Inpatient Experience Survey 2012 Research conducted by Ipsos MORI on behalf of Great Ormond Street Hospital

1 Version 2 Internal Use Only Inpatient Experience Survey 2012 Research conducted by Ipsos MORI on behalf of Great Ormond Street Hospital

Table of Contents 2 Introduction Overall findings and key messages CQUIN Targets Section 1 The overall impression of the visit Section 2 Admission and general communication 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 and improvements Appendices

3 Introduction

Background (1) 4 This is the third 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 survey also contains Commissioning for Quality and Innovation (CQUIN) metrics which are used to determine a proportion of the Trust s income. 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 Survey waves 1 (2009) and 2 (2010/11) demonstrated that GOSH was delivering its inpatient services and patient care to a high standard with 94% and 96% patient satisfaction respectively. There were also some significant improvements between waves 1 and 2 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. Positively, there was a fall in the proportion of patients mentioning specific areas for improvement at GOSH. The 2011/12 survey continues to track inpatients perceptions of GOSH and its services, and the findings will be benchmarked against survey waves 1 and 2 to review the hospital s performance.

Aims 6 The 2011/12 inpatient survey aims to measure and track GOSH s performance in terms of: Inpatients overall perceptions of their visit to the hospital; Satisfaction levels with the admissions process; The quality and effectiveness of staff communications; 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 7 2011/12 Survey The 2011/12 survey replicates the approach used in previous inpatient experience surveys. 760 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 2011. Fieldwork took place between 13 th January and 10 th February 2012. A Computer Assisted Telephone Interviewing (CATI) approach was used. In total, 652 parent and 108 patient interviews were conducted. The average length of each interview was 12 minutes. Previous Surveys The 2010/11 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. For the baseline survey, 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). It should also be borne in mind that the sample of inpatients for the 2012 survey was drawn a little later than the two previous surveys: - 2011/12; inpatients discharged between 1 st August to 31 st October - 2010/11; inpatients discharged between 1 st June to 31 st August - 2009; inpatients discharged between 25 th June to the 30 th September Also, although fieldwork for the 2012 survey took place at roughly the same time as in the 2010/11 survey (January/ February), the baseline survey took place in November 2009.

Statistically significant differences 9 Throughout this report, comparisons with findings from the two previous surveys are made at appropriate points and where statistically significant differences are found. However, these comparisons are best regarded as indicative only. This is because 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 also 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 Patients and their families again report very high satisfaction with the service provided by GOSH. Overall, 96% are satisfied, in line with the 2010/11 survey. Across most performance indicators there have been no significant changes overall, but positively, there have been increases in the proportions who say doctors and nurses were very good at: Asking about how you/your child were feeling; Taking your/your child s concerns seriously; Explaining why you/your child needed treatment or tests; Answering you or your child s questions. In addition, higher proportions of patients and their families say GOSH: Has very clean bathrooms and toilets (although this has not recovered to the level seen in 2009); Has enough staff on the ward to help when they needed something; Dealt with their/their child s fears very well. 11 The only significant fall in satisfaction is with regard to the quality and variety of hospital food a six percentage point decline since 2010/11.

Key messages Sub-group trends patients with disabilities This year (2012) is the first time the survey identified and surveyed patients and parents of patients with disabilities or learning difficulties. The findings suggest that satisfaction levels are high across all areas, and in particular, parents of patients with disabilities are more likely to be able to stay overnight with their child if they wanted to (84% vs. 74% of parents and patients without disabilities). However, satisfaction with certain aspects of the service varies between patients with disabilities or special needs and the other patients surveyed. The findings suggest that patients and parents of patients with learning difficulties or a disability are less likely than other patients to: Agree they knew who to contact if they had a question when they got home (88% vs. 95%) Agree they knew what would happen next once they left hospital (86% vs. 92%) Strongly agree that they have confidence and trust in the doctors (83% vs. 90%) Agree that there were enough staff available on the ward to help when the child needed something (83% vs. 90%) Strongly agree that staff were polite to them at all times (77% vs. 86%) Know how to complain or offer feedback (69% vs 77%) 12

