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1 Version 1 Internal Use Only Inpatient Experience Survey 2014 Research conducted by Ipsos MORI on behalf of Great Ormond Street Hospital 14/03/14

Table of Contents 2 Introduction Overall findings and key messages Section 1 The overall impression of the visit Section 2 Treatment and service Section 3 Doctors and nurses care Section 4 Feeling scared at hospital Section 5 General experience on the ward Section 6 Cleanliness Section 7 Leaving hospital Section 8 Improvements Appendices

3 Introduction

Background (1) 4 This is the fifth inpatient experience survey conducted by the Ipsos MORI Social Research Institute for Great Ormond Street Hospital (GOSH). The 2009 baseline survey was designed to put in place a series of key performance and patient experience indicators to generate benchmark evidence on how well the hospital is delivering services to its patients and their families. The questionnaire has evolved each wave to capture developing issues; this year additional open ended questions related to staff and general experience have been added. The feedback from this annual survey ensures that patients views are taken into account by GOSH, and to help the hospital set meaningful targets and priorities for its services and the care it delivers.

Background (2) 5 The first four waves (2009, 2011, 2012 & 2013) demonstrated that GOSH was delivering its inpatient services and patient care to a high standard with 94%, 96%, 96% and 93% patient satisfaction respectively. There were also some significant improvements between waves 1 and 3 with regard to staff explaining their roles, parents confidence about how to care for their child once at home and information about follow-up and aftercare. Wave 4 saw a small drop in most scores. In particular there had been decreases in respondents saying they felt they could complain and it would be taken seriously; they knew how to complain and offer feedback or they knew about PALS. The 2014 survey continues to track inpatients perceptions of GOSH and its services, and the findings will be benchmarked against all previous survey waves to review the hospital s performance.

Aims 6 The 2014 inpatient survey aims to measure and track GOSH s performance in terms of: Inpatients overall perceptions of their visit to the hospital; Perceptions of the treatment and service received; Aspects of doctors and nurses care; Patients experiences on the ward; The process of leaving hospital; Potential improvements to patients visits. Specific areas of service and patient care are explored within each of these overarching themes throughout this report.

Methodology The 2014 Survey The 2014 survey replicates the approach used in previous inpatient experience surveys. 751 telephone interviews were conducted with either inpatients (aged 10-18), or parents of inpatients (all ages), discharged from the hospital during the period 1 st August and 31 st October 2013. Fieldwork took place between 27 th January and 14 th February 2014. A Computer Assisted Telephone Interviewing (CATI) approach was used. In total, 593 parent and 158 patient interviews were conducted. The average length of each interview was 12 minutes. 7 Previous Surveys The 2013 survey consisted of 751 interviews carried out in January February 2013; 615 interviews with parents and 136 interviews with inpatients aged 10 to 18 years. The 2012 survey consisted of 760 interviews carried out in January February 2012; 652 interviews with parents and 108 interviews with inpatients aged 10 to 18 years. The 2011 survey consisted of 750 interviews carried out in February 2011; 608 interviews with parents and 142 interviews with inpatients aged 10 to 18 years. The first inpatient survey (and considered the baseline) was carried out in November 2009; when Ipsos MORI interviewed 750 inpatients and parents of GOSH inpatients; 612 interviews were conducted with parents and 138 with inpatients aged 10 to 18 years.

Sampling 8 This survey was conducted among a sample of GOSH inpatients, rather than the entire patient population, for the period 1st August to 31st October. As such the results are subject to sampling tolerances (see appendices for details). The sampling period for the 2014 survey replicates the previous couple of years, but earlier surveys were slightly different: - 2013: inpatients discharged between 1 st August to 31 st October 2012-2012: inpatients discharged between 1 st August to 31 st October 2011-2011: inpatients discharged between 1 st June to 31 st August 2012-2009: inpatients discharged between 25 th June to the 30 th September 2009 Although fieldwork for each of the surveys since 2011 have taken place at roughly the same time (January/ February), the baseline survey took place in November 2009.

