The other national lottery: the real guide to hospitals

OVERALL CARE

Overall, how would you rate the care you received?

This is the most comprehensive question in the survey and summarises the overall experience. It shows that, despite having a national health service that is supposed to deliver equal care to all who need it, there is instead wide local variation. At the 230-bed Robert Jones and Agnes Hunt Orthopaedic hospital in Oswestry, Shropshire, 77 per cent of patients rated their care as excellent compared with just 24 per cent at the 350-bed Ealing hospital in west London. While 1 per cent rated their care as fair or poor at Robert Jones, 17 per cent did so at Ealing.

The top 10 hospitals ranked for their overall care were all specialist hospitals – cancer, heart, brain or orthopaedic – and were relatively small, each with a few hundred beds, which are easier to manage. The highest-ranked general hospital was the Norfolk and Norwich with 1,000 beds. But it is located in a prosperous county town – Norwich – with a stable population and good recruitment pool.

Overall, the proportion saying their care was excellent has risen from 38 per cent in 2002 to 42 per cent in 2007 – a small reward for the extra billions invested.

Top 5 trusts

1 Robert Jones and Agnes Hunt Orthopaedic and District Hospital, Oswestry, Shropshire (92)

2 Queen Victoria Hospital, East Grinstead, West Sussex (91)

3 The Cardiothoracic Centre, Liverpool NHS Trust (90)

4 Christie Hospital, Manchester (90)

5 The Royal Marsden, London (90)

Bottom 5 Trusts

1 North Middlesex University Hospital, London (69)

2 Barking, Havering and Redbridge Hospitals NHS Trust, London (68)

3 Mayday, Croydon, London (67)

4 Homerton University Hospital, London (67)

5 Ealing Hospital, London (65)

DOCTORS' HYGIENE

As far as you know, did doctors wash or clean their hands between touching patients?

One in 10 patients going into hospital catches an infection that they would have otherwise avoided. They claim thousands of lives and cost billions of pounds to treat but remain at the bottom of concerns of many doctors, nurses and managers. The simplest and most effective defence is handwashing.

Queen Victoria Hospital in East Grinstead, West Sussex, is a specialist burns unit where avoidance of infection is even more critical than at other trusts. It is thus not surprising that it tops the table for handwashing by doctors. Maidstone and Tunbridge Wells NHS Trust, which came bottom of the table, was the scene of Britain's worst outbreak of Clostridium difficile, which caused 90 deaths between 2004 and 2006, triggering an investigation by the Healthcare Commission. It led to the resignation of the chief executive and chairman of the trust. Though it has since significantly improved, it is possible that patients treated by the trust in December last year, when the survey was carried out, were more acutely conscious of the threat and monitored doctors' handwashing more critically.

Top 5 trusts

1 Queen Victoria Hospital (92)

2 Cardiothoracic Centre, Liverpool (90)

3 Clatterbridge Centre for Oncology, Wirral (90)

4 Walton Centre For Neurology and Neurosurgery (89)

5 Robert Jones and Agnes Hunt Orthopaedic and District Hospital (89)

Bottom 5 Trusts

1 Basildon and Thurrock University Hospitals (68)

2 Shrewsbury and Telford Hospital (66)

3 West Hertfordshire Hospitals (65)

4 Barking, Havering and Redbridge, London (64)

5 Maidstone and Tunbridge Wells (62)

RESPECT AND DIGNITY

Overall, did you feel you were treated with respect and dignity in hospital?

For patients, nothing affects the experience of going into hospital more acutely than the way medical staff talk to them. Most said they were treated properly – again the specialist hospitals topped the league table.

Top 5 trusts

1 The Royal Marsden, London (96)

2 Clatterbridge Centre for Oncology, Wirral (96)

3 Christie Hospital, Manchester (95)

4 Queen Victoria Hospital, East Grinstead, West Sussex (95)

5 The Cardiothoracic Centre, Liverpool (95)

Bottom 5 Trusts

1 Homerton University Hospital, London (81)

2 North Middlesex University, London (81)

3 Barking, Havering and Redbridge Hospitals, London (80)

4 Ealing Hospital, London (80)

5 Mayday Hospital, Croydon (80)

ENOUGH NURSES ON DUTY?

In your opinion were there enough nurses on duty to care for you in hospital?

Despite the huge increase in the number of nurses in the NHS – up by 80,000 during the past decade – patients still complain they are hard to find when needed. The proportion of respondents saying there were "always or nearly always" enough nurses on the ward has declined since 2005, whether because expectations have risen or nurses are spending more time filling in forms is hard to say.

Once again, the specialist trusts such as the Royal Brompton heart hospital in London are the best performers with around 80 per cent of patients saying there were enough nurses compared with just 38 per cent at the Lancashire Teaching Hospitals NHS trust.

Top 5 trusts

1 Queen Victoria Hospital, East Grinstead, West Sussex (91)

2 The Royal Marsden, London (87)

3 Birmingham Women's, Birmingham (86)

4 The Cardiothoracic Centre, Liverpool (86)

5 Royal Brompton and Harefield, London (85)

Bottom 5 Trusts

1 Medway, Kent (61)

2 Maidstone and Tunbridge , Kent and Sussex (60)

3 The Queen Elizabeth Hospital, King's Lynn, Norfolk (60)

4 Swindon and Marlborough, Wiltshire (60)

5 Lancashire Teaching, Lancashire (58)

How the ratings are calculated

SHARED BATH FACILITIES WITH OPPOSITE SEX?

While staying in hospital did you ever have to share the same bathroom as patients of the opposite sex?

Almost a third of patients answered yes; 3 per cent said they had to share at the Nuffield Orthopaedic Hospital compared with almost half at Norfolk and Norwich. Department of Health guidelines require bathrooms be single-sex so this survey indicates how far there is still to go.