Key messages Sub-group trends clinical units There have been some significant improvements in the cardiac and neuroscience units relating to the patient care by doctors and nurses. For example: The proportion of parents and patients in the cardiac unit who feel doctors and nurses were very good at asking them how they were feeling has increased from 57% in 2010/11 to 75% in 2012; And an increase of 14 percentage points for this has also been seen in the Neurosciences unit. However, patients and parents in the neuroscience unit are less likely than those in other units to: know about PALS; feel doctors and nurses were very good at asking them how they were feeling (despite the improvement since the last wave), and; know how to complain or offer feedback. Compared to other units, fewer patients and parents of patients in the medicine unit: Strongly agree that staff were always polite to them, and; Feel the doctors and nurses were very good at explaining why the child patient needed treatment or tests and what would happen in the treatment or tests. Patients in the medicine unit are also more likely to say they were kept awake by noise than patients and parents in the other units. 13

Patients vs. parents 14 As in previous survey waves, there are some key differences of opinion between patients and the parents of patients. At the overall level, patients are more likely to say: - They knew how to complain or offer feedback; - They could complain or offer feedback, and that this feedback would be taken seriously; - Doctors or nurses asked questions about how they were feeling; - They were scared in the hospital, but also that staff helped deal with these fears; - Had enough privacy when doctors/nurses talked about their treatment; - That they were kept awake at night by noise; - They were satisfied with the quality and variety of food; - The process of leaving hospital was easy. In contrast, parents are more likely to say: - They knew about PALS (Patient Advice Liaison Service).

Suggested improvements and recommendations 15 The findings from the 2011/12 patient experience survey suggest improvements can be made to following areas: the quality and variety of food, knowledge of complaints and PALS, and the length of the discharge process. Improvements could also be made to specific aspects of patient care for particular groups of patients, as identified by the sub-groups trends. For example: - Neuroscience patients awareness of the complaints/feedback process; - Explanations to patients in the medicine unit about treatment/tests; - The experiences of patients and parents of patients with a disability/special needs generally compared to those without a disability. Children also indicate they are more scared of operations compared to the stated assumptions of parents. While they do acknowledge that staff helped them deal well with these fears, can anything else be done in this area? While only indicative, non-english speakers do appear to be less likely than those who speak English to be satisfied with the different aspects of service (although further research involving this group would be required to draw firm conclusions).

16 CQUIN targets

CQUIN dashboard (Component 1) GOSH has surpassed the target of 90% as a composite score in the following areas: 17 Overall composite score = 92% Base: All respondents 2012 (760); 13 th January - 10 th February 2012. Base: All respondents 2010/11 (750). Base all respondents 2009 (750).

CQUIN dashboard (Component 2) A target of 5% improvement since 2010/11 was set for the following areas: 18 Satisfaction with hospital food has decreased by six percentage points since 2010/11. This may be due to the unforeseen catering issues which occurred during 2011. Furthermore, the proportion who knew how to complain or offer feedback remains in line with 2010/11 figures, and also did not reach the +5% target. Base: All respondents (760); 13 th January - 10 th February 2012 Base: All respondents 2010/11 (750). Base all respondents 2009 (750).

19 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? 20 2012 2010-11 2009 Satisfied (%) 96 96 94 Dissatisfied (%) 2 2 4 Net satisfied (%) +94 +94 +90 Base: All respondents (760); 13 th January 10 th February; 2010/11 base (750); 2009 base (750). Base: All parents of patients (652); 13 th January 10 th February.. Base: All child patients (108); 13 th January 10 th February.

Satisfaction with visit Q2 Overall, how satisfied or dissatisfied were you with your last visit to Great Ormond Street Hospital? (%) Satisfied 21 Base: All respondents (760); 13 th January 10 th February; 2010/11 base (750); 2009 base (750). Base: All parents of patients (652); 13 th January 10 th February.. Base: All child patients (108); 13 th January 10 th February.

Reason for dissatisfaction Q3 Why were you dissatisfied? 22 2010/11 Base: 17 2009 Base: 31 8 12 4 8 4 8 4 9 5 4 2-2 - 9 12 Base: All respondents who were dissatisfied with their last visit to GOSH (16); 13 th January 10 th February

Advocacy Q 4 PARENT WORDING: How likely or unlikely would you be to recommend Great Ormond Street Hospital to a friend or relative if their child needed treatment? (%) COMBINED CHILD WORDING: If a friend or relative of yours needed treatment, how likely or unlikely would you be to recommend Great Ormond Street Hospital (say Great Ormond Street Hospital is a good place to receive care)? (%) Satisfied 97% 23 96% 96% 98% 97% Base: All respondents (760); 13 th January 10 th February; 2010/11 base (750); 2009 base (750). Base: All parents of patients (652); 13 th January 10 th February.. Base: All child patients (108); 13 th January 10 th February.

