Making hospital care more accessible: what’s changing in York and Scarborough
People have told us that hospital care does not always feel set up for them, especially when they need extra support.
For some, it is not knowing what to expect when they arrive. For others, it is how things are explained, the environment around them, or not feeling that staff understand what matters to them. Carers have also told us they do not always feel recognised or supported in the way they need to be.
These experiences have come through clearly in our work on reasonable adjustments and accessible healthcare. They are not one-off issues, but things we hear repeatedly from people using care across North Yorkshire.
What people told us
When people shared their experiences with us, a number of common themes came up.
People told us they are not always asked about their needs early enough, which means support is often put in place too late. Communication does not always happen in a way that works for them, whether that is the format of information, the pace of conversations, or how clearly things are explained.
Hospital environments can also feel overwhelming or unfamiliar. Busy wards, noise, lighting and a lack of clear information about what is happening next can all add to that. For some people, this can make an already difficult situation much harder to manage.
Carers told us they are not always recognised or involved, even when they play an important role in supporting someone. People also said that support is not always consistent, and can vary depending on the department or the staff member they see.
Taken together, these experiences can make hospital visits more stressful than they need to be, and in some cases can put people off seeking care.
What’s happening at hospitals in York and Scarborough
York and Scarborough Teaching Hospitals NHS Foundation Trust has been making a number of changes to improve how it identifies and supports people who need reasonable adjustments.
Rather than relying on needs being picked up during care, there is now a stronger focus on planning ahead. This includes improving how information is recorded and shared, strengthening communication, and making sure adjustments are more visible to staff across different teams and departments.
The aim is to move away from a situation where support depends on who you happen to see, towards a more consistent approach where people’s needs are recognised and acted on as part of everyday care.
What this looks like in practice
Some of the changes are focused on helping people feel more prepared before they arrive.
For example, the Trust has worked with patients to create a video explaining what happens when you visit the emergency department. This is particularly helpful for people who may find hospital environments unfamiliar or overwhelming, as it gives a clearer sense of what to expect.
There is also more support in place to help staff understand people’s needs and respond in a way that works for the individual.
Staff are also being supported through training and guidance, including Oliver McGowan training on learning disability and autism, to help them better understand reasonable adjustments and how to put them into practice.
Alongside this, there are a number of practical changes in place to make care more accessible and consistent.
These include:
- specialist support through a learning disability and autism liaison service
- hospital passports, which help staff quickly understand a person’s needs (you can find more information in the Trust’s carers leaflet)
- access to dementia support, including Admiral Nurses (also explained in the carers leaflet above)
- a carers charter setting out how carers should be supported
There is also a growing focus on communication.
People can request information in different formats, and work is ongoing to improve how interpretation support is arranged so that people can access help more easily when they need it. A new system is also being introduced to better record and flag people’s needs, making it easier for staff to see and act on this information.
The Trust has also created an online accessibility hub, bringing together information about support in one place so it is easier for people to find and use.
Listening and learning from feedback
Another important part of this work is making better use of feedback.
Information from patients, carers, complaints and compliments, including what people share with Healthwatch, is being brought together and reviewed to identify patterns. This helps highlight where improvements are needed, rather than looking at issues in isolation.
Care is also reviewed with input from patients and local organisations, helping to shape improvement plans based on real experiences. You can find more about this on the Trust’s equality and diversity website pages.
Why this matters
For people, these kinds of changes can make a real difference to how care feels.
Knowing what to expect can reduce anxiety before an appointment or visit. Being able to access information in a way that works for you can make communication clearer and less stressful. Having your needs recognised early can help prevent situations from becoming overwhelming.
It also helps carers feel more involved and supported, rather than having to step in and explain things repeatedly.
While some of these changes may seem small on their own, together they can shape the overall experience of care. They can make it feel more consistent, more understanding, and more responsive to what people actually need.
What we’d like to see next
This is a positive step, but we know from what people tell us that there is still more to do.
From what people tell us, it’s important that:
- people are asked about their needs early and consistently
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this information is clearly recorded and used across services
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communication works for everyone, not just some people
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carers are recognised and supported as part of care
It is also important that improvements are consistent across departments and sites, so that people do not have a very different experience depending on where they are treated.
We will continue to share what people tell us about their experiences and highlight where changes like this are making a difference. We will also compare what is planned with what people tell us is happening in practice.
This article is based on information shared by York and Scarborough Teaching Hospitals NHS Foundation Trust about how they are improving support for people who need reasonable adjustments.
