“Localism and Intimacy, and… Other Rather Imponderable Reasons of That Sort”: A Qualitative Study of Patient Experience in Community Hospitals in England

Background: The community hospital sector is characterised by high levels of upheaval, variation and dispute. Debates over the value and contribution of community hospitals are hampered by a lack of empirical assessment of the experience of patients using these services. This paper presents findings from a study of patient and family experiences in community hospitals in England.

Methods: We adopted a qualitative design involving nine case study hospitals, selected to represent a range of characteristics. Case study data collected included discovery interviews with patients (n=60) and semi-structured interviews with carers (n=28). We conducted thematic analysis of interview data.

Results: The study confirms some of the distinctive functional and technical aspects of care associated with community hospitals, including: access to services facilities and equipment; the environment and atmosphere; information sharing; continuity, and; the potential for longer lengths of stay. The study also finds high reported levels of personalised care in community hospitals. Our study suggests the importance of additional social and psychological aspects of patient experience. Social aspects included having family and friends close, and the importance of being known and maintaining social connections during periods of hospital treatment. Psychological aspects included feeling less anonymous and frightened than they would in an acute setting, especially when coming to terms with loss and change.

Conclusions: Although the experiences uncovered in this study were not uniformly positive, patients and carers placed a high overall value on the distinctive qualities of the care provided by community hospitals. The study suggests the need to weigh the full range of these dimensions of patient experience – including functional, relational, social and psychological – when assessing the role and contribution of community hospitals.