Statistically significant differences 9 Throughout this report, comparisons with findings from the previous surveys are made at appropriate points and where statistically significant differences are found. However, these comparisons are best regarded as indicative only. The samples for each wave of the research are totally independent of each other. Each has been drawn in exactly the same way, so we can be fairly confident that they are representative of the true population of GOSH patients from the sampling period. However, samples were drawn separately in each wave and so their profiles do not match exactly. The samples may differ systematically on some important, unobservable characteristics not collected (such as differing seasonal illnesses). Consequently, any differences between results from each wave cannot be attributed solely to changes over time but could simply be due to differences in the underlying sample profiles.

10 Overall findings

Key messages overall 11 Levels of satisfaction remain high; more than nine in ten (94%) say they are very or fairly satisfied. In 2013, it was noted that reported knowledge of, and confidence in, the complaints and feedback procedures had decreased since 2012. Results this year do show some improvement, though not all are significant changes. Ratings of doctors and nurses remain good, though ratings of how good they are at spending time with patients and asking questions about how patients are feeling are still slightly lower than other aspects of care. The proportions saying these aspects are very good are still lower than in 2012. While levels of fear remain consistent over time, patients and parents are now more likely to say that staff dealt with their fears very well. General experiences remain good and there have been some improvements in perceptions of privacy, being kept awake at night and the number of staff on the ward. However; satisfaction relating to how patients pain is controlled has dropped again this year. Patients and parents were less positive about procedures when leaving the hospital in 2013 than in 2012. Some of these measures have now improved. Parents praise the staff when asked about the best thing about their experience at the hospital. They describe them as friendly, informative and helpful.

Key messages sub-group trends There was little coherent variation by sub groups, although lower scores continue to be seen from parents of children with special needs/disabilities. They are less satisfied with pain control and their visit overall They are also less likely to recommend GOSH to a friend or relative. 12 Whilst there is minimal variation between different clinical units and specialism, there are a number of areas in which results concerning the Medicine Unit and Gastroenterology are lower. For example, patients and parents were less likely here than average to: say they were satisfied with their visit; say these health professionals were good at spending time with them; say that their child s pain was controlled well; feel doctors and nurses were good at asking them how they were feeling; say that doctors and nurses were good at explaining why they needed tests and treatment.

Suggested improvements and recommendations The findings again suggest continued focus on the complaints and feedback processes. Results have improved since 2013 but have not recovered to previous levels. 13 There is also a downward trend regarding how pain is controlled. Patients do differ significantly on this matter but scores are currently lower than when first surveyed in 2009. When asked for suggested improvements, a small proportion of parents express a need for more information and more staff. However, around half feel that nothing could have been improved. Improvements could also be made to the arrangements that are put in place for children with special needs, as the scores from these parents are lower on some measures.

14 Section 1 The overall impression of the visit

Satisfaction with visit Q2 Overall, how satisfied or dissatisfied were you with your last visit to Great Ormond Street Hospital? 15 Base: All respondents 2014 (751); 27 th January - 16 th February 2014.

Satisfaction with visit trend data Q2 Overall, how satisfied or dissatisfied were you with your last visit to Great Ormond Street Hospital? 16 Base: All respondents 2014 (751) January February 2014; 2013 (751) January February 2013; 2012 (760) January February 2012; 2011 (750) February 2011; 2009 (750) November 2009.

Reason for dissatisfaction Q3 Why were you dissatisfied? 17 2013 2012 2011 2009 4 5 8 12 5 5 4 8 5 1 5 4 7 5 4 8 3 4 4 9 - - - - - - - - - - - - - - - - Base: All who said very/fairly dissatisfied at Q2 2014 (27); 27 th January - 16 th February 2014.

Sub-group trends satisfaction 18 Those with special needs or disabilities are less likely to be satisfied with their last visit than those without. Base: All respondents (751) 27 th January 16 th February 2014.

Advocacy Q 4 How likely or unlikely would you be to recommend Great Ormond Street Hospital to a friend or relative if their child needed treatment? 19 Base: All respondents 2014 (751); 27 th January - 16 th February 2014.

Advocacy trend data Q 4 How likely or unlikely would you be to recommend Great Ormond Street Hospital to a friend or relative if their child needed treatment? 20 Base: All respondents 2014 (751) January February 2014; 2013 (751) January February 2013; 2012 (760) January February 2012; 2011 (750) February 2011; 2009 (750) November 2009.

