Royal College of Physicians:Caring for hospital patients with COVID-19 Quality of care in England examined by case record review

Posted : October 20, 2021 - /

Click here for the full report and here for the appendices.


Hospital care of patients with COVID-19 during the early waves of the pandemic has come under the

media spotlight in the past year with articles predominantly focusing on overwhelmed NHS staff,

crowded wards, elective care backlog and families unable to visit their loved ones.

This study into the care of hospital patients with COVID-19 provides a welcome insight into the high

quality of care experienced by the majority of people. The report uses data from patient records

provided by reviewers from a large and representative sample of NHS trusts in England. Reviewers

used a validated method based on the Structured Judgement Review methodology used successfully

for retrospective mortality review.

One of the report’s key findings is the very few instances of poor care. This is exceptional given the

enormous pressures that were very rapidly placed upon the NHS at the start of the pandemic. It is a

cause for celebration of the efforts and expertise of NHS staff.

In this report, a series of patient vignettes bring to life the typical range of care experienced by many

patients in hospital with COVID-19. These are compelling to read and provide key learning points to

influence future care delivery. The study also introduces novel analysis of narrative using natural

language processing in healthcare and the use of sentiment analysis to detect the emotional content

of narrative – there is much to learn from this to support the qualitative analysis of case record


The study was made possible by a grant awarded from the RCP COVID-19 Appeal. I would like to

extend sincere thanks to the many reviewers in NHS trusts and organisations who agreed to take

part and took the time to assess patient cases. These efforts have provided invaluable data to form

the basis for this study and its findings. This report is the result of collaboration with staff at Imperial

College and the Association of Professional Healthcare Analysts who contributed significantly to the

analysis of the data and emerging themes – thank you to them for this support. Finally, particular

thanks must go to Dr Andrew Gibson for steering the report to publication during what continues to

be a very challenging time.

The study underlines that learning from good and excellent care is as important as learning from

poor or negative experiences. We hope it highlights the overall good quality of care experienced by

COVID-19 patients in hospital during the pandemic and contributes to improving care for patients in

the future.

Dr Sarah Clarke

Clinical vice president, Royal College of Physicians