Over a quarter of consultant physicians say their hospital’s ability to deliver continuity of care is poor or very poor. And around the same number believe that their hospital is poor or very poor at delivering stable medical teams for patient care and education, according to a new survey by the Royal College of Physicians out today.
The RCP say the findings reinforce concerns about the increasing pressures that hospitals are facing due to the rise in acute admissions, the ageing population with increasingly complex conditions, and cuts in budgets and staffing.
The survey was sent to 21,000 fellows and members and received a response rate of 30% overall, but 43% from RCP fellows who are working consultant physicians in hospitals.
On continuity of care, 2118 fellows replied with 151 (7%) saying it was very good, 555 (26%) good, 732 (35%) average, 423 (20%) poor and 179 (8%) very poor.
On the stability of medical teams, 2128 fellows replied with 152 (7%) saying it was very good, 578 (27%) good, 698 (33%) average, 409 (19%) poor and 165 (8%) very poor.
In order to address these issues, the President of the RCP Sir Michael Rawlins is setting up a Commission on the Future Hospital, to look at the organisation, processes and standards of care in hospital in order to identify the best way to treat medical inpatients in the future. The Commission will be chaired by Sir Michael, and begins in March. It will have five areas of interest:
- People (medical teams, handover, communication)
- Data (patient records, medical information, audit)
- Place (medical wards, the patient pathway, generalists and specialists)
- Planning infrastructure (radiology, laboratory, pharmacy and support staff, interfaces with community and primary care)
- Patients and compassion (leadership and responsibility, multi-disciplinary teams, end of life care)
This work will cover the main areas of care highlighted by physicians in the survey where the RCP should undertake significant policy work:
- High quality of care, seven days a week – 64%
- Continuity of care as the norm – 62%
- Stable medical teams for patient care and education – 54%
Sir Michael said he was delighted to chair the Commission, which could not come at a more appropriate time. “As the Commission begins, it will be able to take into account the changes to the commissioning and care delivery processes of the NHS arising from the Health and Social Care Bill, and the conclusions of the Francis Inquiry, both of which will underpin our work in improving care for the medical patient.”
Suzie Hughes, chair of the RCP patient and carer network, said:
‘Over the past few decades, care has often been reorganised around the patient without actually involving the patient voice. It is vital that the Commission captures the patient experience as it looks to improve care, and that the final recommendations will have the patient at the centre. Patients are often able to pick up on good practice that can be missed within the system. That good practice is incredibly important in helping to inform the development of hospitals of the future. I am particularly pleased that one of the work-streams is dedicated to ensure that this happens.’