Key messages - overall impression of the visit 21 Satisfaction with GOSH remains high, in line with last year over nine in ten (94%) are satisfied. Seven in ten (72%) say they are very satisfied Patients are more likely to say they are satisfied than parents (97% vs. 93%). The proportion of respondents who are dissatisfied with their visit to GOSH remains low (4%): Parents who were dissatisfied stated this was due to poor levels of care; lack of/ inaccurate information; staff inefficiency; waiting for treatment and the attitude of staff. Almost all respondents said they would be likely to recommend the hospital to a friend or relative (97%). This has remained at a consistently high level since 2009 (96%). Overall, this year, both parents and patients are equally likely to recommend GOSH. Patients are less certain; 14% say they are fairly likely to recommend GOSH compared with 9% for parents..

22 Section 2 Treatment and service

Treatment and service 23 Q6 I am going to read out a number of statements about visiting Great Ormond Street Hospital, and I would like you to tell me whether you agree or disagree with each. Agree 2014 2013 2012 97% 97% 97% 97% 96% 96% 96% 95% 96% 93% 92% 92% 91% 91% 91% 92% 90% 91% 81% 75% 83% 70% 67% 74% 56% 53% 61% Base: All respondents 2014 (751); 27 th January - 16 th February 2014, All respondent 2013, All respondents 2012

Treatment and service - parents 24 Q6 I am going to read out a number of statements about visiting Great Ormond Street Hospital, and I would like you to tell me whether you agree or disagree with each. Parent total (%) Agree 2014 2013 2012 97% 97% 97% 96% 96% 96% 94% 94% 96% 92% 92% 92% 92% 90% 91% 90% 91% 90% 80% 73% 82% 68% 67% 73% 62% 56% 65% Base: All parents 2014 (593); 27 th January - 16 th February 2014. All parents (615) 2013; All parents (652) 2012.

Treatment and service - patients 25 Q6 I am going to read out a number of statements about visiting Great Ormond Street Hospital, and I would like you to tell me whether you agree or disagree with each. Agree 2014 2013 2012 100% 99% 98% 99% 100% 99% 98% 99% 97% 97% 92% 93% 93% 93% 94% 89% 82% 90% 76% 69% 79% 33% 36% 40% Base: All patients 2014 (158); 27 th January - 16 th February 2014. All patients (136) 2013; All patients (108) 2012.

Key messages - treatment and service 26 The level of agreement with most of the statements remains high there have been few changes to the results overall. However, there have been some improvements: Patients and parents are more likely than in 2013 to feel they could complain and it would be taken seriously (81% vs. 75%). More now strongly agree staff introduce themselves compared with 2012 (80% vs. 74%). There is a slightly better understanding than in 2013 of how to complain or offer feedback (70% vs. 67%), though this is not statistically significant. Similarly, slightly more say they know about PALS (56% vs 53%), though again this is not significant and is still lower than two years ago. Patients are generally more positive than parents: Almost all strongly agree that staff were polite at all times, compared with eight out of ten parents (94% vs 83%). Patients are more likely to strongly agree that they have confidence and trust in the doctors and nurses treating them (91% and 92% respectively); this is significantly higher than parents (84% and 79%).

27 Section 3 Doctors and nurses care

Doctors and nurses care Q7 Last time you saw a doctor or nurse how good were they at...? 28 Good 2014 2013 2012 95% 96% 95% 95% 95% 96% 96% 96% 96% 95% 93% 94% 94% 92% 94% 92% 92% 95% 89% 87% 91% Base: All respondents (751) 28 th January 16 th February;

Doctors and nurses care - parent Q7 Last time you saw a doctor or nurse how good were they at...? 29 Good 2014 2013 2012 95% 96% 95% 95% 95% 95% 95% 96% 96% 94% 93% 93% 94% 92% 94% 91% 92% 95% 87% 86% 90% Base: All parents 2014 (593); 27 th January - 16 th February 2014; All parents (615) 2013; All parents (652) 2012.

Doctors and nurses care- patient Q7 Last time you saw a doctor or nurse how good were they at...? 30 Good 2014 2013 2012 94% 96% 96% 96% 99% 99% 98% 96% 98% 98% 93% 96% 97% 91% 95% 95% 93% 95% 97% 95% 98% Base: All patients 2014 (158); 27 th January - 16 th February 2014; All patients (136) 2013; All patients (108) 2012.