Key messages 24 Encouragingly, satisfaction with GOSH has remained consistently high over nine in ten (96%) visitors are satisfied: Of these three in four (76%) are very satisfied ; Parents are more likely to be very satisfied than patients (78% and 64% respectively). The proportion of patients who are dissatisfied with their visit to GOSH remains very low (2%): Dissatisfaction has halved since 2009 from 4% in 2009 to 2% in 2012; The top three reasons for dissatisfaction are the poor level of care/ service, waiting for treatment and lack of or inaccurate information. Almost all of the parents and patients at GOSH would recommend the hospital to a friend or relative (97%). This has remained at a consistently high level since 2009 (96%). As seen in the previous two years of the survey, parents are more likely to say they are very likely to recommend GOSH than patients are. This may be expected as the patients may simply be less likely to think in these terms.

Sub-group trends Satisfaction and Advocacy 25 Overall satisfaction is very high, but the longer patients stay in hospital the less likely they are to be satisfied with their visit to GOSH. Those who had longer stays in hospital are also less likely than those whose stay was shorter to recommend GOSH to a friend or relative. Base: All respondents (760); 13 th January 10 th February

26 Section 2 Admission and general communication

Overnight accommodation Q5 PARENT WORDING: Were you able to stay overnight with your child when you wanted to? COMBINED CHILD WORDING: Were your parents able to stay overnight at Great Ormond Street Hospital when they wanted to? 27 Overall 2012 2010-11 2009 Yes (%) 79 78 76 No (%) 5 5 4 Net yes (%) +74 +73 +72 Base: All respondents (760); 13 th January 10 th February; 2010/11 base (750); 2009 base (750). Base: All parents of patients (652); 13 th January 10 th February. Base: All child patients (108); 13 th January 10 th February.

Treatment and service Q6 I would like you to tell me whether you agree or disagree with each. 28 2010/11 Base: 750 2009 Base: 750 88 88 83 83 80 80 77 77 71 72 71 69 62 63 52 - - - Base: All respondents (760); 13 th January 10 th February; 2010/11 base (750); 2009 base (750). * Base: All parents of patients (652); 13 th January 10 th February

Treatment and service 29 Q6 I would like you to tell me whether you agree or disagree with each. 2010/11 Agree 97% 95% 95% 93% 92% 90% 82% 74% n/a Base: All respondents (760); 13 th January 10 th February. Base: 2010/11 all respondents (750). * Base: All parents of patients (652); 13 th January 10 th February

Treatment and service (parent) Q6 I would like you to tell me whether you agree or disagree with each. 30 Base: All parents of patients (652); 13 th January 10 th February

Treatment and service (child) Q6 I would like you to tell me whether you agree or disagree with each. 31 Base: All child patients (108); 13 th January 10 th February

Key messages 32 Four in five parents and patients say they could stay overnight at GOSH consistent with previous waves. Encouragingly, almost all of the treatment and service statements receive 90%+ overall agreement: Since 2009, Confidence and trust in the doctors has received the highest levels of agreement (90%). However, the statements referring to knowledge of the complaints procedure and PALS receive lower levels of agreement: One in two (53%) strongly agree they knew how to complain or offer feedback; Less than half (46%) strongly agree they knew about PALS; Three in five (61%) strongly agree that if they complained it would be taken seriously. The new statement on PALS received the lowest level of strong agreement (50%): Patients, users of the neuroscience unit and non-english speakers were more likely to disagree that they knew about PALS.

Sub-group trends Politeness 33 Significantly fewer patients and parents of patients in the medicine unit strongly agree that staff were always polite to them compared with the other units (see chart to the right). Overall, almost all of the patients and parents of patients who visited the hospital feel that staff were always polite to them (96%): Of these, four in five strongly agree with this, and one in seven tend to agree with this. Patients and parents of patients with a disability are less likely to strongly agree: Similarly, they are less likely to have confidence and trust in the doctors. Base: All respondents (760); 13 th January 10 th February

Sub-group trends Staff explaining their role 34 Overall, seven in ten patients and parents of patients strongly agree that staff explained their role: Patients and parents of patients who are female are more likely to strongly agree that staff introduced themselves, and explained their role to them; In contrast to results in the 2010/11 survey, there are no significant difference between English speakers and non-english speakers regarding this aspect of service. Only six in ten parents and patients who visited the medicine unit strongly agree that staff explained their role significantly fewer than patients in other clinical units. Parents of older patients (aged 13 to 16) are most likely to feel staff valued their experience as a parent (85% compared with 74% overall).* Base: All respondents (760); 13 th January 10 th February *Note: Although the percentage differences are statistically significant, these figures must be treated as indicative due to the small base size of parents of patients aged 13 16 years old (70).

