Making health appointments work for everyone

Around one in five people in the UK live with a disability. In North Yorkshire alone, tens of thousands of people are likely to need some form of additional support when accessing healthcare. The law says healthcare must adapt to meet people’s needs, through things like longer appointments, accessible information and support with communication.

Our latest findings show this is not happening consistently. Many people are still not being asked what help they need, with 82% saying this conversation never happens and 86% not having their needs recorded.

We spoke to over 200 people about what it’s really like trying to get to, and get through, appointments. What they told us was clear. Small things that should be routine often are not happening. And when they do not happen, it can make appointments stressful, confusing, or in some cases, impossible to attend.

This work looks at reasonable adjustments. In simple terms, that means making small changes so people can access care in a way that works for them. Things like longer appointments, clear information, a quieter space to wait, or help with communication.

These are not optional extras. They are a legal right. But what we heard suggests they are not yet part of everyday practice.

“Nobody asked what I needed”

One of the strongest messages we heard was how rarely people are asked what support they need.

Many people told us that when they booked an appointment, no one asked about anything that might make it easier for them to attend or take part.

It might sound like a small thing, but it has a knock-on effect. It means people often have to explain their situation again and again, sometimes at every appointment.

Some people said they did not even realise they could ask for support in the first place.

Some people said they did not even realise they could ask for support in the first place.

“The staff were very considerate, but I had no knowledge that I could ask for reasonable adjustments.”

Others described having to step in for family members who could not explain their needs themselves.

“She cannot explain them herself, which means I must do it on her behalf. At no point has anyone asked.”

When this basic conversation does not happen early on, everything else becomes harder.

Repeating yourself every time

There is a way for services to record people’s needs on their NHS record, so staff can see what support someone might need at future appointments.

But most people told us this is not happening in practice.

People spoke about having to explain the same things over and over again. For some, that was frustrating. For others, it was upsetting.

“There needs to be better communication between departments, so I do not have to repeat everything again.”

Even when needs had been recorded, people said it did not always make a difference. Staff were not always aware of it, or did not act on it.

This leaves people doing the work themselves, trying to make sure they are heard in busy environments.

When it works, it really works

There were also good examples. And they stood out.

People talked about staff who noticed what was needed without being asked, or who took the time to explain things clearly and calmly.

“We were given photos of the hospital, a nearby parking space, access to a quiet room. It felt like they understood without us having to explain.”

“They always make sure my appointment is on the ground floor without me having to ask.”

These moments made a big difference. They reduced stress and made people feel more confident about attending.

But too often, these experiences depended on the individual member of staff, rather than being something people could rely on every time.

Getting there can be the hardest part

For some people, the challenge starts before they even arrive.

We heard about long journeys, limited transport, and the impact of changes to patient transport rules. For those without access to a car, or with health conditions that make travel difficult, this can be a real barrier.

Parking came up again and again.

People described driving around for long periods looking for a space, or having to park far away and walk back.

“I must drop her at the entrance and leave her alone while I go to park.”

For carers, this created added stress. For the person attending the appointment, it could mean being left somewhere uncomfortable or unsafe.

Waiting rooms that overwhelm

Once people arrive, the environment can make things easier or much harder.

Some people described calm, well organised spaces. But others told us about noisy, busy waiting rooms with bright lighting and nowhere quiet to go.

For people with anxiety, sensory needs, or certain health conditions, this can be overwhelming.

“It can feel overwhelming as soon as you walk in.”

Long waits in these environments made things worse. Some people said they had asked in advance for a quieter space, but were told there was nowhere available.

Simple changes, like a quieter area or clearer information, could make a big difference here.

Communication that works and when it does not

Clear communication came through as one of the most important parts of a good experience.

Many people said staff explained things well and used simple language. When that happened, people felt more involved and more at ease.

But there were also gaps.

Access to interpreters was a major issue. Some people said interpreters were not booked, did not arrive, or arrived late.

Across England, only around 4 in 10 people who need an interpreter say they consistently get one.

For those who rely on them, that meant not being able to fully understand what was happening or take part in decisions about their care.

Others spoke about not receiving information in a format that worked for them, whether that was large print, Easy Read, or another format.

For people who use British Sign Language or need accessible formats like Easy Read, these gaps can make it much harder to understand their care and make informed decisions.

Why this matters

We know staff are working under significant pressure, and many people shared positive experiences of care. But what this report shows is that these basic steps are not yet happening consistently.

None of the issues people raised are new or complicated. Many of the solutions are simple.

• Ask people what they need.
• Record it properly.
• Use that information.
• Make small changes that help people feel comfortable and understood.

What this report shows is that these things are not yet happening consistently.

People say they sometimes delay or avoid care altogether when communication or support needs are not met.

When they do not happen, people feel overlooked, stressed, or unsure whether they will get the support they need. In some cases, it stops people attending appointments altogether.

This article is based on findings from our report on reasonable adjustments and health appointments in North Yorkshire, which draws on the experiences of 232 people across the county