CQC: Mental health patients feel let down by services

A Care Quality Commission survey of acute mental health inpatient services in England today revealed that too great a proportion felt they were let down in some important aspects of the care they received.

The regulator polled 7,500 people who were recently discharged from 64 NHS trusts to discover their views on each stage of their care from the moment they were admitted to hospital to the support they got after they left. This was the largest ever survey of people’s experiences.

User focus and safety

The findings underline two key issues that have been previously identified as priority areas for improvement: focusing on individuals’ needs and ensuring the safety of patients. Both were flagged up as the two top priorities for improvement in a review last year of NHS acute inpatient mental health services.

Today’s survey showed that only 34% of patients felt they were involved as much as they wanted to be. 

Many patients felt that they were not given understandable explanations about their care and treatment. Just under half (48%) said the potential side-effects of medicines they were prescribed while in hospital were not explained to them in a way they could understand.

Lack of safety

The survey also showed that 45% of patients who responded said they ‘always’ felt safe on the ward, while 39% ‘sometimes’ felt safe and 16% did not feel safe at all.

The survey, which was co-ordinated for CQC by the National Centre for Social Research (NatCen), also revealed that:

  • Of those who were detained under the Mental Health Act, 27% said they did not have their rights explained in a way they could understand;
  • Most patients (86%) reported having physical health checks in hospital – but only 44% of those with physical health problems felt that these were ‘definitely’ taken care of. 
  • A third (35%) of patients said there was too little to do on weekdays and 54% that there were not enough activities available to them at weekends or evenings.
  • Limited access to talking therapies such as counselling, cognitive behavioural therapy and anxiety management, with only 29% receiving these overall and less than half of those who wanted talking therapies getting them. National Institute for Health and Clinical Excellence clinical guidelines recommend the use of psychological therapies for mental health problems such as schizophrenia and note that they can be provided in the acute phase of illness as well as after a crisis period.
  • Only half of patients said they were ‘always’ given enough time to discuss their condition and treatment with psychiatrists, and the figure for nurses was lower at 41%.

‘Considerable room for improvement’

CQC chair Barbara Young said: “This survey shows us that there is considerable room for improvement in patients’ experiences of acute inpatient mental health services, and that there remains a particular need to ensure that services are focused on meeting the needs of people as individuals.”

She added: “We will be writing to all the trusts covered by the survey to underline the findings, and we will continue to push for improvement through our assessment and registration systems.”

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