Wales Cancer Patient Experience. Survey Aneurin Bevan University Health Board. Published January 2014

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1 Wales Cancer Patient Experience Survey 2013 Aneurin Bevan University Health Published January 2014 The Wales Cancer Patient Experience Survey was undertaken by Quality Health on behalf of the Welsh Government and Macmillan Cancer Support

2 Aneurin Bevan University Health Introduction The Wales Cancer Patient Experience Survey 2013 (CPES) is designed to monitor national progress on cancer care. The survey is congruent with the Welsh Government's 'Together For Health: Cancer Delivery Plan for the NHS 2016' and measures progress from the patient's point of view against the objectives of the Cancer Delivery Plan. The CPES provides information which can be used to drive local quality improvements, both by Health s/trust and by planners, and is consistent with the objectives of NHS policy in Wales. Executive Summary The results for the Aneurin Bevan University Health show the following key points: Key worker/clinical Nurse Specialists: Very high score for patients having a Clinical Nurse Specialist (91%). Very high scores for the CNS listening carefully (91%) and for getting understandable answers to questions posed by the patient (90%); slighly lower score for being able to contact CNS (78%). Fewer patients had a Key Worker (75%) than had a CNS (91%), but the number of patients having a Key Worker is higher than the all-wales average. High scores for being able to contact Key Workers (88%), Key Workers listening carefully (90%), and for getting understandable answers to questions posed (84%). Information and Support: Patients gave high scores for information on what would be done during tests (86%) but slightly lower scores for information on the purpose of tests (78%), written information on tests (79%) and being told test results (76%). 86% of patients said they were told sensitively they had cancer. 38% of patients said they were not given written information about the type of cancer they had or said it was difficult to understand. 85% of patients were given a choice of treatment, where this was possible. 77% of patients were given written information about the side effects of treatment but far fewer (58%) were given information on any long term side effects that may exist. Only 31% of patients in the Aneurin Bevan University Health said they received information about financial help or benefits they may be entitled to. Fewer patients (25%) said taking part in cancer research was discussed with them compared to 29% in Wales as a whole. Information pre-operatively about what would be done (86% given an explanation) was given more frequently than was information about how the operation had actually gone (78% given explanation). 82% of patients were given clear written information about what they should and should not do after leaving hospital. Assessment and Care planning: 61% of patients were given an opportunity to discuss their needs and concerns about a care plan - but only 22% were actually offered a written care plan. 2

3 Aneurin Bevan University Health Executive Summary (continued) Transition point: from hospital treatment to cancer care in the community 39% of patients said their families/those close to them did not get enough information about how to look after them post discharge or only did so to some extent. 39% of patients who needed it said that they were not given enough help from health and social services post discharge or only were to some extent. 94% of patients said their GP was given enough information about their condition and the treatment they had had; but far fewer patients said their GP practice did everything they could to support them whilst they were having treatment (66%). Variation between Health scores and the all-wales scores: Scores given by patients at Aneurin Bevan are statistically significantly higher than the all-wales figure on being given the name of a Key Worker; and having trust and confidence in the doctors treating them. Scores given by patients at Aneurin Bevan are statistically significantly worse than the all-wales figure on staff giving information on financial benefits and help that might be available; there being always/nearly always enough nurses on duty to care for the patient; and having enough privacy when being examined or treated. Variation between hospitals within the : Scores given by patients at Nevill Hall hospital are statistically significantly higher than the all-wales figure on 6 questions, and lower on only 1 question. Scores given by patients at the Royal Gwent are statistically significantly higher than the all- Wales figure on 2 questions and lower on 4 questions. Variation in scores between tumour groups: There are many variations in scores between individual tumour groups and the all-wales score for that tumour group. There are some lower scores than the all-wales average in the Colorectal/lower GI and Urological tumour groups. In terms of the important questions on access to CNS support and Key Worker support, there are gaps in provision for the CNS in the Gynaecological tumour group and a gap in provision on Key Workers in the Gynaecological tumour groups. Key Strengths identified at level: 80% of patients said their health stayed the same or got better whilst waiting for their first appointment. Information on what would be done during tests was given to 86% of patients. 86% of patients were told sensitively they had cancer. Most patients (83%) were given a choice of treatment, where this was possible. Very high proportions of patients were given the name of a Clinical Nurse Specialist who would be in charge of their care (91%), said the CNS listened carefully to them (91%) and gave understandable answers to questions (90%). Key Workers, where they were notified to the patient, were also said to listen carefully (90%) and gave understandable answers (84%). High proportions of patients who had been asked about taking part in cancer research actually went on to take part (70%). High proportions of patients said they had complete explanations of what would be done in the operation they were having (86%). 3

