"The hospital has a modern feel ..."

What I liked

The hospital has a modern feel despite being quite old, and has had a make-over that retains the spaciousness, landscaped views and 'out-of-town feel' whilst being easily accessible by car and public transport.

I was admitted following a stroke and I had a strong sense of there being a clinical pathway that was followed, and of this being evidence-based. Triage in A & E was done by a male nurse who was very professional, clinically competent and efficient. My overall care in A & E was very good. Although staff work under a lot of pressure the atmosphere was calm and reassuring, teamwork was evident, and I thought the place was very clean bearing in mind the traffic that goes through it. I saw a dedicated cleaner going round constantly picking things up and tidying stuff away.

The MAU was very busy with a high caseload of highly dependent and very poorly people, mostly elderly, some confused and restless. I was attended by medical staff at my request and I was very satisfied by the responsiveness and attitude of the doctors, although it was clear that they were very busy. Medical attention was thorough. Some nurses showed a lot of sensitivity and communicated well, in an adult way. A Ward Manager in MAU responded very well to my complaint about elderly care, he was utterly non-defensive, open to what I had to say, and acted promptly to remedy my concerns. Another (BME) agency staff nurse was very caring to elderly helpless people and helped them to eat and drink with encouragement and old-fashioned charm.

I thought the food was good. I chose the vegetarian option on religious grounds, and it was varied, creative and tasty. My menu choices were carefully fulfilled. The worker who served meals was an exemplar of gracious service and willingness to go "the extra mile".

The bed was easily adjustable and comfortable, bedding clean and changed regularly.

What could be improved

My main gripe has to be the insensitivity of some nurses, especially (I thought) the more senior ones, but also some HCAs. Staff nurses and F grades were less than easily available, and I was at no time aware of there being a dedicated nurse to whom I could turn for information or support. I was never sure who to ask for advice. Uniforms are ambiguous and confusing. On the couple of occasions when I asked to speak to a nurse I was almost always addressed from a distance, and from a height (if I was in a chair or in bed), so that confidentiality was impossible. On one occasion when I asked a nurse if I could ask a question (she was at the medicine trolley) she answered me over her shoulder in a loud voice; her answer was unhelpful and brusque, so that I felt I didn't want to follow it up with her.

Several nurses and HCA's seem to have a default position with older patients that is chirpily informal and patronising, calling them "Mate", "Young Man" or "Darling". I am 71 and quite friendly, but I don't want to be talked to in a 'pally' way by strangers, nor do I want to be frostily called "Sir" (the word is used in a manner reminiscent of policemen pulling over a driver who has shot a red light). Nurses do not seem to be at ease with a 'adult' consultative style of dialogue when on duty in a public ward. They could learn from doctors, and - I suggest - from some of the other staff who do domestic work about the wards.

Some HCA staff seem at a loss when supporting people who are confused or restless. I saw several instances of older people being chided, rebuked or scolded for calling out, and on a few occasions I heard them being ridiculed for being confused or 'difficult'.

Anything else?

My overall impression of care at Basildon Hospital, including care in several diagnostic departments and outpatients, is that it is very good indeed. The range of clinical interventions, and the way they were linked, was quite superb, and I count myself very lucky to have been managed so thoroughly throughout my 'episode'. Staff are generally very courteous and helpful, delays are kept to a minimum, and there is a planned 'seamlessness' to the experience that only a reformed Health Service could deliver (I write as one who trained as a nurse in the 1950s). The serious weakness in the profile is the unsophisticated communication style of many nurses, their attachment to the nurses' station, and their apparant obliviousness to being on public display, so that they are content to talk amongst themselves about last night's party, or a partner's personal behaviour, as if they didn't have a discriminating and sensate audience. This failing is very prevalent, and of course it pervades all ranks by "trickle-down".

If this received attention I think Basildon Hospital would thoroughly deserve a reputation for excellence, and staff would find that patients and visitors would reciprocate by manifesting better manners themselves. But there is a lot to do to get there, I think.