Sub-group trends Complaining and offering feedback 35 Overall, three in four patients and parents of patients knew how to complain or offer feedback. As shown in the chart to the right, one in four patients and parents in the neuroscience unit did not know how to complain or offer feedback; this is significantly more than the one in seven (15%) patients overall. Patients and parents of patients who speak English are more likely than those who do not speak English* to: know how to complain or offer feedback feel their complaint would be taken seriously. Base: All respondents (760); 13 th January 10 th February *Note: Tese figures must be treated as indicative due to the small base size of non-english speaking parents and patients (35).

Sub-group trends PALS 36 Patients and parents of patients who speak English are significantly more likely those who do not speak English* to know about the Patient Advice Liaison Service (PALS). Parents and patients in the Neuroscience unit are also more likely not to know about PALS than patients and parents in other units (45% disagree compared with 32% overall). Base: All respondents (760); 13 th January 10 th February *Note: These figures must be treated as indicative due to the small base size of non-english speakers (35).

37 Section 3 Doctors and nurses care

Communication and service Q7 Last time you saw a doctor or nurse how good were they at...? 38 2010/11 Base: 750 2009 Base: 750 75 78 76 76 72 76 70 73 73 74 63 68 59 61 Base: All respondents (760); 13 th January 10 th February; 2010/11 base (750); 2009 base (750)

Communication and service Q7 Last time you saw a doctor or nurse how good were they at...? 39 2010/11 Good 95% 96% 96% 93% 94% 92% 88% Base: All respondents (760); 13 th January 10 th February; 2010/11 (750). Base: 2010/11 all respondents (750).

Communication and service (parent) Q7 Last time you saw a doctor or nurse how good were they at...? 40 Base: All parents of patients (652); 13 th January 10 th February

Communication and service (child) Q7 Last time you saw a doctor or nurse how good were they at...? 41 Base: All child patients (108); 13 th January 10 th February

Pain control Q12a 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? 42 Overall 2012 2010-11 2009 Satisfied (%) 87 88 86 Dissatisfied (%) 3 4 4 Net satisfied (%) +84 +84 +81 Base: All respondents (760); 13 th January 10 th February; 2010/11 base (750); 2009 base (750). Base: All parents of patients (652); 13 th January 10 th February.. Base: All child patients (108); 13 th January 10 th February.

Key messages 43 Overall, nine in ten patients and parents agree doctors and nurses are good across each of the communication and service indicators. Four in five parents and patients say doctors and nurses are very good at explaining why treatment or tests were needed, and what would happen in the treatment or tests (80% and 78% respectively): This falls to seven in ten (69%) patients and parents for asking how the parent and child were feeling. This said there has still been an increase of 10 percentage points in those saying very good since 2010/11. Encouragingly the Cardiac and Neuroscience units have improved significantly since 2010/11 across the majority of aspects of care that doctors and nurses provide: For cardiac patients, there has been an 18 percentage point increase in doctors and nurses being very good at spending enough time with the patient and parent and asking them questions about how they were feeling; In the Neuroscience unit there has a 24 percentage point increase in doctors and nurses being very good at taking the patient s and parent s concerns seriously. Child patients are significantly more likely than parents to feel doctors and nurses involve them in decisions about their care (86% compared with 74%).

Doctor and nurses care difference between 2012 and 2010/11 in Cardiac and Neuroscience units Doctors and nurses are VERY GOOD at 44 Base 2012: Patients and parents of patients in the Cardiac unit (125); 13 th January 10 th February; 2010/11 (116). Base: 2012: Patients and parents of patients in the Neuroscience unit (104); 13 th January 10 th February ; 2010/11 (89).

