Supporting people with autism in hospital: what’s changing on one ward
We hear time and again that support can come too late. Needs are not always picked up until someone is already overwhelmed or distressed, which can make a hospital stay much harder than it needs to be.
Busy wards, bright lights, constant noise, and not always knowing what is happening next can all add to that. For some people, it is the environment. For others, it is communication or not being asked what would help. Often, it is a combination of all of these.
At the heart of it is something simple. People want to be understood from the start.
What people told us
In our work on accessible healthcare and reasonable adjustments, people told us things like:
- In our work on accessible healthcare, people told us things like:
- feeling overwhelmed by noise, lighting or busy environments
- struggling with sudden changes or unfamiliar routines
- not always being asked about their needs early on
- support only being put in place after things have already escalated
For people with autism, this can turn an already difficult situation into something much harder to manage.
A different approach on one ward
One local provider of mental health care, Tees, Esk and Wear Valleys NHS Foundation Trust, has been trying to change that on one of its inpatient wards.
Rather than waiting for problems to arise, staff now ask people about their needs as part of coming onto the ward. It is a simple set of questions, but it shifts the focus to understanding the person in front of them from the start.
This includes things like:
- sensitivity to noise, lighting or busy spaces
- how someone prefers to communicate
- what helps them feel calm or safe
- how they manage changes to routine
These are not complicated changes. But having those conversations early means staff are not guessing later, or trying to respond when someone is already struggling.
In practice, it can mean small adjustments that make a big difference. Knowing what might trigger distress can help staff step in sooner, adapt how they communicate, or make changes to the environment where they can.
Building confidence on the ward
Staff have also had support from the trust’s autism team, alongside named staff who can offer guidance day to day.
Like most changes, it was not instant. It took time to become part of how the ward runs. But it is now something staff are more used to thinking about, rather than something extra.
From what people tell us, that confidence and understanding from staff can shape the whole experience. Feeling listened to and taken seriously often matters just as much as the practical changes themselves.
Why this matters
When this kind of approach is in place, it can stop situations from becoming overwhelming in the first place.
It means staff have a clearer picture of what someone needs, rather than trying to work it out in the moment. For patients, that can mean feeling calmer, safer and more able to cope with being in hospital.
For staff, it makes it easier to respond in a way that works for the individual, rather than relying on trial and error.
It also shows that improving care is not always about large scale change. Often, it is about doing the basics well and doing them early.
What we would like to see next
This is the kind of change people have been asking for.
From what we hear, it is important that:
- people are asked about their needs as early as possible
- that information is used, not just written down
- staff feel confident in how to respond
- this way of working is consistent, wherever someone receives care
We would like to see this approach used more widely, so people do not have a completely different experience depending on where they are treated.
We will continue to share what people tell us, and highlight where changes like this are starting to make a real difference.
This article is based on information shared by Tees, Esk and Wear Valleys NHS Foundation Trust about how they are improving support for people who need reasonable adjustments.
