DH survey reveals choice recall of just 30%

Only 30% of patients can recall being offered a choice of hospital for their outpatient appointments, according to figures from the National Patient Choice Survey, commissioned by the Department of Health.

Around 79,000 patients were questioned by Ipsos MORI to monitor their awareness of choice and to see if they could recall the choices of hospital offered to them by their GPs. Patients who had been referred by a GP for a first outpatient appointment in any of 160 major acute NHS trusts during the two-week period 22 May to 4 June 2006 were invited to take part in the survey.

The main findings of the May/June survey are:

• 30% of patients recalled being offered a choice of hospital for their first outpatient appointment;
• 29% of patients were aware before they visited their GP that they had a choice of hospitals for their first appointment;
• 20% of patients who were offered a choice of hospital were also offered a copy of the ‘Choosing your hospital’ booklet;
• 75% of patients who were offered choice were satisfied with the process and 5% were dissatisfied.

Location or transport considerations were given most often, by 57% of patients, as an important factor when choosing a hospital.

Health minister, Lord Warner, said: “This is the first in a series of surveys collated at the end of May 2006 that shows how well PCTs are offering choice to patients. In 14 PCTS, at least 60 per cent of patients were offered a choice by their GP for their first hospital appointment. These PCTs prove that choice can work.

“However, some PCTs have performed less well and this has brought down the national average to 30% – this is not good enough and we will need to support these PCTs to improve.”

Dr Richard Vautrey, negotiator with the BMA’s GPs committee, said that patients should be surveyed when they are referred, and not weeks later when they visit their chosen hospital.

“This is certainly an improvement on previous surveys and shows that many practices are offering their patients a choice of where they want to be referred. However the experience of most GPs is that patients are choosing to go to their local hospital when they are referred, and most refuse the ‘Choosing your hospital’ booklet when it is offered to them.

“As patients were asked the questions in this survey many weeks after they were referred, it is not surprising that many of them cannot remember the full details of the conversation they had with their GP despite the best efforts of many GPs to offer choice at the time.”

Provisional results from a parallel July survey indicate a slight increase in positive responses from patients. The full results will be published next month, however preliminary results from the survey indicate:

• 35% of patients recalled being offered a choice of hospital for their first outpatient appointment;
• 32% of patients were aware before they visited their GP that they had a choice of hospitals for their first appointment;
• 55% of patients who were aware of choice recalled being offered choice, whereas 26% of those not aware of choice recalled being offered it;
• 26% of patients who were offered a choice of hospital were also offered a copy of the ‘Choosing your hospital’ booklet.

Lord Warner added: “Preliminary results from the second set of survey results at the end of July indicate an increase in the national average figure to 35% – this shows that the situation is improving. There is a definite correlation between local awareness and patient recall of choice.

“We are serious about Choice and I expect performance will improve as PCTs act on the results of the survey and learn from those areas where performance is already high.”

Lord Warner also announced that further resources would be made available to help patients make more informed choices in their healthcare.

Liberal Democrat Shadow Health Secretary, Steve Webb MP said: “This survey shows that exercising choice in healthcare depends on where you live. People do not have equal access to a ‘menu’ of options across the country.

“There is a danger of increasing health inequalities between those who have access to information and those who don’t.

A new library pilot project was also unveiled by the minister alongside new regional and national versions of the ‘Choosing your hospital’ booklet.

The project, Partnership for Patients, is a collaboration between the Department of Health, Department for the Environment and Rural Affairs, Department for Culture Media and Sport and the Museums, Libraries and Archives Council.

It will be led by Health Link, a patient organisation operating as a social enterprise and will allow the public, as well as under-represented groups such as members from the Black and Minority Ethnic (BME) community, older people, rural communities and people with disabilities, to access information about choice of health provider through their local library.

The project will be piloted in three libraries in each of the pilot areas: Derbyshire, Gloucestershire and the seven London boroughs of Bromley, Southwark, Newham, Hackney, Greenwich, Haringey and Waltham Forest. The scheme will advertise choice options in libraries through choice-trained librarians, broadband enabled computers, plasma screens, banners and poster publicity.

Users will be able to select a special ‘Choice’ icon on the library computer network that will provide information on choice of providers available in their local area and assistive technology in libraries will be able to support disabled PC users.

EHI Primary Care revealed last month that the DH had dropped questions on the DES survey and were now considering new ways of measuring choice.