Public Expenditure on Health and Personal Social Services 2009 - Health Committee Contents

5.  ACTIVITY AND PERFORMANCE

5.1.27  Could the Department provide the latest data from the National Patient Choice Bimonthly Survey on (a) patients' awareness of choice, (b) whether they were offered choice at referral and (c) whether they were able to attend the hospital they wanted, broken down by PCT? What is the Department doing to ascertain what proportion of patients are choosing a provider that is not their usual local NHS provider and what effect this is having on NHS services? (Q66)

Answer

  1.  Data from the latest National Patient Choice survey is set out in table 66 and shows (a) patients awareness of choice; (b) whether they were offered choice at referral; and (c) whether they were able to attend the hospital they wanted, broken down by PCT as at December 2008.

2.  The Department of Health has commissioned a piece of work through the Health Reform Evaluation Programme (HREP) to look at "How patients choose and how providers respond". This research is led by the King's Fund (in collaboration with other institutions) and seeks to explore:

— what factors patients take into account when choosing a hospital;


— how patients experience choice;

— what support and advice different patients are given to exercise their choice and how this affects the choices they make; and

— how providers respond to patients choosing hospitals when there is widely available information about services, and they can lose money as a result of these patient choices.

  3.  Details of the research methodology are available from the HREP website[12] or the King's Fund website,[13] although it can be summarised as:

— interviews with GPs (how do they support choice);

— interviews with provider staff (how do their organisations respond to choice); and

— patient surveys (how did they experience choice and make choices and a hypothetical choice exercise).

Table 66

PATIENTS AWARE OF CHOICE, OFFERED CHOICE AND GOING TO THE HOSPITAL THEY WANTED BY PCT, NATIONAL PATIENT CHOICE SURVEY, DECEMBER 2008