Sub-group trends Spending time with patients 45 Overall, nine in ten (95%) patients and parents feel the amount of time doctors and nurses spend with them is good. Patients and parents in the Cardiac unit are the most likely to feel the doctors and nurses were very good at spending time with them (83%). Conversely, patients and parents of the Surgical unit are the least likely to say these health professionals were very good at spending time with them (70%) Patients and parents of patients staying overnight for up to two days are significantly more likely to feel the doctors and nurses were very good at spending time with them compared to those who stayed overnight for seven or more days (75% compared with 60% respectively). Base: All respondents (760); 13 th January 10 th February

Sub-group trends Asking how patients were feeling 46 The majority of parents and patients felt doctors and nurses were good at asking them how they were feeling. There is variation across the clinical units, with patients and parents in the Neurosciences least likely to feel doctors and nurses were very good at asking them how they were feeling. There appears to be a link between ethnicity and patient s perceptions on how well doctors and nurses asked them were feeling: Those who are non-white are significantly more likely to say the health professionals were very good at asking them how they were feeling compared to white patients (75% and 63% respectively). Base: All respondents (760); 13 th January 10 th February *Note: Small base size therefore please treat as indicative

Sub-group trends Explaining treatment and tests 47 Overall, over nine in ten (95%) of parents and patients say doctors and nurses in GOSH are good at explaining why the child patient needed treatment or tests. Parents and patients in the Cardiac unit are much more likely than those in the Medicine unit to feel the doctors and nurses were very good at this. Also, the parents and patients in the Medicine unit were less likely than other units, in particular Cardiac and Surgery, to feel the doctors and nurses were very good at explaining what would happen in the treatment or tests (73% compared with 85% and 80% respectively) White parents and patients are also more likely than non-white parents and patients to feel the doctors and nurses were very good at explaining why they needed treatment or tests (82% compared with 74%). Base: All respondents (760); 13 th January 10 th February

48 Section 4 Feeling scared at the hospital

Feeling scared Q8 PARENT WORDING: How scared, if at all, was your child when visiting the hospital? COMBINED CHILD WORDING: How scared, if at all, were you in the hospital? 49 % Scared Base: All respondents (760); 13 th January 10 th February Base: All parents of patients (652); 13 th January 10 th February.. Base: All child patients (108); 13 th January 10 th February.

Reason for being scared Q9 PARENT WORDING: What was your child scared/frightened of? COMBINED CHILD WORDING: What were you scared/frightened of? 50 2010/11 Base: 231 2009 Base: 234 28 29 35 24 26 18 16 12 17 18 1 2 3 3 2 3 2 6 3 6 Base: All who were scared or frightened (237); 13 th January 10 th February

Reason for being scared Q9 PARENT WORDING: What was your child scared/frightened of? COMBINED CHILD WORDING: What were you scared/frightened of? 51 Base: All parents of patients who were scared or frightened (183); 13 th January 10 th February Base: All child patients who were scared or frightened (44); 13 th January 10 th February

Alleviating fears Q10 PARENT WORDING: And how well do you think the staff dealt with your child s fears? COMBINED CHILD WORDING: And how well do you think the staff dealt with your fears? By dealt with, I mean helped you feel less scared. 52 Overall 2012 2010-11 2009 Well (%) 93 88 91 Not well (%) 7 10 8 Net well (%) +86 +78 +83 Base: All respondents (760); 13 th January 10 th February; 2010/11 base (750); 2009 base (750). Base: All parents of patients (652); 13 th January 10 th February.. Base: All child patients (108); 13 th January 10 th February.

Key messages 53 Three in ten (30%) children were scared when visiting GOSH this figure has remained consistent since 2009. Patients are significantly more likely than parents to say they were scared: Child patients are most likely to be scared or frightened of operations or surgery (40% compared with 20% of parents); However, the proportion of child patients saying they were scared of injections has dropped 16 percentage points (from 56%) since 2010/11. The top three reasons for being scared are: injections, treatment in general, and operations/surgery. Positively, nine in ten patients and their parents say that staff dealt with their fears well (93%): In particular, there is an increase of nine percentage points since 2010/11 for those who felt staff dealt with their fears very well (70% in 2012 compared with 61% in 2010/11).