4 Aneurin Bevan University Health Executive Summary (continued) Key Strengths identified at level (continued): Some scores for doctors were high with 91% of patients having confidence and trust and 88% saying doctors did not talk in front of patients as if they were not there. 87% of patients said nurses did not to talk in front of them as if they were not there. 91% of patients did not believe that information was being withheld from them, and 86% said they did not receive conflicting information. High scores of over 80% were achieved for privacy. 85% of patients said that staff did everything they could to control their pain whilst they were in hospital. 81% of patients said they were always treated with respect and dignity. 82% of patients said they were told what to do/not to do when they left hospital. Very high numbers of patients (90%) were told who to contact if they were concerned, after discharge. Most patients said staff did everything they could to control the side effects of chemotherapy (87%). 97% of patients said that Doctors had the right notes and results with them when they were seen in outpatients. 94% of patients said their GP was given enough information about their condition and treatment they had at the hospital. Overall scores were high, with most patients saying that they were given the right amount of information (84%); that they were not treated as a set of cancer symptoms but were treated as a whole person (82%); and that their care was excellent or very good (84%). Key weaknesses identified: 38% of patients were not given understandable written information about the type of cancer they had or were given no information at all. Information on potential long term side effects was given to only 58% of patients. Fewer patients (75%) were given details of their Key Worker compared to 91% being told about a CNS. Only 61% were offered the opportunity to discuss needs and concerns and only 22% of patients were offered a written care plan. 27% of patients were not given information about emotional support (e.g. through support groups) but would have liked some. Information was given to only a minority of patients on any financial help or benefits they might be entitled to (31%). Only 51% of patients said they were able to talk to their doctor as often as they would like during their treatment; and 58% that families/carers were able to talk to a doctor when they needed to. Only 69% of patients had confidence and trust in ward nurses and only 54% thought there were always enough nurses on the ward to care for patients. Only 58% of patients said they were asked what name they would prefer to be called by. 19% of patients said they did not have the opportunity to discuss any worries or fears they had whilst they were in hospital or only did so some of the time. Only 61% of patients said all the information on how to look after the patient on discharge was given to their family. Only 61% of patients said that they got enough support from health, social services post discharge. 4

5 Aneurin Bevan University Health Background Participating s and Trust All 7 Local Health s and 1 NHS Trust providing cancer services took part in the survey, accounting for all providers of adult cancer care in Wales. One Health (Powys Teaching) provides supportive and palliative care to patients but its residents are treated in hospitals located in other Health s in Wales and England for the acute stage of treatment. The level reports, of which this is one, report on a total of 23 hospitals and on each tumour group where there is sufficient data to do so. Patients selected to take part The survey included all adult patients (aged 16 and over) with a primary diagnosis of cancer who had been admitted to a Welsh NHS hospital as an inpatient or as a day case patient, and had been discharged between 1st June 2012 and 31st March The eligibility period for data capture purposes was designed to ensure that there was sufficient data from patients available for analysis in respect of most variables. Patients eligible for the survey were taken from Health s/trust patient administration systems; the inclusion criteria were that the patient had an International Classification of Disease (ICD10) code of C00-99 (excluding C44 and C84) or D05. The types of cancer patients included significant numbers with rarer cancers as well as patients in the Big 4 cancer groups i.e. breast, prostate, lung, and colorectal/lower GI. Health /Trust samples were checked rigorously for duplicates and patient lists were also deduplicated nationally to ensure that patients did not receive multiple copies of the questionnaire. Health /Trust samples were rigorously checked for deceased patients through the DBS system on at least three occasions during the fieldwork, to ensure that the numbers of deceased patients in samples was reduced to an absolute minimum. process was undertaken by Quality Health and was highly effective. Survey method naires were sent by post to patients home addresses following their discharge. naires were printed in both English and Welsh. Up to two reminders were sent to non-responders. A freepost envelope was included for their replies. Patients could call a free telephone line to ask questions, complete the questionnaire verbally, or to access an interpreting service. 5

6 Aneurin Bevan University Health Response rate A total of 10,945 patients who had received treatment for cancer during June 2012 to March 2013 were included in the national sample for the Wales Cancer Patient Experience Survey. These patients were allocated to 13 different cancer groups. 407 eligible patients from this were sent a survey, and 274 questionnaires were returned completed. represents a response rate of 68% once deceased patients and questionnaires returned undelivered were accounted for. The all-wales national response rate was 69% (7352 respondents). Percentage scores The questions in the cancer survey have been summarised as the percentage of patients who reported a positive experience. For example, percentage of patients who were given a complete explanation of their diagnostic tests and percentage of patients who said that nurses did NOT talk in front of them as if they were not there. Neutral responses, such as Don t know/can t remember and I did not need an explanation are not included in the denominator when computing the score. ensures that only those responses from patients requiring particular information or care are included when assessing responses and that any comparisons made between Health s/trust and between hospitals are made on a like for like basis. The higher the score, the better the Health /Trust's performance. Some scores represent performance across a pathway involving primary and community care in addition to acute care but represent important parts of the patient experience along the pathway of care. Low numbers of respondents and data not reported Some Health s/trust, and some hospitals within Health s/trust, have relatively small numbers of cancer patients, so the total number of respondents to the survey may be low despite the high response rate. Reports for these Health s/trust and hospitals have been completed in the normal way, but the results for them need to be treated with a greater degree of caution. It is important to recognise, however, that the low numbers of respondents in these Health s/trust and hospitals are simply the result of low numbers of cancer patients being treated. Patients were asked to complete the questionnaire in respect of the Health /Trust named on the covering letter. In those Health s/trust without a radiotherapy or chemotherapy unit, where patients reported receiving these treatments despite these instructions, responses have been suppressed to ensure that only responses relevant to the Health /Trust in question are reported. In almost all Health s/trust and hospitals, there were tumour groups where the number of respondents was less than 20; this is particularly true of tumour groups representing rarer cancers. Where the number of respondents in a particular tumour group is less than 20, we have used the convention of leaving the relevant cell blank. is further explained in the introduction to the tumour group tables in this report. Where the response group is fewer than 30, greater degrees of caution need to be used in interpreting the data. 6