			Aware of choice(1)		Offered choice(2)		Able to go where wanted(3)
PCT code	PCT name	Cases(4)	%Yes	%No	%Yes	%No	%Yes	%No	%No preference
5HG	Ashton, Leigh and Wigan	354	57%	43%	59%	38%	75%	3%	19%
5C2	Barking and Dagenham	203	48%	52%	54%	40%	60%	19%	20%
5A9	Barnet	420	53%	45%	51%	41%	68%	11%	16%
5JE	Barnsley	159	63%	37%	60%	37%	74%	8%	17%
5ET	Bassetlaw	92	65%	35%	60%	38%	80%	5%	13%
5FL	Bath and North East Somerset	407	57%	43%	49%	48%	75%	4%	19%
5P2	Bedfordshire	437	50%	49%	37%	58%	67%	4%	25%
5QG	Berkshire East Teaching	176	45%	55%	44%	50%	61%	14%	22%
5QF	Berkshire West	134	58%	41%	68%	28%	84%	3%	10%
TAK	Bexley Care Trust	256	55%	45%	49%	46%	68%	9%	20%
5PG	Birmingham East and North	84	56%	43%	56%	42%	69%	11%	20%
5CC	Blackburn with Darwen Teaching	143	62%	38%	57%	40%	76%	13%	10%
5HP	Blackpool	307	56%	44%	48%	48%	73%	5%	20%
5HQ	Bolton	375	59%	40%	55%	42%	78%	5%	17%
5QN	Bournemouth and Poole	388	54%	45%	57%	39%	84%	4%	10%
5NY	Bradford and Airedale Teaching	628	48%	52%	36%	59%	56%	9%	31%
5K5	Brent Teaching	239	42%	56%	44%	47%	64%	7%	25%
5LQ	Brighton and Hove City Teaching	246	40%	59%	26%	68%	53%	7%	37%
5QJ	Bristol Teaching	403	43%	57%	49%	46%	72%	8%	18%
5A7	Bromley	73	48%	52%	48%	47%	64%	12%	22%
5QD	Buckinghamshire	873	51%	48%	48%	47%	71%	5%	22%
5JX	Bury	120	56%	43%	58%	42%	77%	4%	17%
5J6	Calderdale	427	54%	45%	48%	48%	79%	6%	13%
5PP	Cambridgeshire	834	48%	51%	36%	59%	75%	6%	17%
5K7	Camden	229	55%	44%	55%	39%	79%	3%	17%
5NP	Central & Eastern Cheshire	1,107	55%	44%	45%	51%	71%	6%	21%
5NG	Central Lancashire	216	57%	42%	56%	40%	70%	13%	16%
5C3	City and Hackney Teaching	235	35%	64%	37%	55%	57%	9%	32%
5QP	Cornwall and Isles of Scilly	702	47%	51%	46%	49%	55%	19%	24%
5ND	County Durham	986	67%	32%	67%	31%	77%	8%	14%
5MD	Coventry Teaching	645	60%	39%	53%	42%	78%	3%	17%
5K9	Croydon	88	56%	43%	50%	48%	69%	9%	22%
5NE	Cumbria	1,419	61%	38%	51%	44%	72%	8%	17%
5J9	Darlington	223	59%	40%	44%	52%	76%	6%	16%
5N7	Derby City	576	49%	51%	41%	54%	66%	7%	25%
5N6	Derbyshire County	1,208	63%	36%	58%	39%	79%	4%	15%
5QQ	Devon	1,590	54%	45%	45%	51%	75%	6%	17%
5N5	Doncaster	317	63%	36%	46%	50%	75%	5%	17%
5QM	Dorset	825	63%	36%	61%	34%	78%	5%	14%
5PE	Dudley	255	54%	45%	29%	66%	56%	7%	34%
5HX	Ealing	382	56%	44%	42%	52%	64%	9%	24%
5P3	East and North Hertfordshire	320	58%	41%	49%	47%	66%	10%	21%
5NH	East Lancashire	620	61%	38%	65%	32%	72%	11%	15%
5NW	East Riding of Yorkshire	708	45%	54%	36%	60%	57%	10%	30%
5P7	East Sussex Downs and Weald	709	50%	50%	39%	57%	70%	5%	22%
5QA	Eastern and Coastal Kent Teaching	1,115	49%	50%	49%	46%	65%	9%	22%
5C1	Enfield	465	55%	45%	54%	41%	70%	9%	18%
5KF	Gateshead	542	63%	36%	57%	41%	72%	6%	19%
5QH	Gloucestershire	954	48%	51%	53%	44%	72%	7%	18%
5PR	Great Yarmouth and Waveney	69	67%	33%	68%	32%	78%	6%	12%
5A8	Greenwich Teaching	349	52%	48%	52%	44%	69%	9%	22%
5NM	Halton and St Helens	723	55%	45%	53%	44%	70%	9%	20%
5H1	Hammersmith and Fulham	245	49%	51%	41%	50%	69%	6%	22%
5QC	Hampshire	2,021	51%	49%	47%	50%	67%	8%	22%
5C9	Haringey Teaching	198	41%	59%	43%	52%	63%	8%	28%
5K6	Harrow	183	47%	52%	56%	37%	74%	7%	17%