Sub-group trends 54 Three in four parents of patients aged one year old or under say their child was not scared, falling to half of patients aged 10 to 12 years old. Patients and parents of patients in the Infection, Cancer and Immunity unit are the most likely to say they were not scared (73% compared with 65% overall). Patients are more likely to say they were scared than the parents of patients (43% vs. 28%). Operations and surgery are a greater source of fear for the patients (40%) than suggested by their parents (20%). Base: All respondents (760); 13 th January 10 th February

55 Section 5 General experience of the ward

General experiences on the ward Q11 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. 56 2010/11 Agree 94% 92% 86% 85% 78% 20% Base: All respondents (760); 13 th January 10 th February. Base: 2010/11 all respondents (750).

General experiences on the ward (parent) Q11 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. 57 Base: All parents of patient (652); 13 th January 10 th February

General experiences on the ward (child) Q11 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. 58 Base: All child patient s (108); 13 th January 10 th February

Satisfaction with entertainment 59 Q12b During your stay at Great Ormond Street Hospital, how satisfied or dissatisfied were you with each of the following? PARENT & CHILD (13-18 YEARS) WORDING: The quality and amount of toys, games and things to do on the ward CHILD (10-12 YEARS) WORDING: The toys games and things to do % Satisfied Base: All respondents (760); 13 th January 10 th February; 2010/11 base (750); 2009 base (750). Base: All parents of patients (652); 13 th January 10 th February.. Base: All child patients (108); 13 th January 10 th February.

Satisfaction with food 60 Q12c During your stay at Great Ormond Street Hospital, how satisfied or dissatisfied were you with each of the following? PARENT & CHILD (13-18 YEARS) WORDING: The quality and variety of hospital food CHILD (10-12 YEARS) WORDING: The food % Satisfied Base: All respondents (760); 13 th January 10 th February; 2010/11 base (750); 2009 base (750). Base: All parents of patients (652); 13 th January 10 th February.. Base: All child patients (108); 13 th January 10 th February.

Providing arrangements for patients with special needs 61 All parents of patients (652); 13 th January 10 th February *All parents of patients with special needs or disabilities (290); 13 th January 10 th February

Key messages 62 The general experience on the wards at GOSH are in line with the 2010/11 survey. The vast majority of patients/parents again believe that GOSH respects privacy: Over nine in ten say they/their child had enough privacy when being examined by doctors/nurses, and when doctors/nurses talked about their treatment (94% for both respectively). Approaching nine in ten (88%) also agree there were enough staff on the wards in line with 2010/11. Eight in ten (82%) say they were satisfied with the quality and amount of toys, games and things to do on the ward. The majority of parents (85%) also agree that GOSH puts in place arrangements for children with special needs a new metric for 2011/12. The only significant decline in satisfaction across the experience metrics is related to food: There has been a decline in satisfaction by six percentage points regarding the quality and variety of hospital food.

Sub-group trends - privacy Overall, over nine in ten patients and parent of patients say they had enough privacy when the doctors or nurses examined the patient or discussed their treatment (94% each). Patients and parents of patients in the Neurosciences unit are most likely to feel they had enough privacy when the doctors or nurses examined the patient (99% vs. 94% overall). 63 In contrast to 2010/11, parents of patients aged six to nine years old are less likely than other age groups to strongly feel their child had enough privacy when being examined (71% vs. 78% overall): In 2010/11, 85% of parents of this age group strongly agreed with this, and 12% tended to agree. Base: All respondents (760); 13 th January 10 th February

Sub-group trends environment of the ward Overall, one in four agree that they were kept awake at night by noise (24%). Those more likely to be kept awake by noise tend to be: Male patients (27% vs. 19% female patients); Patients in the Medicine unit (37% vs. 24% overall); Patients who have stayed overnight for at least a week (36% vs. 22% who stayed up to two days). Since 2010/11, agreement that the wards are designed for those aged 10 to 12 years old have increased by 16 percentage points (up from 70% to 86%): However, parents of children aged under a year are less likely to agree the ward is well designed for their child than they were in 2010/11 (69% vs. 82%); Patients and parents in the Surgery unit (79%) are more likely to agree than other units (74%), particularly Cardiac (68%). Parents of patients aged two to nine years old are more likely to agree that there were enough toys, games and things to do for their child on the ward. 64 Base: All respondents (760); 13 th January 10 th February

Sub-group trends patient needs 65 Almost nine in ten patients and parents of patients agree that staff were available when the child needed something (88%) Patients and parents of patients in the medicine unit are more likely to disagree with this (14% vs. 7% overall) ; As are patients and parents of patients with special needs or disabilities (12% vs. 4% without special needs or disabilities). Overall, half of patients and parents are satisfied with the hospital food (54%): Patients are more likely to be satisfied than their parents (73% vs. 51%). That said, one in five (22%) parents did not come into contact with the food and so felt the question did not apply to them. Base: All respondents (760); 13 th January 10 th February

