We conducted a prospective study of patient's understanding of the Patient's Charter. Every patient attending the Accident and Emergency (A&E) Department of St Bartholomew's Hospital over a 7-day period was questioned by an interviewer. Those not interviewed by this process were sent a postal questionnaire. A total of 584 patients attended during the study period, from whom 451 data sets were collected, a response rate of 77%. Only 51 patients were aware of The Patient's Charter guarantee of 'immediate assessment'. When asked what they understood by 'immediate', 67% of respondents considered this to mean 15 min or longer. Fifty-four per cent of respondents felt that this assessment should be performed by a nurse. A follow-up study conducted over a 48-h period in January 1994 showed no significant difference in the responses to the same questions. We conclude that the vast majority of patients in this study exhibited a very low level of awareness regarding the guarantees of The Patient's Charter. We also note that their interpretation of the term 'initial assessment' is at variance with that expressed by the NHS Chief Executive in a widely circulated document.
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