Nursing Times Award Winner

From car park to grave

NOTE: Please read and then see link (below) to our BBC Radio 4 interview with Eddie Mair on Sept 6th

Imagine there were road works outside your house. Suddenly there’s nowhere to park and you have friends coming to visit. Would you wait for them to turn up late, having spent an hour touring the area to find somewhere to leave their car? Or would you contact them, apologise profusely for the situation and assure them that you will move your car off your driveway so that they can have your space? If you didn’t have that option, then you might suggest postponing the visit.

Last month I was asked to attend a meeting at a large Hospital Trust. No one had warned me that the car park I usually use had been closed for renovation. For over half an hour, I circled the multi-storey car park next door, but with everyone trying to park in the smaller space, there was no room. People, who were already stressed by a hospital visit, were angry and upset. I saw one lady in tears. What if they missed that vital appointment? Many would have taken time off work to attend. Would it all have been a waste of time?

No one was on hand to offer us another alternative, so eventually, along with many other people, I left. Half an hour later I found a space a considerable distance away from the hospital. I arrived at the meeting very late and feeling very stressed. Everyone was sympathetic. They knew I’d have problems parking, but not one of them had thought to warn me. The clear feeling that hit me was that no one saw it as their responsibility. Someone even said that, even though the car park was on the hospital’s site, the hospital didn’t own it so it wasn’t their fault. I don’t own the road outside my house but if road works stop my friends from parking there, I do see it as my responsibility to warn them and offer alternative plans.

Across the country, hospital car parking issues create massive additional stress to people who are already anxious or frightened. Whether patients or visitors, they come in good faith to a place they want to believe will look after them. But, all too often, they are let down at the first hurdle.

Many large Trusts have several car parks but it is not always made clear which one is closest to where you need to be. Even if you can find a space, the costs are high and, if you have to pay and display, then you have to over-estimate the time you need to avoid a fine. And that’s assuming the machines work. Often they don’t.

On a recent visit to a Trust, I queued with others to pay for my ticket. The machine was faulty and no one was quite sure what to do. Because of this stress, the conversation was all about lack of communication with many blaming the Trust for their anxiety. Most of those people were about to enter the hospital with that additional emotional baggage which did not bode well for the staff who would be dealing with them.

So, what’s the answer? With money and space in short supply, it’s not likely to be about building bigger, cheaper car parks. So let’s think back to the moment you realized your own friend was going to have a problem parking outside your own home.

You couldn’t stop the road works. You couldn’t build a bigger driveway. But you could warn your guests and suggest an alternative plan. You could also have asked them to ring when they were close so that you could go outside and guide them in. If they had to park several roads away and it was raining, you could take an umbrella with you when you greeted them so that they didn’t get wet as they walked to your door. They would be pleased, amused and touched by that gesture. They would then be likely to look back on their arrival with amusement rather than frustration. A simple idea that had made the world of difference to them.

And that is what the healthcare charity, Kissing it Better is all about. On the one hand it’s basic common sense. If you’ve taken the trouble to invite friends to your house, why would you want it to start with a bad experience that could tarnish the rest of the day? But the efforts you make to ensure they feel welcome mean far more than that. It shows you are organized, thoughtful and caring. In short, it creates a brilliant first impression. By moving your car and then waiting outside to greet them, it also shows you have put their comfort above your own which is what all good hosts should do.

So what can hospitals do? I have suggested putting volunteers into car parks to help guide people to spaces that are near to where they need to be. Someone told me that could be dangerous for the volunteers as car parks can be dangerous, especially at night. But, hold on, that implies that no one cares about the risks for patient or their visitors, many of whom may be ill or anxious, or both.

These are our suggestions.

- Send a clear letter to everyone who has a booked appointment, warning them of any potential parking issues and enclosing a clear map of the car park closest to their appointment. Some hospitals already do this, but not all.

- Alert local radio, newspapers etc if a car park is unexpectedly closed to ensure as many people as possible are aware. Advise people to leave more time for travelling.

- Ensure that there is someone at the car park entrance to offer help. Ideally it would be great if that person could issue a disc, or something similar, to anyone who fears that the extra time taken to park will mean they might miss their appointment. The disc will be proof that they arrived on time, but the system delayed them. Reassurance that they will not be in trouble and not miss out, is often all that is needed to calm someone down.

- If their appointment is moved to the end of the session, ensure they do not have to pay the extra cost in the car park that the delay has caused.

-Ideally, there should be specially trained volunteers on hand who are trained to manoeuvre wheelchairs so that they can help people to get to their appointment and back again. Time and again I hear hospital vent their frustrations that visitors do not return hospital wheelchairs after taking someone to their car. Many can’t as that would mean leaving a vulnerable person in a car, unattended, while they did it. Also, pushing a wheelchai across a car park can be exhausting, especially if it is uphill. An additional pair of hands, and a friendly face, can make the world of difference.

- And think of that umbrella. How amused would you be if you were offered one on a rainy day as you got out of your car? Of course there will be some people who may not return them, but most of us don’t want to carry a wet umbrella once we are inside. A big box at the hospital entrance and a volunteer on hand to take the umbrella, would be all it takes to make that system run well. Also, why not get a company to make a hundred umbrellas with the hospital logo on them. Or, better still, get them sponsored. Sponsorship would sort out the cost issue and the logo would make them more difficult to steal.

- And finally, car parking is expensive and for families who are visiting patients who are long-stay, the costs quickly add up. After four weeks of incurring expensive car park charges following my mother’s admission, never having the right change, and dealing with broken machines in the dead of night, someone told me that I could have had a much cheaper weekly pass. Was I pleased when I found out? No. I was furious that no one had told me earlier. Once again, a complete lack of communication over something so simple that would have made the world of difference to me.

The vast majority of people who work for the NHS want to make life easier for patients and visitors. But many, worried by targets and overwork, are no prepared to get involved in an issue they think doesn’t concern them. But it should concern them.

Hospitals are built as places to look after the most vulnerable members of our community. All the staff have to do is think ‘How would I feel if that happened to me?’

The NHS was set up to care for people from cradle to grave. We believe that many patients perception of their care could be significantly improved if it started in the car park.

Interview with Eddie Mair on iPM on BBC Radio 4 Transmitted 6th September www.bbc.co.uk/programmes/b0089nbb/episodes/player

Jill Fraser

Jill Fraser

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