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Experiences of the NHS & Private-sector medical care

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Experiences, perceptions and reporting of the NHS

Although the NHS has a high level of popular public support within the country, the national press is often highly critical of it and this may have affected perceptions of the service within the country as a whole and outside. An independent survey conducted in 2004 found that users of the NHS often expressed very high levels satisfaction about their personal experience of the medical services they received. Of hospital inpatients, 92% said they were satisfied with their treatment; 87% of GP users were satisfied with their GP, 87% of hospital outpatients were satisfied with the service they received, and 70% of Accident and Emergency department users reported being satisfied.

When asked whether they agreed with the question "My local NHS is providing me with a good service" 67% of those surveyed agreed with it, and 51% agreed with the statement "The NHS is providing a good service. The reason for this disparity between personal experience and overall perceptions is not clear. Similarly the survey also showed that net satisfaction with NHS services (the number reporting satisfied less those reporting dissatisfied) was generally higher amongst NHS services users than for all respondents (users as well as non-users). Where more people had no recent experience of that service, the difference in net positive perception reported by users compared to non-users was more likely to diverge.

For example, the least used service surveyed was walk-in centres (only 15% of all persons surveyed had actually used an NHS Walk in clinic in the last year) but 85% of walk in clinic users were satisfied with the service they received. Users' net positive satisfaction was 80%. However, for all respondents (including non-recent users) the overall net positive satisfaction was just 25%. The service with the highest rate of use was the GP service (77% having seen their GP in the last year) and the difference in net satisfaction between users and all users was the smallest (76% and 74% net satisfied respectively)

It is also apparent from the survey that most people realise that the national press is generally critical of the service (64% reporting it as being critical compared to just 13% saying the national press is favourable), and also that the national press is the least reliable source of information (50% reporting it to be not very or not at all reliable, compared to 36% believing the press was reliable). Newspapers were reported as being less favourable and also less reliable than the broadcast media. The most reliable sources of information were considered to be leaflets from GPs and information from friends (both 77% reported as reliable) and medical professionals (75% considered reliable).

Private-sector medical care

England also has a private health care sector. Private health care is sometimes funded by employers through medical insurance as part of a benefits package to employees though it is mostly the larger companies that do. Insurers also market policies directly to the public. Most private care is for specialist referrals with most people retaining their NHS GP as point of first contact.

The private sector now does some subcontracting work for the NHS. Thus an NHS patient can be treated in the private sector as an NHS patient if the Health Services has subcontracted work to the hospital.

Some private hospitals are business enterprises and some are non-profit-making trusts. Some hospital groups provide insurance plans (e.g. Bupa, Benenden), and some insurance companies have deals with particular private hospital groups. Some private sector patients can be treated in NHS hospitals in which case the patient or his/her insurance company is billed.

The Care Quality Commission, after inspecting more than 200 private sector hospitals, warned in April 2018 that informality in processes meant that systematic and robust safety procedures were not in place. Hospital consultants are generally not employed by the private hospitals where they have admitting rights and the commission said private companies could be reluctant to challenge them. Safety was viewed as the responsibility of individual clinicians, rather than a corporate responsibility supported by formal governance processes. Furthermore, private hospitals “were not set up to anticipate and handle emergency situations”. There were only 15 critical care services across 206 hospital sites so in an emergency they had to rely on the 999 service.

Most people think that the NHS is well run, with 73% of people reporting that they are satisfied with the running of the service and only a little over 10% reporting themselves as dissatisfied.

England's healthcare is ranked 14th in Europe in the Euro Health Consumer Index.

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