Staff and communications

Questions in this survey looked at whether patients were able to get the attention they needed from staff, as well as focusing on a number of issues with staff communication. More specifically related to the pandemic, we asked about the impact of personal protective equipment (PPE), such as face shields and masks.

Patients were also asked about their experiences of communicating with their family and friends; an area that was impacted by the restrictions put in place to deal with the spread of the virus.

Overall, results show that patients felt able to get attention from staff when needed and reported generally positive experiences of communication during their stay. However, a minority of patients reported not always being able to understand the information provided to them by staff, and said that their ability to understand staff was sometimes hindered by PPE. Further, while most patients were able to keep in touch with their family and friends during the pandemic, a small proportion said they did not receive the help they needed to do so.

Attention from hospital staff

As discussed in the policy section of this report, workforce challenges in the NHS were a concern before the pandemic. During the pandemic there was enormous support for the NHS with retired health professionals volunteering to return to the frontline.

Survey results show that patients were generally positive about the attention they received from staff during the pandemic. Three-quarters (77%) responded ‘yes, always’ when asked if they were able to get help from staff when they needed attention.

However, COVID-19 patients were significantly less likely to say they could always get help from a member of staff when needed (71% compared with 77% for patients without a COVID diagnosis).

Understanding care and treatment

Communication between staff and patients is a key element of the patients’ experience, not least to facilitate effective involvement in decisions. As a result, NICE has produced clinical guidelines to improve communication with, and the inclusion of, people using NHS adult services.

While the results are generally positive, patients reported some issues with staff communication during the pandemic. For example, while the majority of patients (74%) said they could ‘always’ understand the answers given to them by staff when they had questions about their care or treatment, 20% said they could only understand them ‘sometimes’ and 4% could ‘never’ understand them.

COVID-19 patients were significantly less positive than non-COVID patients (69% said they ‘always’ understood answers given to them compared with 74%).

Similarly, 19% of patients said they were ‘sometimes’ given contradictory information about their care and treatment by hospital staff during their stay and 8% said this happened ‘often’.

The impact of PPE on communication

Due to the COVID-19 pandemic, staff were required to wear PPE while in hospital, which included face masks and shields. The results show that this did have some impact on effective communication between patients and staff. However, the majority of patients (73%) said that they were ‘always’ able to understand staff when they were talking to them wearing PPE.

COVID-19 patients reported a greater impact. Seventy per cent of COVID-19 patients said they were ‘always’ able to understand staff wearing PPE, compared with 74% of non-COVID patients.

Certain groups of patients found communicating with staff who were wearing PPE especially difficult. People aged 85 and over were less likely to always understand what they were being told, as were people with dementia or Alzheimer’s, patients who were deaf or hard of hearing, and autistic people or those with a learning disability.

Keeping in touch with family and friends

During the pandemic, there were restrictions on visitors in hospital, prompting concerns that patients may have been negatively affected by a lack of contact with their loved ones. When asked if they were able to keep in touch with family and friends as much as they wanted to, three-quarters (75%) said ‘yes, often’, while 18% said ‘sometimes’ and 8% said ‘no, never’.

COVID-19 patients were significantly less likely to say they were able to do so (68% saying ‘yes, often’ compared with 76% non-COVID patients).

Most patients who needed help to keep in touch with family and friends while in hospital said that they received that help, ‘often’ (61%) or ‘sometimes’ (25%). However, 13% said they didn’t receive support but would have liked this. This picture was similar for both COVID-19 and non-COVID patients.

Patients who were able to keep in touch with family and friends most commonly did this by phone call (70%) or by messages on a mobile phone (65%). While 20% overall said they kept in touch by video call, such as using FaceTime, Skype, Zoom or Teams, this increased to 26% of patients with COVID-19. Six per cent of people reported having visitors in hospital.

Notably, older patients were more likely to say they were not able to keep in touch with family and friends (10% aged 75 to 84 said they were ‘never’ able to do this, rising to 16% for people aged 85+). This may be partly a result of the fact that they were more likely to be reliant on phone calls to keep in touch, compared with younger patients who more frequently used mobile messaging, video calls and social media. However, there was no difference by age in terms of those reporting they had help from staff to keep in touch.

Patients with a sensory impairment, including people who were blind or deaf, as well as people with a learning disability, a mental health condition or neurological condition were also less likely to feel they were able to keep in touch ‘often’.

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