66 Section 6 Cleanliness

Cleanliness Q13 And how clean, if at all, did you think the following areas were? (%) 67 2010/11 Base: 750 2009 Base: 750 80 86 72 77 61 70 Base: All respondents (760); 13 th January 10 th February; 2010/11 base (750); 2009 base (750)

Cleanliness 68 Q13 And how clean, if at all, did you think the following areas were? (%) 2010/11 Clean 96% 94% 95% Base: All respondents (760); 13 th January 10 th February. Base: 2010/11 all respondents (750).

Cleanliness (parent and child) Q13 And how clean, if at all, did you think the following areas were? (%) 69 Base: All parents of patients (652); 13 th January 10 th February.. Base: All child patients (108); 13 th January 10 th February.

Hand hygiene Q14 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? 70 Overall 2012 2010-11 2009 All/most/some of the time (%) 89 88 87 Rarely/never (%) 2 2 2 Base: All respondents (760); 13 th January 10 th February; 2010/11 base (750); 2009 base (750). Base: All parents of patients (652); 13 th January 10 th February.. Base: All child patients (108); 13 th January 10 th February.

Key messages 71 The overall level of cleanliness of the hospital facilities remains high over nine in ten parents say they are clean/very clean. In 2010/11, the proportion of those who considered the facilities to be very clean fell below 2009 levels. Therefore, it was suggested that improvements could be made in this area, and to raise the proportion of those who thought facilities were very clean : Patients and parents who class the cleanliness of the bathrooms and toilets as very clean has increased since 2010/11 from 61% to 67%. Three in ten (29%) still view the bathrooms and toilets as fairly clean. Nine in ten (89%) parents and patients say GOSH staff washed their hands, and only 2% say staff never washed their hands: These overall figures have remained consistent over time; owever, the proportion who saw staff wash their hands all of the time has steadily increased since 2009 (from 61% in 2009 to 68% in 2012).

Sub-group trends 72 Encouragingly, in 2012, the proportion of parents and patients in the Cardiac unit who say the bathroom and toilets are very clean has increased to 60% from 47% in 2010/11, though this is still lower than other units: Surgery has also seen a good increase (from 60% in 2010/11 to 67%). Patients and parents of patients aged 13 to 16 years old are significantly more likely to say the ward where the child stayed in was very clean (86% compared with 75% overall). Three in four (76%) of patients and parents in the Infection, Cancer and Immunity unit say the staff cleaned their hands all of the time: this is significantly higher than the other units, particularly Medicine (60%) and Neurosciences (59%). Base: All respondents (760); 13 th January 10 th February

73 Section 7 Leaving hospital and improvements

Leaving hospital Q15 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. 74 2010/11 Base: 750 2009 Base: 750 80 77 80 78 79 76 73 71 65 65 18 20 Base: All respondents (760); 13 th January 10 th February; 2010/11 base (750); 2009 base (750) * Base: All parents of patients (652); 13 th January 10 th February

Leaving hospital Q15 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. 75 2010/11 Agree 94% 91% 91% 90% 89% 40% Base: All respondents (760); 13 th January 10 th February; 2010/11 base (750).

Leaving hospital (parent) Q15 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. 76 Base: All parents of patients (652); 13 th January 10 th February

Leaving hospital (child) Q15 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. 77 Base: All child patients (108); 13 th January 10 th February

Top 10 good points 78 Q16 PARENT WORDING: Was there anything particularly good about your child s hospital visit? COMBINED CHILD WORDING: Was there anything particularly good about your visit to hospital? Child patient Base: 108 Parents of patient Base: 652 14 31 24 27 20 24 6 11 11 10 13 5 7 3 2 3 3 2 1 2 Base: All respondents (760); 13 th January 10 th February

Top 10 suggested improvements 79 Q17 PARENT WORDING: Was there anything that could have been improved about your child s hospital visit? COMBINED CHILD WORDING: Was there anything that could have been improved about your hospital visit? 2010/11 Base: 750 2009 Base: 750 6 9 9 10 4 7 6 6 3 6 5 9 4 3 3 2 2 2 Base: All respondents (760); 13 th January 10 th February - -

