Just a bunch of grapes? Liminality and the experiences of adult visitors to NHS acute medical and surgical wards in England

In this thesis, I argue that the practice of visiting patients on the more general acute medical
and surgical wards in National Health Service hospitals in England has been underresearched
and is frequently overlooked by policy. This is despite the large number of written
complaints received annually about NHS acute hospital care services in England.

The thesis commences with an extensive examination of the contextual influences on hospital
visitors’ experiences and expectations. This is followed by a detailed account of the
qualitative research, using semi-structured interviews, with participants who had been
hospital visitors. Visiting experiences were described as a journey through the patient’s
admission, hospital stay and discharge or death. This journey was identified as a time of
liminality (van Gennep 1960) with the visitors’ everyday routines and structures suspended
and transitions to be made. Liminality and its core features identified by Turner (1974)
therefore provided a theoretical framework through which to explore the data.

The analysis resulted in the identification of extensions to the understandings of liminality
when applied to the hospital-visiting scenario. In turn, the use of liminality, as central to the
theoretical framework, provided richer interpretations of hospital visitors’ experiences and so
adds to the knowledge about the practice of hospital visiting. Evidence is therefore provided
to support future policy, training and professional education improvements and to suggest
measures to improve hospital visiting experiences. These improvements, especially in terms
of hospital hospitality, effective communication and improved discharge management, could
increase hospital visitors’ satisfaction and reduce the costs to the NHS incurred by
responding to the high volume of written complaints.