A black and white image showing a battered nurse call bell

What would I change about being disabled in hospital

A black and white image showing a battered nurse call bell
Nurse call bell

I discussed in the previous post what it’s like to be disabled in hospital, and how I’m experiencing my current admission. I talked about how the hospital system isn’t set up to meet the needs of disabled patients, only ill patients. In the next two blogs, I will discuss suggestions for preparation in case you’re suddenly admitted, and things you can do once admitted to get your needs met.

If when I was admitted, I’d flagged as a patient with mobility impairment, there could have been a quick form to assess my needs. This could have established whether I was a fall risk, needed an air mattress, needed hoisting, or needed grippy socks. This could convert into a risk score to allow appropriate teams to be bleeped to meet a patient’s needs, from tissue viability to physiotherapy.

This approach could be generalised to also assess the needs of patients with, for example, mental health problems. These patients might need quick access to rescue medication, or someone to listen to them if they were upset or a side-room which was quiet and away from the main ward. Their score could include risk to self and others, but also whether they would need additional nursing time or a referral to psych liaison.

Similarly, for patients with sensory impairments, it would be easy to track what communication methods worked for someone. This could look like everyone entering their room knowing, for example, to introduce themselves and say their role because the patient was blind, or that the patient needed a BSL interpreter for all conversations. The Accessible Information Standard exists, but for patients with milder hearing impairments, they might simply need a well lit room and people talking to them to face them. A quick form would capture the patient’s needs in that domain accurately and trigger for referral to an interpreter or specialist team.

I believe it exists slightly for cognitive impairments like – the This Is Me form for patients with Alzheimer’s, or the Hospital Passport for patients with learning disabilities, but these rely on the patient having the forms already. Patients with learning disabilities already do not receive the care they need and while improvements are being made, it is crucial that everyone involved in someone’s care knows what they want and need. If there are concerns about staff ability to understand and communicate with the patient, steps need to be taken at the point of admission.

A simple intake form implemented nationally could ask patients about mobility impairments, mental health problems, sensory impairments, and learning disabilities. A coded scoring system would allow staff to note quickly what support a patient might need from a list of standardised options, with space to note anything that wasn’t on that form. For patients with no impairments, the form would be very rapid, and for patients with impairments it would save staff time later in the admission by capturing the granularity of peoples needs at the outset. It could also reduce challenges like pressure sores and panic attacks by ensuring that proactive steps were taken to meet the needs of the patients.

This would allow hospitals to put the support patients needed into place in a proactive way, rather than a reactive way that relies on patients being able to effectively advocate for themselves when admitted. It would meet the anticipatory requirement to make goods and services accessible to disabled people, and be an effective way of meeting patient need.

Ensuring wards were adequately staffed would also contribute to this. Where staff are pressed for time, there is no additional staff time to meet added needs of specific groups of patients. Where staff are having to triage and firefight on the ward, patients like me who need the preventative care of repositioning slip through the cracks.

What do you think the NHS could do better at for disabled patients? And what does it do well already? 

Comment here, on twitter @jamierhale or on facebook

I hope you found these proposals interesting. To read the other blogs in this series, click Being Disabled in Hospital:
1. Challenging
2. What would I change
3. Tips for preparing for an unexpected admission
4. Tips for managing during an admission