Key messages 80 Positively, patients and their families feel well equipped when the time comes to leave GOSH. As was the case in 2010/11, eight in ten parents strongly agree that: They were confident about how to care for their child once at home (81%); Who to contact if they had a question when they got home (80%). New to 2011/12, we asked patients and parents about what was particularly good about their hospital visit: Quality of care (29%) was the most frequently mentioned aspect; parents were twice as likely to mention this compared to patients (31% and 14% respectively); The other aspects that particularly pleased patients and parents about their visit were the helpfulness of nurses (27%) and helpfulness of doctors (24%) testament to the role played by staff in delivering patient care. The three most common improvements suggested by parents and patients for GOSH relate to: Accommodation: more beds, privacy, family orientated and organised earlier (7%); Shorter waiting times in the hospital and the pharmacy (6%); Better, more variety and healthier food (5%).

Sub-group trends leaving hospital 81 The majority of patients and parents of patients who speak English found the process of leaving hospital easy*: Patients were also more likely to find this process easier than the parents (95% vs. 85%); Half of non-white patients and parents felt the process took a long time (45% vs. 37% of White patients and parents). Parents and patients in the Infection, Cancer and Immunity unit were most likely to agree that they had enough information about any medicine (93%): this is significantly higher than both the Cardiac (83%) and the Medicine unit (86%); they were also more likely to agree that they had enough information about what would happen next and any other care they might need after leaving hospital (95% vs. 90% overall and 88% in the Cardiac and Surgery units). Fewer patients and parents of patients with special needs or disabilities knew who to contact if they had a question when they got home (88% vs. 95%). Base: All respondents (760); 13 th January 10 th February *Small base, please treat as indicative

Sub-group trends leaving hospital 82 In thinking about the best points of their experience, parents are particularly impressed with the quality of care GOSH provides (31% vs. 14% of child patients). Child patients are more likely to mention the toys, games and things to do and the accommodation than their parents (13% and 7% vs. 5% and 3% of parents). Parents and patients in the cardiac unit were particularly happy with the helpfulness of their doctors (31% vs. 24% overall). The longer the stay in the hospital the more appreciative parents and patients became of the nurses, with two in ten saying they were particularly happy with how helpful the nurses were (41% of those staying a week or more vs. 25% staying two days or less). When considering improvements, patients and parents of patients in the surgery unit were most likely to feel matters concerning accommodation could have improved their visit (11% vs. 7% overall). Base: All respondents (760); 13 th January 10 th February

83 Appendices

Technical note 84 Ipsos MORI conducted 760 interviews with parents of Great Ormond Street Hospital (GOSH) inpatients (652 interviews) and GOSH inpatients aged 10+ (108 interviews). Interviews took place using CATI technology (Computer Assisted Telephone Interviewing) during the period 13 th January to 10th February 2012. Quotas were set, and weighting applied, to ensure the results represent the known demographic profile of GOSH patients at the time of treatment (1st August to 31st October 2011) patient s age, gender and ethnicity. Quotas and weighting 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. Base: All respondents 2010/11 (750), and all respondents 2009 (750), unless otherwise stated. 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 85 Ethnicity % White 46 Non-white 29 Not stated 24 Sex % Male 53 Female 48 Age within gender % Male 0 9 35 Female 0 9 33 Male 10 12 8 Female 10 12 6 Male 13+ 10 Female 13+ 9 Clinical unit % Cardiac 16 Infection, Cancer and Immunity (ICI) 19 Medicine 15 Neuroscience 14 Surgery 36 Foreign language interviews N Arabic 5 Turkish 6 Urdu 4 Somali 7 Polish 4 Bengali 9 LOS % 0 2 days 85 3 6 days 8 7+ days 7 Type of interview % Parent 57 Child 86 Age of patient % 0 1 21 2 5 28 6 9 18 10-12 13 13 16 16 16+ 3

Statistical reliability 86 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% ± ± ± 760 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 87 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% + 760 (Inpatient survey 2012) vs. 750 (Inpatient survey 2010/11) 125 (Cardiac unit patients) and 142 (ICI unit patients) 399 (Male patients) vs. 361 (Female patients) 3 5 5 7 11 12 4 7 7 * 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.

88 Version 2 Internal Use Only For further information contact Chris.Marshall@ipsos.com 020 7347 3486 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