Royal College of Physicians:Caring for hospital patients with COVID-19 Quality of care in England examined by case record review
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
Dr Sarah Clarke
Clinical vice president, Royal College of Physicians