Sub-group trends doctors and nurses care 31 Again, results are quite consistent across different groups when asking about care. Parents of the youngest patients score lowest for clinical staff spending enough time with you and your child; those with children under one year are more dissatisfied than any other age group - 12% dissatisfaction vs 2% on average for all other ages Parents of children with special needs/disabilities score far lower across all statements on clinicians care. Base: All respondents (751); 27 th January 16 th February 2014

Key messages - doctors and nurses care 32 Overall, ratings of doctors and nurses have remained in line with previous results. However, the proportions rating various aspects as very good are still lower than in 2012: Fewer are likely to rate spending time with patients and parents and asking question about how patients and parents are feeling as very good (65% vs. 74% and 61% vs. 69% respectively). Again patients are more positive than parents. More say that the staff were very good at: asking question about how they are feeling (75% vs. 58%) taking their concerns seriously (76% vs. 71%) involving them in decisions about their care (79% vs. 73%). However, this is not the case when discussing treatment and tests: Explaining why and what would happen during treatment and tests are both scored lower by patients (72% vs. 78% and 72% vs. 77% saying very good respectively).

33 Section 4 Feeling scared at the hospital

Feeling scared Q9 How scared, if at all, was your child when visiting the hospital? 34 Scared 29% 28% 30% 30% 30% Base: All respondents 2014 (751) January February 2014; 2013 (751) January February 2013; 2012 (760) January February 2012; 2011 (750) February 2011; 2009 (750) November 2009.

Feeling scared trend data Q9 How scared, if at all, was your child when visiting the hospital? 35 % Scared Base: All respondents 2014 (751) January February 2014; 2013 (751) January February 2013; 2012 (760) January February 2012; 2011 (750) February 2011; 2009 (750) November 2009.

Reasons for being scared Q10 What was your child scared/frightened of? 36 2013 2012 2011 26 24 35 24 26 28 25 24 26 10 12 17 12 13 16 1 2 3 5 4 2 2-1 * 1 2 1 2 2 Base: All who were scared when visiting hospital (217) 27 th January 16 th February; 2013 base (212) 2012 base (237); 2011 base (231); 2009 base (234)

Reasons for being scared Q10 PARENT WORDING: What was your child scared/frightened of? COMBINED CHILD WORDING: What were you scared/frightened of? 37 Base: All parents of patients who were scared or frightened (178); 27 th January 16 th February 2014 Base: All child patients who were scared or frightened (39); 27t h January 16 th February 2014

Alleviating fears Q11 And how well do you think the staff dealt with your child s fears? 38 Base: All parents of patients who were scared or frightened (178); 27 th January 16 th February 2014 Base: All child patients who were scared or frightened (39); 27t h January 16 th February 2014

Alleviating fears Q11 And how well do you think the staff dealt with your child s fears? 39 Base: All respondents 2014 (751) January February 2014; 2013 (751) January February 2013; 2012 (760) January February 2012; 2011 (750) February 2011; 2009 (750) November 2009.

Key messages - feeling scared at the hospital 40 Three in ten (29%) children were scared when visiting GOSH in line with previous years. In contrast to previous years, parents are more likely to report fear on behalf of their children than the patients themselves: Overall, three quarters (74%) of patients say they are not scared compared with two thirds (64%) of parents Parents are more likely to say their child was very scared (13% vs 3%). Patients and parents are now more likely to say staff dealt with their fears very well compared with last year (71% vs. 63%). As in previous years, the main causes of fear are treatment in general, injections and operations/surgery The proportion citing unfamiliar surroundings and people as a cause of their fear has increased from 10% in 2013 to 21% in 2014.

Sub-group trends fears 41 Children aged between 6 and 9 were the most likely to be scared They were significantly more scared about injections compared with all other groups (41% vs. 29% for all who were scared) Base: All respondents (751) 28 th January 16 th February;

42 Section 5 General experience on the ward

General experiences on the ward Q12 I am going to read out a number of statements about your time at Great Ormond Street Hospital, and I would like you to tell me whether you agree or disagree with each. 43 Agree 2014 2013 2012 96% 93% 94% 94% 92% 94% 85% 83% 88% 86% 82% 88% 78% 76% 74% 18% 22% 24% Base: All respondents 2014 (751); 27 th January - 16 th February 2014.