5D9	Hartlepool	56	61%	38%	54%	43%	66%	13%	20%
5P8	Hastings and Rother	489	47%	52%	31%	65%	62%	9%	25%
5A4	Havering	239	48%	52%	53%	43%	72%	8%	16%
5MX	Heart of Birmingham Teaching	110	45%	55%	33%	62%	62%	8%	25%
5CN	Herefordshire	421	46%	53%	27%	68%	68%	3%	26%
5AT	Hillingdon	557	40%	60%	29%	66%	57%	9%	30%
5HY	Hounslow	181	44%	56%	40%	56%	66%	4%	25%
5NX	Hull Teaching	487	46%	53%	36%	60%	55%	6%	37%
5QT	Isle of Wight Healthcare	366	40%	60%	19%	76%	65%	4%	27%
5K8	Islington	88	55%	45%	51%	40%	78%	2%	17%
5LA	Kensington and Chelsea	114	47%	53%	50%	45%	59%	16%	23%
5A5	Kingston	58	43%	57%	31%	67%	47%	14%	38%
5N2	Kirklees	732	49%	49%	48%	48%	72%	7%	19%
5J4	Knowsley	184	47%	52%	42%	54%	66%	10%	23%
5LD	Lambeth	174	47%	52%	53%	42%	67%	11%	20%
5N1	Leeds	1,439	48%	52%	37%	59%	54%	12%	31%
5PC	Leicester City Teaching	566	40%	59%	31%	63%	45%	16%	36%
5PA	Leicestershire County and Rutland	974	48%	52%	43%	53%	57%	11%	28%
5LF	Lewisham	289	46%	53%	39%	55%	64%	6%	26%
5N9	Lincolnshire Teaching	2,066	60%	40%	50%	46%	68%	9%	21%
5NL	Liverpool	422	54%	45%	54%	41%	74%	4%	19%
5GC	Luton Teaching	15	40%	53%	53%	40%	73%	0%	20%
5NT	Manchester	728	48%	51%	41%	54%	69%	7%	21%
5L3	Medway Teaching	70	50%	49%	63%	33%	70%	10%	20%
5PX	Mid Essex	677	43%	57%	31%	65%	56%	5%	35%
5KM	Middlesbrough	232	72%	28%	66%	32%	88%	4%	7%
5CQ	Milton Keynes	647	39%	60%	28%	67%	60%	4%	32%
5D7	Newcastle	384	55%	45%	29%	67%	57%	5%	37%
5C5	Newham	274	42%	58%	37%	54%	59%	10%	28%
5PQ	Norfolk	1,190	55%	45%	51%	46%	79%	4%	15%
5PW	North East Essex	887	46%	53%	40%	55%	63%	7%	25%
TAN	North East Lincolnshire	290	60%	40%	36%	62%	64%	8%	27%
5NF	North Lancashire	793	61%	38%	56%	40%	76%	5%	16%
5EF	North Lincolnshire	332	62%	37%	57%	39%	72%	6%	17%
5M8	North Somerset	558	47%	50%	41%	54%	70%	5%	22%
5PH	North Staffordshire	503	57%	42%	56%	41%	76%	6%	17%
5E1	North Tees	144	56%	43%	51%	44%	65%	11%	24%
5D8	North Tyneside	486	60%	39%	40%	57%	66%	5%	28%
5NV	North Yorkshire and York	1,577	52%	47%	41%	55%	74%	5%	19%
5PD	Northamptonshire Teaching	1,295	60%	40%	54%	41%	74%	7%	18%
TAC	Northumberland Care Trust	624	58%	41%	43%	53%	67%	5%	25%
5EM	Nottingham City	384	54%	45%	47%	49%	68%	8%	21%
5N8	Nottinghamshire County Teaching	1,328	60%	40%	59%	38%	79%	5%	14%
5J5	Oldham	51	59%	41%	75%	25%	78%	8%	14%
5QE	Oxfordshire	805	57%	43%	49%	47%	77%	3%	18%
5PN	Peterborough	297	41%	59%	35%	62%	61%	8%	30%
5F1	Plymouth Teaching	272	55%	45%	51%	44%	72%	4%	21%
5FE	Portsmouth City Teaching	392	53%	47%	45%	49%	64%	8%	26%
5NA	Redbridge	419	53%	46%	43%	53%	63%	11%	25%
5QR	Redcar and Cleveland	267	66%	33%	49%	47%	74%	3%	19%
5M6	Richmond and Twickenham	42	31%	69%	52%	43%	52%	14%	31%
5NQ	Rochdale, Heywood and Middleton	47	47%	53%	62%	32%	64%	13%	23%
5H8	Rotherham	74	70%	27%	61%	34%	80%	4%	14%
5F5	Salford Teaching	344	62%	38%	50%	48%	80%	4%	15%
5PF	Sandwell	88	50%	49%	55%	41%	75%	9%	13%
5NJ	Sefton	356	46%	53%	39%	58%	62%	4%	32%
5N4	Sheffield	1,156	51%	48%	39%	56%	65%	7%	25%
5M2	Shropshire County	84	56%	43%	58%	38%	73%	8%	15%
TAM	Solihull	33	64%	33%	73%	27%	76%	12%	12%
5QL	Somerset	547	62%	37%	62%	35%	73%	8%	17%
5M1	South Birmingham	331	39%	60%	30%	64%	61%	2%	34%
