Making hospital care more accessible in York and Scarborough
Hospital care does not always feel set up for everyone.
In our work across North Yorkshire, people have told us about barriers across many hospitals.
Getting to hospital, knowing what is going to happen, and feeling understood once you are there should be straightforward.
But for many people, especially if they need extra support accessing an appointment, this is not always the case.
In our recent report, Making health appointments work for everyone, people told Healthwatch that when their needs are not recognised early, care can quickly become stressful, confusing or overwhelming.
People described not always being asked what they need, struggling with how information is shared, and finding hospital environments difficult to manage. Carers also told us they do not always feel recognised or involved in conversations around a loved one.
But care is changing for the better, as the example below illustrates.
What’s changing
York and Scarborough Teaching Hospitals NHS Foundation Trust has been making several 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.
This is what reasonable adjustments are in practice. They are small, practical changes that help people access care safely and comfortably, and under the law, health services are expected to make them where needed.
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 treatment and appointments.
For example, the hospitals have worked with patients to create a video explaining what happens when you visit the emergency department. For people who may find hospital environments unfamiliar or overwhelming, this video can help to make things feel more predictable, less stressful and help them to know 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 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 several practical changes in place to make care more accessible and consistent.
These include:
- specialist support through a learning disability and autism liaison service, helping staff understand someone’s needs and put the right support in place early
- hospital passports, which give staff a quick, clear picture of a person’s needs and preferences so care can be more personalised and consistent
- access to dementia support, including admiral nurses (see page 15 for contact details), who provide free, expert advice, support and understanding to help families care for their loved one
- a carers charter, setting out how the NHS will identify, include and support unpaid carers early, making sure they are listened to, given clear information, involved in decisions, and treated as a recognised and valued part of someone’s care
There is also a growing focus on communication.
People can request information in different formats, and work is ongoing to improve how interpretation services are arranged so that support is easier to access. A new online tool has been introduced in the hospitals to better record and flag people’s needs, making it easier for staff to see and act on this information.
Hospitals in York and Scarborough have 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 shape improvements based on real experiences. This includes making sure care works for people with different needs, including communication, culture and personal circumstances.
Further information about this approach is available on the York and Scarborough Teaching Hospitals NHS Foundation Trust equality and diversity pages on its website.
What difference this is making
For people, these changes can make a real difference to how care feels.
People are more likely to feel:
- clearer about what to expect before they arrive
- more confident that their needs are understood
- less overwhelmed by the environment or communication
- better supported if they are a carer
For staff, having clearer information and systems in place makes it easier to respond consistently, rather than relying on individual knowledge or last minute adjustments.
Why this matters
Across North Yorkshire, people have told us that hospital care does not always feel set up for them, especially when they need extra support.
We hear that:
- people are not always asked about their needs early enough
- communication does not always work for them
- hospital environments can feel overwhelming
- carers are not always recognised or involved
- support can vary depending on who they see
Taken together, these experiences can make care more stressful than it needs to be, and in some cases can put people off seeking help.
This example shows what can happen when the NHS plans, ask the right questions, and act on what people say.
It reflects what people told us in our report on making health appointments work for everyone, where small, practical adjustments, made early and consistently, can make care easier to navigate and less stressful.
While some of these changes may seem small on their own, together they can make care feel more consistent, more understanding, and more responsive to what people need.
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.