7 Aneurin Bevan University Health Benchmark charts Percentage scores are displayed on benchmark bar charts in the following section. Each blue bar represents the range of results across all Health s/trust for one question. The black circle in the bar represents the score for this Health /Trust. The line on either side of the circle shows the 95% confidence interval (the amount of uncertainty surrounding the Health /Trust's score). The vertical line in the blue area indicates the national mean score on that question for all respondents in Wales Blue area representing range of scores Circle and horizontal line representing Health /Trust score and confidence interval Vertical line representing Welsh national mean score The table below each benchmarking chart shows the following: in column one, the Health /Trust score for each question; the second column displays the highest Health /Trust's score for this question and the third column displays the number of respondents who gave this answer for this question. Where no Health /Trust data or confidence interval is displayed on the range chart or in the tables for a particular question, there is insufficient data (below 20 respondents) to allow display. Confidence intervals will be wider where the number of respondents is smaller. Further information Full details of the survey method are in the National Report of the Wales Cancer Patient Experience Survey 2013, which will be available at from late January Further details of survey development, nationally agreed methodology, and cognitive testing are also available at 7

8 Aneurin Bevan University Health Who responded to the survey at this Health /Trust? 274 patients responded to the survey from the Health /Trust. The tables on this and the next page show the number of patients from each, the numbers of patients from each tumour group and the age and gender distribution of these patients. Respondents by Number of respondents Nevill Hall 57 Royal Gwent 212 Ysbyty Ystrad Fawr 5 Total 274 Respondents by tumour group Tumour Group Number of respondents* Breast 68 Colorectal / Lower Gastrointestinal 65 Lung 3 Prostate 19 Brain/Central Nervous System 0 Gynaecological 26 Haematological 17 Head and Neck 14 Sarcoma 1 Skin 4 Upper Gastrointestinal 7 Urological 47 Other 3 * These figures will not match the numerator for all questions in the comparisons by tumour group section of this report because not all questions were answered by all responders. 8

9 Aneurin Bevan University Health Age and Gender The survey asked respondents to give their year of birth. information has been amalgamated into 6 age bands. 31 respondents did not provide their gender and/or age. The age and gender distribution for the was as follows: Missing Total Men Women Missing Total Sections in this Report report has three sections, as follows: 1. Overall Health /Trust level results for all tumour groups: compared to the all-wales results, this shows results for all tumour groups. These are displayed on charts showing the range of scores on each question, from the poorest score achieved by a Health /Trust to the highest score achieved on that question by a Health /Trust. The score for this Health /Trust is shown as a black circle with the confidence interval (the amount of uncertainty surrounding the Health /Trust's score on that question) shown as a black line. In the table under the charts, the score for the Health /Trust is compared to the all-wales score for all tumour groups for each question; and columns show the number of respondents for each Health /Trust for each question and whether the Health /Trust is statistically significantly different from the all-wales score. 2. level results within the Health /Trust: results are shown for each hospital where there are enough respondents, with the hospital named in the column above the tables; the percentage score for each hospital for each question is displayed in the table, using the all tumour group data. Where a hospital has a score which is statistically significantly different from the all-wales score for that question, it is highlighted in yellow. s with small numbers of respondents (usually smaller local hospitals) are not reported. 3. Tumour group results within the Heath /Trust: tables show the results for each tumour group for each question at Health /Trust level. A separate column shows the all-wales figure for each tumour group for each question. Cells representing tumour groups with numbers of respondents less than 20 are left blank. 9

10 Aneurin Bevan University Health results Seeing your GP Q1 Saw GP once / twice before being told had to go to hospital Q2 Patient thought they were seen as soon as necessary Q4 Patient's health got better or remained about the same while waiting 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% < worse Percentage score better > 7A6 Q1 Q2 Q4 Saw GP once / twice before being told had to go to hospital Patient thought they were seen as soon as necessary Patient's health got better or remained about the same while waiting 2013 Score for this 2013 Score Number of respondents for this 75% 73% % 78% % 79% 265 Significantly Different from 10

11 Aneurin Bevan University Health Diagnostic tests Q6 Staff gave complete explanation of purpose of test(s) Q7 Staff explained completely what would be done during test Q8 Given easy to understand written information about test Q9 Given complete explanation of test results in understandable way 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% < worse Percentage score better > 7A6 Q6 Q7 Q8 Staff gave complete explanation of purpose of test(s) Staff explained completely what would be done during test Given easy to understand written information about test 2013 Score for this 2013 Score Number of respondents for this 78% 83% % 87% % 84% 176 Significantly Different from Q9 Given complete explanation of test results in understandable way 76% 79%

12 Aneurin Bevan University Health Finding out what was wrong with you Q11 Patient told they could bring a friend when first told they had cancer Q12 Patient felt they were told sensitively that they had cancer Q13 Patient completely understood the explanation of what was wrong Q14 Patient given easy to understand written information about the type of cancer they had 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% < worse Percentage score better > 7A6 Q11 Q12 Patient told they could bring a friend when first told they had cancer Patient felt they were told sensitively that they had cancer 2013 Score for this 2013 Score Number of respondents for this 68% 70% % 84% 271 Significantly Different from Q13 Patient completely understood the explanation of what was wrong 73% 75% 271 Q14 Patient given easy to understand written information about the type of cancer they had 62% 62%

13 Aneurin Bevan University Health Deciding the best treatment for you Q15 Patient given a choice of different types of treatment Q16 Patient's views definitely taken into account by doctors and nurses discussing treatment Q17 Possible side effects explained in an understandable way Q18 Patient given easy to understand written information about side effects Q19 Patient definitely told about treatment side effects that could affect them in the future Q20 Patient definitely involved in decisions about care and treatment 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% < worse Percentage score better > 7A6 Q15 Q16 Q17 Patient given a choice of different types of treatment Patient's views definitely taken into account by doctors and nurses discussing treatment Possible side effects explained in an understandable way 2013 Score for this 2013 Score Number of respondents for this 85% 84% % 71% % 75% 233 Significantly Different from Q18 Patient given easy to understand written information about side effects 77% 82% 209 Q19 Patient definitely told about treatment side effects that could affect them in the future 58% 55% 197 Q20 Patient definitely involved in decisions about care and treatment 73% 71%