5P1	South East Essex	93	48%	51%	58%	39%	73%	4%	16%
5A3	South Gloucestershire	364	46%	53%	43%	53%	67%	10%	21%
5PK	South Staffordshire	715	60%	39%	48%	47%	70%	6%	21%
5KG	South Tyneside	273	72%	28%	44%	52%	72%	5%	21%
5PY	South West Essex Teaching	573	50%	49%	53%	45%	70%	8%	20%
5L1	Southampton City	342	32%	67%	20%	73%	48%	9%	39%
5LE	Southwark	92	40%	60%	46%	48%	68%	7%	21%
5F7	Stockport	444	54%	45%	53%	42%	77%	4%	17%
5PJ	Stoke on Trent Teaching	248	60%	39%	60%	36%	75%	5%	18%
5PT	Suffolk	612	48%	50%	33%	62%	66%	5%	25%
5KL	Sunderland Teaching	741	65%	34%	45%	50%	74%	4%	19%
5P5	Surrey	1,855	50%	49%	47%	49%	70%	7%	20%
5M7	Sutton and Merton	502	46%	54%	42%	52%	64%	11%	23%
5K3	Swindon	289	48%	51%	33%	64%	72%	1%	24%
5LH	Tameside and Glossop	459	63%	37%	62%	36%	79%	4%	17%
5MK	Telford and Wrekin	6	50%	50%	83%	17%	67%	33%	0%
TAL	Torbay Care Trust	410	54%	45%	42%	55%	77%	5%	16%
5C4	Tower Hamlets	41	54%	46%	56%	37%	66%	12%	17%
5NR	Trafford	224	45%	54%	43%	51%	68%	11%	19%
5N3	Wakefield	757	52%	48%	50%	47%	65%	9%	23%
5M3	Walsall Teaching	268	59%	40%	40%	52%	70%	5%	22%
5NC	Waltham Forest	428	47%	53%	44%	50%	65%	10%	23%
5LG	Wandsworth	46	52%	48%	50%	46%	70%	15%	11%
5J2	Warrington	433	54%	46%	39%	57%	71%	3%	24%
5PM	Warwickshire	490	57%	43%	63%	35%	77%	7%	15%
5NN	West Cheshire	386	52%	47%	44%	51%	76%	5%	17%
5PV	West Essex	283	57%	42%	46%	52%	72%	4%	21%
5P4	West Hertfordshire	965	41%	58%	39%	57%	61%	9%	26%
5P9	West Kent	509	42%	56%	39%	55%	67%	6%	24%
5P6	West Sussex Teaching	957	51%	48%	50%	45%	74%	8%	16%
5LC	Westminster	115	37%	63%	33%	57%	65%	10%	23%
5QK	Wiltshire	688	56%	43%	50%	46%	76%	4%	17%
5NK	Wirral	192	57%	42%	52%	44%	69%	6%	22%
5MV	Wolverhampton City	436	45%	54%	32%	65%	70%	3%	25%
5PL	Worcestershire	123	55%	43%	50%	44%	63%	11%	24%
Total	England	75,878	50%	50%	46%	49%	68%	7%	23%
Source:
National Patient Choice Survey, December 2008
Quality: The number of valid survey responses varies by PCT, from fewer than 60 patients in 10 PCTs (where there were local problems with the survey process) to more than 1,000 in 14 PCTs. The confidence interval around the percentage of patients offered choice is ÷6% for the average PCT.
Footnotes:
1.  Response to Q1 "Before you visited your GP, did you know that you now have a choice of hospitals that you can go to for your first hospital appointment?"
2.  Response to Q3 "Were you offered a choice of hospital for your first hospital appointment?"
3.  Response to Q5 "Were you able to go to the hospital that you wanted to go to?"
4.  Total valid responses, including patients who replied `don't know' or did not respond to the question. The national total is weighted to take account of age and sex bias among respondents and includes 3,482 (5%) weighted cases not listed by responsible PCT because the PCT was not clear.

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12   www.lshtm.ac.uk/hsru/hrep/projects/patients.htm Back

13   www.kingsfund.org.uk/research/projects/patient_choice/patient_choice.html Back

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Prepared 20 January 2010