General experiences on the ward - parents Q12 I am going to read out a number of statements about your time at Great Ormond Street Hospital, and I would like you to tell me whether you agree or disagree with each. 44 Agree 2014 2013 2012 95% 93% 94% 94% 96% 93% 82% 82% 87% 84% 80% 87% 80% 76% 74% 17% 21% 22% Base: All parents 2014 (593); 27 th January - 16 th February 2014; All parents (615) 2013; All parents (652) 2012.

General experiences on the ward - patients Q12 I am going to read out a number of statements about your time at Great Ormond Street Hospital, and I would like you to tell me whether you agree or disagree with each. 45 Agree 2014 2013 2012 97% 93% 96% 98% 96% 99% 94% 88% 91% 93% 92% 93% 72% 74% 73% 22% 27% 33% Base: All patients 2014 (158); 27 th January - 16 th February 2014; All patients (136) 2013; All patients (108) 2012.

Entertainment on the ward Q13b During your stay at Great Ormond Street Hospital, how satisfied or dissatisfied were you with each of the following? The quality and amount of toys, games and things to do on the ward 46 % Satisfied Base: All respondents 2014 (751) January February 2014; 2013 (751) January February 2013; 2012 (760) January February 2012; 2011 (750) February 2011; 2009 (750) November 2009.

The quality and variety of hospital food Q13c During your stay at Great Ormond Street Hospital, how satisfied or dissatisfied were you with each of the following? The quality and variety of hospital food % Satisfied 47 Base: All respondents 2014 (751) January February 2014; 2013 (751) January February 2013; 2012 (760) January February 2012; 2011 (750) February 2011; 2009 (750) November 2009.

Sub-group trends patient needs 48 Parents and patients still disagree on the quality and variety of food on the ward. Patients are almost twice as likely to be very satisfied with hospital food compared with parents (49% vs 28%) Three quarters (76%) of patients who are of BME ethnic background are also more satisfied than white patients (55%). Children who are 13 years or older are significantly less satisfied than the 6-9 age group with the quality and variety of toys on the ward; only two thirds are satisfied with the quality and variety of toys, compared with 85% for the younger patients. Base: All respondents 2014 (751); 27 th January - 16 th February 2014.

Providing arrangements for patients with special needs 49 Base: All respondents 2014 (751); 27 th January - 16 th February 2014.

Pain control Q13a During your stay at Great Ormond Street Hospital, how satisfied or dissatisfied were you with each of the following: How your/ your child s pain was controlled? 50 Base: All respondents 2014 (751); 27 th January - 16 th February 2014.

Pain control a divergence between parents and patients Q13a During your stay at Great Ormond Street Hospital, how satisfied or dissatisfied were you with each of the following: How your/ your child s pain was controlled? % Satisfied 51 Base: All respondents 2014 (751) January February 2014; 2013 (751) January February 2013; 2012 (760) January February 2012; 2011 (750) February 2011; 2009 (750) November 2009.

How did staff improve the experience? 52 Q8a Thinking about the day to day care at GOSH, what things did the staff do that most improved your experience? Base: All parents (593); 27 th January 16 th February 2014

How did staff have a negative impact on the experience? 53 Q8b Thinking about the day to day care at GOSH, what things did the staff do that most impacted negatively on your experience? Base: All parents (593); 27 th January 16 th February 2014

Key messages - general experience on the ward 54 While results are similar to previous years, there have been some improvements since last year: Privacy whilst being examined and whilst doctors and nurses talked about treatment have seen significant increases in those who would strongly agree (82% vs. 76% and 78% vs. 72% respectively). Additionally, those who strongly disagree their child was kept awake at night by noise has also increased (37% from 32%). Although more strongly agree there were enough staff on the ward (64% vs. 57%) than last year, this is still lower than two years ago. There has been a drop in overall levels of satisfaction on how pain was controlled (77% from 83% last year and from 88% in 2011). Patients are again more positive than parents, and are more likely to strongly agree with some statements: Privacy whilst doctors and nurses talked about treatment (86% vs. 76%) There were enough staff on the ward (76% vs. 61% for parents) They diverge significantly from parents on how pain was controlled, with two thirds (67%) very satisfied compared with three in five (58%) of parents.

