Cancer patient experience: inequalities in care
This week we published the results of the 2015 National Cancer Patient Experience Survey, www.ncpes.co.uk. At a national level, the results are positive (on a scale of 0 to 10, the average rating from patients of their overall care is 8.7). But as in previous years there are areas where experience is less good (for example, only 55% of patients say they were given information about financial support; and only 33% were given a care plan).
For the first time, we conducted exactly the same survey in Scotland, and the results were also published this week, http://www.gov.scot/Topics/Statistics/Browse/Health/cancersurvey. They are remarkably similar (exactly the same score on the overall experience question, for example). But there are also interesting differences in some areas: @_RoseGray at Cancer Research UK has written a great blog on this, http://scienceblog.cancerresearchuk.org/2016/06/08/cancer-care-in-england-and-scotland-what-do-patients-really-think/.
But underneath the headline national figures, there are some fascinating insights into the experiences of different groups of cancer patients, as we have seen in previous years.
Men and women report quite different experiences of the care. Of the 50 questions in the survey, there are statistically significant differences on 37. And on 30 of these it is men who report a more positive experience – by a large margin in some cases. For example, nearly 10% more men than women report that they were asked what name they prefer to be called by when they were in hospital.
Looking across age groups, there are significant differences too – in this case, on every single question in the survey. The youngest age group (16-24 year olds) report the most positive experience on 14 questions. But it’s the older age groups (65+) who appear most satisfied, with the most positive scores on 35 of the questions overall.
Different ethnic groups report different experiences of cancer care as well. White patients are significantly more positive about their care on 36 questions out of 50; black patients on 5 (including being invited to take part in cancer research); and Asian patients on only 2 (including being given a care plan).
Deprivation too, appears to play a part. And it’s at the extremes where the most positive impacts seem to be. Patients in the most deprived areas report a significantly more positive experience on 10 questions; those in the least deprived areas on 22; whereas those in the middle report the least positive experiences throughout.
And some of the most striking differences are between the experiences of patients with different cancers. We’ve analysed this looking at thirteen groups of tumours. Again, there are significant differences on every single question. Skin cancer, and breast cancer, are the two groups with the most positive scores; urological, and brain, have the least. And there are fascinating differences on individual questions too.
Lots of detail to be explored in the results overall, then. And a huge amount of useful analysis that commissioners and providers of care can do – as well as the individual cancer charities and patient organisations that I know are already looking at the detailed figures.
On 5th July, there’ll be even more useful data available, when we publish all of these results at CCG- and Trust-level too. Watch this space, www.ncpes.co.uk.