Throughout this process, the Lancashire and South Cumbria New Hospitals Programme team has been committed to ensuring we hear from a wide range of local people, patients, staff, and stakeholders.

We have provided information in a variety of different ways, including Easy Read versions of all major programme documents, videos in British Sign Language and an accessible website, which can be translated into different languages and formats.

At the longlist to shortlist phase, we reviewed how many different groups within our diverse local communities had been involved.

We identified that we needed to hear more from the following groups:

• Asylum seekers and refugees
• Military veterans
• Those on low incomes, unemployed or socially deprived
• Blind and visually impaired people
• Deaf and hearing impaired people
• People with mental health problems or cognitive conditions
• People with specific communication needs
• People with specific education and training needs
• People with physical disabilities
• People with a mixture of disabilities.

To fill this gap, we approached organisations representing these groups of people, either through our own desk research or using contacts within the NHS to make introductions. We conducted 16 in-depth telephone interviews, and attended two group forum sessions.

What we heard: additional patient groups

We heard that access to, and navigation of sites is a key challenge for under-represented communities and inclusion groups, particularly for patients with additional needs. Signage is not adapted to those with sight issues or for people who do not speak English as their first language. This can make the hospital a disorientating place for these visitors.

For those on low incomes, the cost of travelling to hospital can be at best a strain, or at worst prohibitive to attending. This can be compounded by being sent to different hospitals for different treatments, doubling the effort required.

Patient representatives felt confidentiality and comfort is key and that single rooms are important. Reasons include embarrassment at their situation, domestic violence cases (to be separated from the abuser), for patients hard of hearing to be able to hear more easily, for military veterans suffering from Post-Traumatic Stress Disorder (PTSD) to have a more peaceful consultation, and for those from cultures or religions who are more likely to feel uncomfortable in an environment where they can be overheard.