55 Section 6 Cleanliness

Cleanliness Q14 And how clean, if at all, did you think the following areas were? (%) 56 Clean 2014 2013 2012 98% 96% 96% 94% 93% 95% 94% 92% 96% Base: All respondents (751); 27 th January 10 6h February. 2014

Cleanliness - parent and patient Q14 And how clean, if at all, did you think the following areas were? (%) 57 Clean 2014 2013 2012 97% 96% 96% 99% 94% 98% 94% 93% 95% 96% 92% 96% 93% 92% 95% 97% 94% 97% Base: All parents 2014 (593); 27 th January - 16 th February 2014. Base: All patients 2014 (158); 27 th January - 16 th February 2014.

Hand hygiene Q15 As far as you are aware, did the doctors and nurses who were treating your child clean their hands before and after examining your child, either by washing them or by using hand gel? 58 Base: All respondents 2014 (751); 27 th January - 16 th February 2014.

Hand hygiene Q15 As far as you are aware, did the doctors and nurses who were treating your child clean their hands before and after examining your child, either by washing them or by using hand gel? 59 Cleaned hands (%) Base: All respondents 2014 (751) January February 2014; 2013 (751) January February 2013; 2012 (760) January February 2012; 2011 (750) February 2011; 2009 (750) November 2009.

Key messages - cleanliness 60 Perceptions of cleanliness are still high overall, and show no significant change from previous waves over nine in ten patients say each area is very or fairly clean. Patients are generally more positive about cleanliness than parents, although not significantly so. The proportion who say that staff clean their hands at least some of the time remains in line with last year 83%, but is still lower than in 2012 (89%).

61 Section 7 Leaving hospital

Leaving hospital Q16 I am going to read out a number of statements about the time when you/your child was at Great Ormond Street Hospital, and I would like you to tell me whether you agree or disagree with each. 62 Agree 2014 2013 2012 89% 86% 90% 87% 86% 92% 89% 87% 89% 93% 93% 92% 87% 85% 86% 38% 42% 38% Base: All respondents 2014 (751) January February 2014; 2013 (751) January February 2013; 2012 (760) January February 2012; 2011 (750) February 2011; 2009 (750) November 2009.

Leaving hospital - parent Q16 I am going to read out a number of statements about the time when you/ at Great Ormond Street Hospital, and I would like you to tell me whether you agree or disagree with each. 63 Agree 2014 2013 2012 93% 93% 92% 87% 86% 92% 87% 87% 89% 89% 86% 90% 85% 85% 85% 36% 44% 38% Base: All parents 2014 (593); 27 th January - 16 th February 2014; All parents (615) 2013; All parents (652) 2012.

Leaving hospital - patient Q16 I am going to read out a number of statements about the time when you/ at Great Ormond Street Hospital, and I would like you to tell me whether you agree or disagree with each. 64 Agree 2014 2013 2012 91% 87% 94% 94% 85% 91% 94% 85% 95% 44% 38% 39% Base: All patients 2014 (158); 27 th January - 16 th February 2014; All patients (136) 2013; All patients (108) 2012.

Key messages - leaving hospital 65 As in previous years, patients and their families are positive about leaving the hospital and the processes involved. There were some drops in confidence and satisfaction between 2012 and 2013. Since then there have been some improvements, though not in all measures: More strongly agree this year that the process was easy compared with 2013 (65% vs. 58%) There is also more strong agreement that they had enough information about medicine (78% vs. 73%) and about what would happen next (73% vs. 66%) However, the proportion who strongly agree they were confident about how to care for their child once at home is still lower than two years ago (76% vs. 75% in 2013, down from 81% in 2012) Similarly, the proportion who strongly agree they would know who to contact if they had a question remains in line with last year (74% vs. 72% in 2013, down from 80% in 2012).