14 Aneurin Bevan University Health Clinical Nurse Specialist Q21 Patient given the name of the CNS in charge of their care Q22 Patient finds it easy to contact their CNS Q23 CNS definitely listened carefully the last time spoken to Q24 Get understandable answers to important questions all / most of the time 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% < worse Percentage score better > 7A6 Q21 Q22 Q23 Q24 Patient given the name of the CNS in charge of their care Patient finds it easy to contact their CNS CNS definitely listened carefully the last time spoken to Get understandable answers to important questions all / most of the time 2013 Score for this 2013 Score Number of respondents for this 91% 88% % 78% % 92% % 92% 173 Significantly Different from 14

15 Aneurin Bevan University Health Key Workers Q25 Patient given the name of the Key Worker in charge of their care Q26 Patient finds it easy to contact their Key Worker Q27 Key Worker definitely listened carefully the last time spoken to Q28 Get understandable answers to important questions all / most of the time Q29 Patient offered opportunity to discuss needs & concerns in order to put together a care plan Q30 Patient offered a written care plan 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% < worse Percentage score better > 7A6 Q25 Q26 Q27 Q28 Q29 Patient given the name of the Key Worker in charge of their care Patient finds it easy to contact their Key Worker Key Worker definitely listened carefully the last time spoken to Get understandable answers to important questions all / most of the time Patient offered opportunity to discuss needs & concerns in order to put together a care plan 2013 Score for this 2013 Score Number of respondents for this Significantly Different from 75% 66% 217 * 88% 82% 60 90% 92% 69 84% 91% 62 61% 58% 209 Q30 Patient offered a written care plan 22% 22%

16 Aneurin Bevan University Health Support for people with cancer Q31 staff gave information about emotional support Q32 staff gave information about impact cancer could have on work / education Q33 staff gave information on getting financial help 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% < worse Percentage score better > 7A6 Q31 Q32 Q33 staff gave information about emotional support staff gave information about impact cancer could have on work / education staff gave information on getting financial help 2013 Score for this 2013 Score Number of respondents for this 63% 69% % 68% 111 Significantly Different from 31% 44% 113 * 16

17 Aneurin Bevan University Health Cancer research Q34 Taking part in cancer research discussed with patient Q35 Patient has taken part in cancer research 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% < worse Percentage score better > 7A6 Q34 Q35 Taking part in cancer research discussed with patient Patient has taken part in cancer research 2013 Score for this 2013 Score Number of respondents for this 25% 29% % 64% 60 Significantly Different from 17

18 Aneurin Bevan University Health Operations Q37 Staff gave complete explanation of what would be done Q38 Patient given easy to understand written information about the operation Q39 Staff explained how operation had gone in understandable way 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% < worse Percentage score better > 7A6 Q37 Q38 Q39 Staff gave complete explanation of what would be done Patient given easy to understand written information about the operation Staff explained how operation had gone in understandable way 2013 Score for this 2013 Score Number of respondents for this 86% 87% % 70% % 78% 226 Significantly Different from 18

19 Aneurin Bevan University Health Doctors Q41 Patient able to talk to a octor as often as required Q42 Got understandable answers to important questions all / most of the time Q43 Patient had confidence and trust in all doctors treating them Q44 Doctors did not talk in front of patient as if they were not there Q45 Patient's family definitely had opportunity to talk to doctor 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% < worse Percentage score better > 7A6 Q41 Q42 Q43 Q44 Q45 Patient able to talk to a doctor as often as required Got understandable answers to important questions all / most of the time Patient had confidence and trust in all doctors treating them Doctors did not talk in front of patient as if they were not there Patient's family definitely had opportunity to talk to doctor 2013 Score for this 2013 Score Number of respondents for this 51% 54% % 80% 205 Significantly Different from 91% 87% 239 * 88% 84% % 61%

20 Aneurin Bevan University Health Ward nurses Q46 Got understandable answers to important questions all / most of the time Q47 Patient had confidence and trust in all ward nurses Q48 Nurses did not talk in front of patient as if they were not there Q49 Always / nearly always enough nurses on duty 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% < worse Percentage score better > 7A6 Q46 Q47 Q48 Q49 Got understandable answers to important questions all / most of the time Patient had confidence and trust in all ward nurses Nurses did not talk in front of patient as if they were not there Always / nearly always enough nurses on duty 2013 Score for this 2013 Score Number of respondents for this 70% 75% % 73% % 86% 240 Significantly Different from 54% 60% 239 * 20

21 Aneurin Bevan University Health care and treatment (part 1 of 2) Q50 Patient did not think hospital staff deliberately misinformed them Q51 Patient never thought they were given conflicting information Q52 All staff asked patient what name they preferred to be called by Q53 Always given enough privacy when discussing condition / treatment Q54 Always given enough privacy when being examined or treated Q55 Patient was able to discuss worries or fears with staff during visit 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% < worse Percentage score better > 7A6 Q50 Q51 Q52 Q53 Q54 Q55 Patient did not think hospital staff deliberately misinformed them Patient never thought they were given conflicting information All staff asked patient what name they preferred to be called by Always given enough privacy when discussing condition / treatment Always given enough privacy when being examined or treated Patient was able to discuss worries or fears with staff during visit 2013 Score for this 2013 Score Number of respondents for this 91% 89% % 84% % 62% % 83% 233 Significantly Different from 89% 94% 233 * 58% 63%

