Care providers can play an important role in making sure the people they support remain heard, safe and treated with dignity.

When someone you support goes into hospital, your knowledge of that person matters.

New NHS England guidance on privacy, dignity and safety in hospital accommodation reinforces that decisions about hospital accommodation should be person-centred wherever possible, considering clinical needs, safety, privacy and dignity.

For care providers, there is an important message:

Advocacy shouldn’t stop at the hospital door.

Your staff may know things that aren’t immediately obvious to a busy hospital team. They may understand how the person communicates, what causes them distress, what helps them feel safe and what support they normally need to maintain their dignity.

Don’t wait for someone to complain

Importantly, NHS England says that the absence of formal complaints cannot be assumed to mean that there are no issues. Regular communication with patients and, where appropriate, those important to them is essential to ensuring privacy, dignity and safety are maintained. 

Someone may find it difficult to communicate their concerns. That’s where people who know them can make a real difference.

Privacy, dignity and accommodation matter

The guidance says hospital teams should consider privacy for conversations, communication and accessibility needs, safeguarding concerns and the person’s involvement in decisions about their care. 

It also reinforces requirements around same-sex hospital accommodation, including sleeping accommodation and toilet and bathroom facilities. There are specified situations where these requirements do not apply, and clinical need remains the priority. 

Where mixed-sex accommodation is unavoidable, NHS England says additional care should be taken to protect privacy and dignity. Patients, relatives and carers should also be kept informed of the reasons, what is being done and the expected timeline for resolving the situation.

Read the NHS England guidance on privacy, dignity and safety in hospital accommodation

Remember HCPA’s Impartial Assessors

Providers don’t have to manage the assessment process alone.

HCPA’s Impartial Assessors are also available in hospitals for all types of care providers to provide an independent assessment, gather information and updates during admission and general communication support for new and returning individuals. This is a fully funded service that helps you make informed decisions and provide an additional advocate for the people you support. The service can support any adult care setting in Hertfordshire, supporting older people, nursing, dementia adult disability, learning disability and mental health.

Use the Impartial Assessor service as part of your approach to supporting safe and appropriate transitions from hospital.

Click here for the service details. 

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HCPA Hospital Advocacy Checklist

When someone you support is admitted to hospital, consider:

Communication

• Can the person communicate what they need?
• Does the hospital know how they normally communicate?
• Have communication or accessibility needs been considered?
• Does the person understand what is happening and the decisions being made?

Safety

• Have you asked the person whether they feel safe?
• Have you noticed changes in behaviour or signs of distress?
• Is there anything you have observed that concerns you?
• Are there safeguarding concerns that need to be raised?

Privacy and dignity

• Is their privacy being protected during personal care?
• Can sensitive conversations happen privately?
• Do they feel comfortable with their accommodation?
• Is anything happening that you know would cause this person distress or embarrassment?

Hospital accommodation

• Is their sleeping accommodation appropriate?
• Do they have appropriate access to toilet and bathroom facilities?
• If they are in mixed-sex accommodation, have the circumstances been explained?
• Where relevant, are they or their representative being kept informed?

Advocacy

• Does the hospital understand what’s important to this person?
• Is important information from the care service being shared with the hospital?
• If the person finds it difficult to speak up for themselves, who is helping them have a voice?
• Is there anything that needs to be raised or escalated before discharge?

Note: These are HCPA-style suggested advocacy prompts rather than requirements within the NHS England guidance.

The question to remember

“Is there anything this person would want us to say, explain or challenge if they were fully able to speak up for themselves?”

You know the person. Use that knowledge.

Hospital staff bring clinical expertise. Care staff bring detailed knowledge of the individual. Working together can help ensure that people receive care that is not just clinically appropriate, but safe, respectful and person-centred.

Read the NHS England guidance on privacy, dignity and safety in hospital accommodation