66 Section 8 Improvements

Top ten best things 67 Q17 What was the best thing about your experiences of the staff at GOSH? Base: All parents (593); 27 th January 16 th February 2014

Top ten problems 68 Q18 What was the worst thing about your experiences of the staff at GOSH? Base: All parents (593); 27 th January 16 th February 2014

Top five suggested improvements 69 Q19 If you could change one thing about the staff at GOSH, what would it be? Base: All parents (593); 27 th January 16 th February 2014

70 Appendices

Technical note 71 Ipsos MORI conducted 751 interviews with parents of Great Ormond Street Hospital (GOSH) inpatients (593 interviews) and GOSH inpatients aged 10+ (158 interviews). Interviews took place using CATI technology (Computer Assisted Telephone Interviewing) during the period 27 January to 14 February 2014. Quotas were set to ensure the results represent the known demographic profile of GOSH patients at the time of treatment (1 August to 31 October 2013) patient s age, gender and ethnicity. Quotas have also been applied to ensure the sample is representative of the known clinical profiles of GOSH patients patient s length of stay and the name of their clinical unit. Where results do not sum to 100%, this may be due to multiple responses, computer rounding or the exclusion of don t know/not stated categories. Numbers, not percentages, are reported here where sample sizes are very small (less than 30); these are indicated with an N. An asterisk (*) indicates a percentage of less than 0.5% but greater than zero.

Sample composition 72 Ethnicity % White 45 BME 17 Not stated 37 Sex % Male 51 Female 49 Age within gender (patient) % Male 0 9 33 Female 0 9 30 Male 10-12 7 Female 10-12 5 Male 13+ 11 Female 13+ 13 Clinical unit % Cardiac 17 Infection, Cancer and Immunity 19 Medicine 16 Neuroscience 13 Surgery 34 Foreign language interviews Bengali 9 Turkish 7 Urdu 6 Polish 4 N LOS % 0 2 days 87 3 6 days 9 7+ days 4 Type of interview % Parent 79 Child 21 Age of patient % 0 1 16 2 5 27 6 9 20 10-12 12 13-16 18 16+ 4

Statistical reliability 73 Because a sample, rather than the entire GOSH inpatient population for the period 1 st August to 31 st October, was interviewed the percentage results are subject to sampling tolerances which vary with the size of the sample and the percentage figure concerned. For example, for a question where 50% of the people in a (weighted) sample of 760 respond with a particular answer, the chances are 95 in 100 that this result would not vary more than three percentage points, plus or minus, from the result that would have been obtained from a survey of the entire patient population of 5,570* (using the same procedures). An indication of approximate sampling tolerances are given in the table below. Size of sample on which the survey results are based Approximate sampling tolerances applicable to percentages at or near these levels 10% or 90% 30% or 70% 50% ± ± ± 751 interviews 2 3 4 * The size of the GOSH inpatient population for the period 1 st August to 31 st October 2011, following de-duplication of patient records, the removal of records containing overseas address and the removal of incomplete patient records from the sample provided to Ipsos MORI by GOSH.

Statistical reliability 74 When results are compared between separate groups within a sample, different results may be obtained. The difference may be real, or it may occur by chance (because not everyone in the population has been interviewed). To test if the difference is a real one - i.e. if it is statistically significant, we again have to know the size of the samples, the percentage giving a certain answer and the degree of confidence chosen. If we assume the 95% confidence interval, the differences between the two sample results must be greater than the values given in the table below: Size of sample on which the survey results are based Approximate sampling tolerances applicable to percentages at or near these levels 10% or 90% + 30% or 70% + 50% + 751 (Inpatient survey 2014) vs. 751 (Inpatient survey 2013) 111 (Cardiac unit patients) and 130 (ICI unit patients) 3 5 5 7 11 12 * The size of the GOSH inpatient population for the period 1 st August to 31 st October following de-duplication of patient records, the removal of records containing overseas address and the removal of incomplete patient records from the sample provided to Ipsos MORI by GOSH.

75 Version 1 Internal Use Only For further information contact Alex.McCallum@ipsos.com 020 3059 5274 Anna.Quigley@ipsos.com 020 7347 3996 This Version work 2 was Internal carried Use out Only in accordance with the requirements of the international quality standard for market research, ISO 20252:2006 and with the Ipsos MORI Terms and Conditions which can be found here