22 Aneurin Bevan University Health care and treatment (part 2 of 2) Q56 staff did everything to help control pain all of the time Q57 Always treated with respect and dignity by staff Q58 Given clear written information about what should / should not do post discharge Q59 Staff told patient who to contact if worried post discharge Q60 Family definitely given all information needed to help care at home 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% < worse Percentage score better > 7A6 Q56 Q57 Q58 Q59 staff did everything to help control pain all of the time Always treated with respect and dignity by staff Given clear written information about what should / should not do post discharge Staff told patient who to contact if worried post discharge 2013 Score for this 2013 Score Number of respondents for this 85% 86% % 85% % 81% % 92% 226 Significantly Different from Q60 Family definitely given all information needed to help care at home 61% 57%

23 Aneurin Bevan University Health Arranging home support Q61 Patient definitely given enough care and help from health or social services 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% < worse Percentage score better > 7A Score for this 2013 Score Number of respondents for this Significantly Different from Q61 Patient definitely given enough care and help from health or social services 61% 59%

24 Aneurin Bevan University Health care as a day patient / outpatient Q62 Staff definitely did everything to control side effects of radiotherapy Q63 Staff definitely did everything to control side effects of chemotherapy Q64 Staff definitely did everything they could to help control pain Q65 staff definitely gave patient enough emotional support 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% < worse Percentage score better > 7A Score for this 2013 Score Number of respondents for this Significantly Different from Q62 Q63 Q64 Q65 Staff definitely did everything to control side effects of radiotherapy Staff definitely did everything to control side effects of chemotherapy Staff definitely did everything they could to help control pain staff definitely gave patient enough emotional support 82% 79% 51 87% 83% 63 79% 81% % 72%

25 Aneurin Bevan University Health Outpatient appointments with Doctors Q67 Doctor had the right notes and other documentation with them 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% < worse Percentage score better > 7A Score for this 2013 Score Number of respondents for this Significantly Different from Q67 Doctor had the right notes and other documentation with them 97% 96%

26 Aneurin Bevan University Health Care from your general practice Q68 GP given enough information about patient`s condition and treatment Q69 Practice staff definitely did everything they could to support patient 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% < worse Percentage score better > 7A Score for this 2013 Score Number of respondents for this Significantly Different from Q68 Q69 GP given enough information about patient`s condition and treatment Practice staff definitely did everything they could to support patient 94% 92% % 67%

27 Aneurin Bevan University Health Your overall NHS care Q70 and community staff always worked well together Q72 Given the right amount of information about condition and treatment Q73 Patient did not feel that they were treated as a `set of cancer symptoms` Q74 Patient`s rating of care excellent / very good 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% < worse Percentage score better > 7A6 Q70 Q72 and community staff always worked well together Given the right amount of information about condition and treatment 2013 Score for this 2013 Score Number of respondents for this 67% 65% % 86% 222 Significantly Different from Q73 Patient did not feel that they were treated as a `set of cancer symptoms` 82% 81% 250 Q74 Patient`s rating of care excellent / very good 84% 89%

28 Aneurin Bevan University Health Comparisons by - All Cancers Data The following tables show the all cancers (all tumour groups) data for each hospital within the Health /Trust and the national percentage scores for the all cancers dataset. Where a cell in the table is blank this indicates that the number of patients in that group was below 20 and too small to display. The number of respondents by hospital is displayed at the beginning of this report. scores that are statistically significant from the all-wales score are highlighted in yellow. Seeing your GP Nevill Hall Royal Gwent All Cancers Q1 Saw GP once / twice before being told had to go to hospital 77% 75% 73% Q2 Patient thought they were seen as soon as necessary 75% 73% 78% Q4 Patient's health got better or remained about the same while waiting 86% 78% 79% 28

29 Aneurin Bevan University Health Diagnostic tests Nevill Hall Royal Gwent All Cancers Q6 Staff gave complete explanation of purpose of test(s) 82% 76% 83% Q7 Staff explained completely what would be done during test 92% 85% 87% Q8 Given easy to understand written information about test 82% 79% 84% Q9 Given complete explanation of test results in understandable way 75% 76% 79% 29

30 Aneurin Bevan University Health Finding out what was wrong with you Nevill Hall Royal Gwent All Cancers Q11 Patient told they could bring a friend when first told they had cancer 73% 66% 70% Q12 Patient felt they were told sensitively that they had cancer 89% 85% 84% Q13 Patient completely understood the explanation of what was wrong 67% 75% 75% Q14 Patient given easy to understand written information about the type of cancer they had 52% 65% 62% 30

31 Aneurin Bevan University Health Deciding the best treatment for you Nevill Hall Royal Gwent All Cancers Q15 Patient given a choice of different types of treatment 94% 83% 84% Q16 Patient's views definitely taken into account by Doctors and nurses discussing treatment 80% 74% 71% Q17 Possible side effects explained in an understandable way 77% 72% 75% Q18 Patient given easy to understand written information about side effects 82% 76% 82% Q19 Patient definitely told about treatment side effects that could affect them in the future 60% 57% 55% Q20 Patient definitely involved in decisions about care and treatment 71% 73% 71% 31

32 Aneurin Bevan University Health Clinical Nurse Specialist Nevill Hall Royal Gwent All Cancers Q21 Patient given the name of the CNS in charge of their care 93% 90% 88% Q22 Patient finds it easy to contact their CNS 68% 80% 78% Q23 CNS definitely listened carefully the last time spoken to 98% 89% 92% Q24 Get understandable answers to important questions all / most of the time 94% 88% 92% 32