Top 5 trusts

1 University Hospitals, Coventry and Warwickshire (97)

2 The Princess Alexandra Hospital, Harlow, Essex (97)

3 Airedale NHS Trust, North Yorkshire (97)

4 Royal West Sussex (92)

5 Queen Victoria Hospital, East Grinstead (91)

Bottom 5 Trusts

1 St Mary's, west London (49)

2 Winchester and Eastleigh NHS Trust (49)

3 Ipswich Hospital (48)

4 Rotherham NHS Trust (48)

5 Norfolk and Norwich University Hospital (47)

LENGTH OF WAIT FOR ADMISSION

Overall, from the time you first talked to a GP about being referred to hospital, how long did you wait to be admitted to a hospital?

Long waiting times have been the defining weakness of the NHS for decades. The Government is committed to getting them down to a maximum of 18 weeks from GP referral by the end of the year. A decade ago, it was common to wait more than a year for treatment. For this survey, one in five patients said they had waited more than six months, suggesting the Government's target could be hard to meet. However, official hospital statistics indicate the NHS is on course to hit the target.

Top 5 trusts

1 The Rotherham, South Yorkshire (91)

2 Clatterbridge Centre for Oncology, Wirral (90)

3 The Royal Marsden, London (90)

4 Christie Hospital, Manchester (90)

5 Poole Hospital (90)

Bottom 5 Trusts

1 Medway, Kent (36)

2 West Hertfordshire (33)

3 Royal Orthopaedic Hospital, Birmingham (31)

4 Nuffield Orthopaedic Centre, Oxford (29)

5 Robert Jones and Agnes Hunt Orthopaedic, Oswestry (28)

QUALITY OF HOSPITAL FOOD?

How do you rate the food?

Jamie Oliver did it for school meals – who is going to do it for hospital food? The goo that passes for sustenance in some trusts is ripe for a makeover, a decade after the celebrity chef, Lloyd Grossman, tried to do so. More than half of respondents described the food as good or very good, but one in six said it was poor.

Top 5 trusts

1 Robert Jones and Agnes Hunt Orthopaedic, Owestry (80)

2 Royal National Hospital For Rheumatic Diseases, Bath (69)

3 Queen Victoria Hospital, East Grinstead, West Sussex (69)

4 East Cheshire (68)

5 West Dorset General (68)

Bottom 5 Trusts

1 Barts and The London (41)

2 North Middlesex University (41)

3 Worthing and Southlands, West Sussex (41)

4 Hereford Hospitals (39)

5 Royal Liverpool and Broadgreen University Hospitals (38)

SPEED OF NURSES' RESPONSE TO CALL

How many minutes after you used the call button did itusually take before you got the help you needed?

Again, this reflects the number of nurses available on the wards. Response times have fallen since 2006, according to the survey, suggesting nurses are busier or there are staff shortages. At Northumbria Healthcare Trust, more than 80 per cent of patients said they got help within two minutes, compared with less than 30 per cent at Queen Mary's Sidcup

Top 5 trusts

1 The Cardiothoracic Centre, Liverpool (81)

2 Birmingham Women's (77)

3 Royal Brompton, London (76)

4 Papworth, Huntingdon, 76

5 Liverpool Women's (74)

Bottom 5 Trusts

1 North West London (53)

2 The Queen Elizabeth Hospital, King's Lynn (53)

3 Ealing Hospital (53)

4 Barking, Havering and Redbridge, London (52)

5 Queen Mary's, Sidcup (50)

MIXED-SEX WARDS

[Following admission], did you ever share a sleeping area, for example a roomor bay, with patients of the opposite sex?

It was Lord Darzi, the Health minister, who admitted earlier this year that eradicating mixed-sex wards was "an aspiration that cannot be met". These figures show how difficult it is going to be.

One in four respondents said that they occupied a mixed-sex ward when they were first admitted. Where patients are admitted urgently, or placed in intensive care, clinical priorities take precedence and trusts can mix the sexes.

Tony Blair's pledge in 1996 to end mixed-sex accommodation has become a millstone round minister's necks. Best performer was the Cardiothoracic Centre in Liverpool where just 5 per cent had to share. Worst performer was Maidstone and Tunbridge Wells.

Top 5 trusts

1 The Cardiothoracic Centre, Liverpool (97)

2 Northumbria Healthcare (97)

3 Nuffield Orthopaedic Centre (97)

4 Harrogate and District (97)

5 Robert Jones and Agnes Hunt Orthopaedic and District Hospital (96)

Bottom 5 Trusts

1 North Middlesex University Hospital (59)

2 Winchester and Eastleigh (59)

3 Weston Area Health (58)

4 Medway, Kent (55)

5 Maidstone and Tunbridge Wells (51)

HOW CLEAN WAS THE HOSPITAL?

In your opinion, how clean was the hospital ward or room that you were in?

Standards are falling, says this survey, with 53 per cent of patients saying their ward was very or fairly clean, down from 56 per cent in 2002. But it may reflect increased expectations, because of fears about hospital infection. In the top trusts, such as the Walton Centre for Neurology, more than 80 per cent said their ward was very clean. At Homerton University hospital only about a third did.

Top 5 trusts

1 Queen Victoria, EastGrinstead (940

2 Robert Jones and Agnes Hunt Orthopaedic , Oswestry (94)

3 Walton Centre for Neurology and Neurosurgery (92)

4 The Cardiothoracic Centre, Liverpool (92)

5 Clatterbridge Centre for Oncology, Wirral (92)

Bottom 5 Trusts

1 Mayday, Croydon (73)

2 Hillingdon Hospital , London (73)

3 NW London Hospitals (72)

4 Ealing Hospital (72)

5 Homerton University Hospital, London (71)

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