitals, a Care Quality Commission (CQC) survey shows.

The problem is highlighted in the healthcare inspectorate’s 2017 inpatient survey of every NHS acute trust in England.

The annual survey draws on comments of more than 70,000 adults about the care they received when staying in hospital for at least one night in July last year.

Lower scores for trust and dignity

Patients with mental health conditions on average reported less confidence than other patients in hospital staff, believed they were treated with less respect and dignity, and felt less informed about their care.

The CQC found that patients with mental health conditions scored their confidence and trust in staff and decisions about their treatment 0.5 points lower than the mean score awarded by other patients.

Patients with mental health conditions also gave scores 0.5 points lower than the mean when asked if they were treated with respect and dignity in hospital and scored 0.6 points lower for whether their needs, values and preferences were considered.

The survey found 68% of all patients felt nurses ‘definitely’ answered important questions in a way they could understand and 78% said they always had confidence in the nurses treating them, up from 72% in 2009.

But 41% said their discharge was delayed, and one in four of these delays were longer than four hours, mostly while medications were pending.

The number of respondents who felt there were ‘always or nearly always’ adequate nurses on duty was 59% in 2017. CQC statistics since 2009 show this figure has remained fairly static.

Half of patients in the 2017 survey said they always knew which nurse was in charge of their care.

Additionally, a total of 27% of people surveyed felt they had no one to talk to about their fears about being in hospital, an increase of 2% since 2016.

More confidence

CQC chief inspector of hospitals Ted Baker said it was encouraging the results showed areas of improvement and that the level of confidence in doctors and nurses was better than in previous years.

But he added: ‘This year’s survey results show a continued disparity between the experiences of people with a mental health condition and those without. This is an area that hospitals must address to ensure people with physical and mental health conditions are treated equally in acute settings.’

Results of a related RCN survey of members are due to be published later this year. The Parity of Esteem survey asked nurses what changes are required to bring about equality of treatment for mental and physical health.

Parity pledge

RCN lead for parity of esteem Tim Coupland said preliminary results showed that around 60% of respondents felt greater investment in services help achieve parity in their organisation.

He added: ‘This CQC report makes disturbing reading and is not good news for mental health equality. The government’s pledge to deliver parity of esteem for those with mental health conditions still feels out of reach, and that is largely down to a failure to fund and support services adequately.’

Mental health charity Mind chief executive Paul Farmer said: ‘People with mental health problems consistently report worse experiences of acute care than those without. Those working in and commissioning services need to use these results to look at how care can be improved to address this inequality.’

Further information 

Adult inpatient survey 2017

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