33 Aneurin Bevan University Health Key Workers Nevill Hall Royal Gwent All Cancers Q25 Patient given the name of the Key Worker in charge of their care 83% 74% 66% Q26 Patient finds it easy to contact their Key Worker 94% 86% 82% Q27 Key Worker definitely listened carefully the last time spoken to 94% 88% 92% Q28 Get understandable answers to important questions all / most of the time 82% 84% 91% Q29 Patient offered opportunity to discuss needs & concerns in order to put together a care plan 70% 58% 58% Q30 Patient offered a written care plan 20% 21% 22% 33

34 Aneurin Bevan University Health Support for people with cancer Nevill Hall Royal Gwent All Cancers Q31 staff gave information about emotional support 68% 62% 69% Q32 staff gave information about impact cancer could have on work / education 67% 72% 68% Q33 staff gave information on getting financial help 23% 33% 44% 34

35 Aneurin Bevan University Health Cancer research Nevill Hall Royal Gwent All Cancers Q34 Taking part in cancer research discussed with patient 26% 25% 29% Q35 Patient has taken part in cancer research 64% 71% 64% 35

36 Aneurin Bevan University Health Operations Nevill Hall Royal Gwent All Cancers Q37 Staff gave complete explanation of what would be done 79% 87% 87% Q38 Patient given easy to understand written information about the operation 69% 74% 70% Q39 Staff explained how operation had gone in understandable way 80% 78% 78% 36

37 Aneurin Bevan University Health Doctors Nevill Hall Royal Gwent All Cancers Q41 Patient able to talk to a Doctor as often as required 59% 49% 54% Q42 Got understandable answers to important questions all / most of the time 84% 77% 80% Q43 Patient had confidence and trust in all Doctors treating them 94% 90% 87% Q44 Doctors did not talk in front of patient as if they were not there 89% 88% 84% Q45 Patient's family definitely had opportunity to talk to Doctor 68% 55% 61% 37

38 Aneurin Bevan University Health Ward nurses Nevill Hall Royal Gwent All Cancers Q46 Got understandable answers to important questions all / most of the time 85% 65% 75% Q47 Patient had confidence and trust in all ward nurses 73% 67% 73% Q48 Nurses did not talk in front of patient as if they were not there 92% 86% 86% Q49 Always / nearly always enough nurses on duty 58% 52% 60% 38

39 Aneurin Bevan University Health care and treatment Nevill Hall Royal Gwent All Cancers Q50 Patient did not think hospital staff deliberately misinformed them 96% 91% 89% Q51 Patient never thought they were given conflicting information 92% 85% 84% Q52 All staff asked patient what name they preferred to be called by 69% 55% 62% Q53 Always given enough privacy when discussing condition / treatment 86% 79% 83% Q54 Always given enough privacy when being examined or treated 96% 87% 94% Q55 Patient was able to discuss worries or fears with staff during visit 57% 58% 63% Q56 staff did everything to help control pain all of the time 86% 85% 86% Q57 Always treated with respect and dignity by staff 88% 79% 85% Q58 Given clear written information about what should / should not do post discharge 79% 83% 81% Q59 Staff told patient who to contact if worried post discharge 88% 91% 92% Q60 Family definitely given all information needed to help care at home 72% 58% 57% 39

40 Aneurin Bevan University Health Arranging home support Nevill Hall Royal Gwent All Cancers Q61 Patient definitely given enough care and help from health or social services 64% 61% 59% 40

41 Aneurin Bevan University Health care as a day patient / outpatient Nevill Hall Royal Gwent All Cancers Q62 Staff definitely did everything to control side effects of radiotherapy 58% 90% 79% Q63 Staff definitely did everything to control side effects of chemotherapy 83% 88% 83% Q64 Staff definitely did everything they could to help control pain 74% 80% 81% Q65 staff definitely gave patient enough emotional support 68% 67% 72% 41

42 Aneurin Bevan University Health Outpatient appointments with Doctors Nevill Hall Royal Gwent All Cancers Q67 Doctor had the right notes and other documentation with them 100% 96% 96% 42

43 Aneurin Bevan University Health Care from your general practice Nevill Hall Royal Gwent All Cancers Q68 GP given enough information about patient`s condition and treatment 90% 95% 92% Q69 Practice staff definitely did everything they could to support patient 69% 66% 67% 43

44 Aneurin Bevan University Health Your overall NHS care Nevill Hall Royal Gwent All Cancers Q70 and community staff always worked well together 69% 66% 65% Q72 Given the right amount of information about condition and treatment 88% 83% 86% Q73 Patient did not feel that they were treated as a `set of cancer symptoms` 86% 81% 81% Q74 Patient`s rating of care excellent / very good 87% 83% 89% 44

45 Aneurin Bevan University Health Comparisons by tumour group for this The following tables show the Health /Trust and the national percentage scores for each question broken down by tumour group. Where a cell in the table is blank this indicates that the number of patients in that group was below 20 and too small to display. The number of respondents by tumour group is displayed at the beginning of this report. Seeing your GP Cancer Type Q1 Saw GP once / twice before being told had to go to hospital Q2 Patient thought they were seen as soon as necessary Q4 Patient's health got better or remained about the same while waiting Breast 94% 91% 78% 81% 97% 92% Colorectal / Lower Gastro 67% 68% 66% 74% 70% 74% Lung 66% 83% 76% Prostate 72% 81% 86% Brain / CNS 58% 76% 62% Gynaecological 74% 68% 73% 76% 81% 70% Haematological 59% 77% 64% Head & Neck 72% 73% 75% Sarcoma 61% 68% 60% Skin 84% 76% 90% Upper Gastro 65% 78% 62% Urological 70% 76% 72% 78% 87% 82% Other Cancers 67% 81% 74% All cancers 75% 73% 73% 78% 80% 79% 45

46 Aneurin Bevan University Health Diagnostic tests Cancer Type Q6 Staff gave complete explanation of purpose of test(s) Q7 Staff explained Q8 Given easy to completely what understand written would be done during information about test test Q9 Given complete explanation of test results in understandable way Breast 91% 87% 86% 88% 85% 85% 83% 84% Colorectal / Lower Gastro 73% 83% 88% 88% 76% 87% 66% 79% Lung 85% 88% 83% 79% Prostate 85% 88% 84% 81% Brain / CNS 77% 84% 84% 71% Gynaecological 72% 77% 80% 83% 74% 79% 80% 76% Haematological 82% 89% 81% 73% Head & Neck 85% 85% 80% 80% Sarcoma 77% 83% 70% 83% Skin 84% 85% 69% 78% Upper Gastro 78% 84% 82% 72% Urological 65% 80% 84% 87% 86% 87% 74% 79% Other Cancers 81% 88% 78% 77% All cancers 78% 83% 86% 87% 79% 84% 76% 79% 46

47 Aneurin Bevan University Health Finding out what was wrong with you Cancer Type Q11 Patient told they could bring a friend when first told they had cancer Q12 Patient felt they were told sensitively that they had cancer Q13 Patient completely understood the explanation of what was wrong Q14 Patient given easy to understand written information about the type of cancer they had Breast 73% 77% 89% 90% 82% 81% 68% 69% Colorectal / Lower Gastro 76% 76% 86% 85% 72% 78% 60% 62% Lung 71% 83% 75% 57% Prostate 69% 84% 80% 78% Brain / CNS 81% 78% 61% 32% Gynaecological 61% 64% 88% 82% 69% 73% 59% 49% Haematological 65% 83% 56% 66% Head & Neck 65% 85% 77% 50% Sarcoma 56% 81% 63% 34% Skin 55% 85% 81% 60% Upper Gastro 69% 77% 68% 48% Urological 63% 65% 83% 80% 64% 75% 56% 57% Other Cancers 62% 78% 69% 48% All cancers 68% 70% 86% 84% 73% 75% 62% 62% 47

48 Aneurin Bevan University Health Deciding the best treatment for you Cancer Type Breast 93% 89% 80% 75% 80% 77% 90% 88% Colorectal / Lower Gastro 79% 77% 72% 67% 71% 75% 76% 83% Lung 83% 73% 80% 83% Prostate 91% 71% 76% 85% Brain / CNS 94% 75% 75% 73% Gynaecological 75% 79% 65% 68% 65% 75% 71% 81% Haematological 78% 65% 72% 79% Head & Neck 82% 76% 74% 74% Sarcoma 83% 73% 77% 67% Skin 75% 78% 72% 64% Upper Gastro 84% 65% 75% 81% Urological 67% 74% 77% 70% 65% 68% 74% 70% Other Cancers 74% 69% 67% 74% All cancers 85% 84% 75% 71% 73% 75% 77% 82% Cancer Type Q15 Patient given a choice of different types of treatment Q19 Patient definitely told about treatment side effects that could affect them in the future Q16 Patient's views definitely taken into account by Doctors and nurses discussing treatment Q20 Patient definitely involved in decisions about care and treatment Breast 69% 58% 80% 74% Colorectal / Lower Gastro 62% 56% 67% 71% Lung 55% 72% Prostate 65% 72% Brain / CNS 64% 59% Gynaecological 61% 52% 71% 73% Haematological 52% 68% Head & Neck 55% 70% Sarcoma 58% 79% Skin 44% 75% Upper Gastro 49% 65% Urological 44% 45% 65% 68% Other Cancers 46% 67% All cancers 58% 55% 73% 71% Q17 Possible side effects explained in an understandable way Q18 Patient given easy to understand written information about side effects 48

49 Aneurin Bevan University Health Clinical Nurse Specialist Cancer Type Q21 Patient given the name of the CNS in charge of their care Q22 Patient finds it easy to contact their CNS Q23 CNS definitely listened carefully the last time spoken to Q24 Get understandable answers to important questions all / most of the time Breast 98% 96% 73% 80% 93% 93% 96% 93% Colorectal / Lower Gastro 92% 91% 80% 81% 94% 92% 85% 92% Lung 93% 75% 94% 90% Prostate 80% 77% 92% 91% Brain / CNS 85% 65% 93% 92% Gynaecological 82% 91% 92% 78% 92% 93% 100% 93% Haematological 80% 82% 93% 94% Head & Neck 90% 64% 85% 86% Sarcoma 83% 72% 88% 87% Skin 79% 83% 93% 95% Upper Gastro 95% 74% 91% 89% Urological 85% 70% 79% 80% 85% 92% 83% 91% Other Cancers 87% 81% 89% 93% All cancers 91% 88% 78% 78% 91% 92% 90% 92% 49

50 Aneurin Bevan University Health Key Workers Cancer Type Breast 85% 78% 80% 82% 85% 94% 91% 94% Colorectal / Lower Gastro 81% 74% 90% 83% 92% 91% 77% 87% Lung 80% 82% 96% 87% Prostate 54% 84% 95% 94% Brain / CNS 72% 56% 88% 82% Gynaecological 44% 62% 100% 90% 100% 90% 100% 93% Haematological 53% 84% 95% 93% Head & Neck 69% 69% 84% 88% Sarcoma 55% 75% 92% 91% Skin 47% 72% 89% 94% Upper Gastro 79% 81% 94% 86% Urological 70% 39% 83% 84% 85% 87% 80% 92% Other Cancers 66% 85% 92% 90% All cancers 75% 66% 88% 82% 90% 92% 84% 91% Cancer Type Q25 Patient given the name of the Key Worker in charge of their care Q29 Patient offered opportunity to discuss needs & concerns in order to put together a care plan Q26 Patient finds it easy to contact their Key Worker Q30 Patient offered a written care plan Breast 68% 66% 18% 24% Colorectal / Lower Gastro 67% 64% 22% 28% Lung 67% 30% Prostate 50% 19% Brain / CNS 80% 25% Gynaecological 50% 55% 19% 18% Haematological 56% 25% Head & Neck 62% 0% 24% Sarcoma 55% 10% Skin 41% 11% Upper Gastro 65% 26% Urological 46% 37% 16% 15% Other Cancers 51% 17% All cancers 61% 58% 22% 22% Q27 Key Worker definitely listened carefully the last time spoken to Q28 Get understandable answers to important questions all / most of the time 50

51 Aneurin Bevan University Health Support for people with cancer Cancer Type Q31 staff gave information about emotional support Q32 staff gave information about impact cancer could have on work / education Q33 staff gave information on getting financial help Breast 79% 77% 85% 72% 52% 46% Colorectal / Lower Gastro 56% 67% 64% 69% 17% 44% Lung 71% 73% 62% Prostate 67% 66% 0% 32% Brain / CNS 74% 83% 62% Gynaecological 71% 65% 75% 59% 56% 46% Haematological 69% 76% 45% Head & Neck 71% 66% 45% Sarcoma 65% 56% 50% Skin 53% 63% 29% Upper Gastro 70% 73% 50% Urological 41% 46% 58% 52% 28% 23% Other Cancers 63% 61% 47% All cancers 63% 69% 71% 68% 31% 44% 51

52 Aneurin Bevan University Health Cancer research Cancer Type Q34 Taking part in cancer research discussed with patient Q35 Patient has taken part in cancer research Breast 27% 38% 63% 61% Colorectal / Lower Gastro 24% 31% 85% 69% Lung 31% 62% Prostate 32% 58% Brain / CNS 27% 38% Gynaecological 5% 26% 100% 78% Haematological 26% 73% Head & Neck 30% 0% 60% Sarcoma 20% 64% Skin 10% 92% Upper Gastro 19% 57% Urological 23% 15% 55% 61% Other Cancers 27% 74% All cancers 25% 29% 70% 64% 52

53 Aneurin Bevan University Health Operations Cancer Type Q37 Staff gave complete explanation of what would be done Q38 Patient given easy to understand written information about the operation Q39 Staff explained how operation had gone in understandable way Breast 90% 89% 79% 76% 79% 79% Colorectal / Lower Gastro 79% 85% 62% 70% 81% 78% Lung 87% 67% 82% Prostate 89% 78% 76% Brain / CNS 85% 44% 59% Gynaecological 96% 83% 91% 68% 88% 78% Haematological 82% 54% 73% Head & Neck 89% 49% 79% Sarcoma 91% 43% 84% Skin 92% 64% 80% Upper Gastro 86% 74% 79% Urological 78% 86% 82% 72% 66% 73% Other Cancers 86% 61% 80% All cancers 86% 87% 74% 70% 78% 78% 53

54 Aneurin Bevan University Health Doctors Cancer Type Q41 Patient able to talk to a Doctor as often as required Q42 Got understandable answers to important questions all / most of the time Q43 Patient had confidence and trust in all Doctors treating them Q44 Doctors did not talk in front of patient as if they were not there Breast 48% 55% 84% 82% 93% 89% 95% 90% Colorectal / Lower Gastro 59% 58% 83% 82% 90% 88% 83% 81% Lung 54% 77% 79% 75% Prostate 53% 74% 86% 90% Brain / CNS 46% 82% 79% 68% Gynaecological 44% 52% 88% 78% 90% 86% 90% 85% Haematological 61% 81% 84% 78% Head & Neck 53% 80% 87% 79% Sarcoma 53% 83% 90% 85% Skin 65% 90% 95% 82% Upper Gastro 58% 77% 85% 81% Urological 34% 44% 53% 75% 88% 85% 81% 83% Other Cancers 46% 81% 79% 83% All cancers 51% 54% 79% 80% 91% 87% 88% 84% Cancer Type Q45 Patient's family definitely had opportunity to talk to Doctor Breast 68% 66% Colorectal / Lower Gastro 58% 60% Lung 53% Prostate 60% Brain / CNS 56% Gynaecological 41% 62% Haematological 63% Head & Neck 66% Sarcoma 53% Skin 67% Upper Gastro 61% Urological 49% 56% Other Cancers 65% All cancers 58% 61% 54

55 Aneurin Bevan University Health Ward nurses Cancer Type Q46 Got understandable answers to important questions all / most of the time Q47 Patient had confidence and trust in all ward nurses Q48 Nurses did not talk in front of patient as if they were not there Q49 Always / nearly always enough nurses on duty Breast 67% 80% 68% 77% 90% 89% 68% 69% Colorectal / Lower Gastro 74% 75% 71% 69% 86% 84% 55% 55% Lung 68% 72% 81% 52% Prostate 74% 76% 86% 58% Brain / CNS 62% 67% 81% 63% Gynaecological 84% 73% 75% 69% 90% 86% 50% 55% Haematological 76% 77% 87% 53% Head & Neck 76% 73% 83% 62% Sarcoma 79% 77% 95% 71% Skin 75% 81% 87% 74% Upper Gastro 74% 71% 85% 60% Urological 51% 70% 65% 71% 81% 84% 40% 56% Other Cancers 71% 72% 87% 59% All cancers 70% 75% 69% 73% 87% 86% 54% 60% 55