Who is who in a hospital team

A hospital stay involves a surprising number of people.

Knowing who does what means your question reaches the right person first time.

The responsible consultant

• Leads decisions about diagnosis and treatment.
• Usually sees you on ward rounds rather than continuously.
• Ask for their name on the first day.
• Ask when they do rounds.
• Save major questions for that time.
• Ask for a separate meeting for a big decision.

Resident and junior doctors

• Present on the ward far more of the time.
• Handle day-to-day medical decisions.
• Order tests and review results.
• Good first point of contact for most medical questions.
• They escalate to the consultant when needed.

Nurses

• Provide the continuous care and observation.
• Know your condition hour by hour better than anyone.
• First people to tell about any change.
• Administer medicines and monitor for effects.
• Ask who is your named nurse each shift.
• Ask for the nurse in charge if you need escalation.

The ward pharmacist

• Reviews prescriptions for safety and interactions.
• Explains what each medicine does.
• Advises on alternatives and formulations.
• Helps sort out supply for discharge.
• Often the most accessible expert on medicines.
• Ask whether the ward has one and when they visit.

Physiotherapists and occupational therapists

• Assess mobility, breathing and daily function.
• Guide safe movement after surgery or illness.
• Recommend equipment for home.
• Often determine whether discharge is safe.
• Engage with them early; it shortens the stay.

Dietitians and speech therapists

• Dietitians advise on nutrition during illness.
• They can arrange supplements or modified diets.
• Speech therapists assess swallowing as well as speech.
• Ask for referral if eating or swallowing is difficult.
• Both have a direct effect on recovery.

Discharge coordinators and case managers

• Organise what must be in place before you leave.
• Arrange home support, equipment and transport.
• Liaise with services outside the hospital.
• Ask for them on the first day, not the last.
• Their work takes time to arrange.

Social workers

• Help with practical, financial and housing problems.
• Know local support services and entitlements.
• Can advise on care arrangements at home.
• Under-used because patients do not know to ask.
• Ask if money, housing or caring duties are a worry.

Porters and support staff

• They move patients between departments.
• Tell them if you are in pain before being moved.
• Tell them about lines or drains attached to you.
• Ask where you are being taken and why.

Interpreters

• Ask whether professional interpreting is available.
• Request it for consent and for major discussions.
• Family members are a poor substitute for clinical detail.
• Ask for translated written instructions too.
• Misunderstanding instructions causes real harm.

Healthcare assistants

• Help with washing, eating, moving and comfort.
• Often spend the most time at the bedside.
• Frequently the first to notice a change.
• Tell them if something feels wrong.
• They pass concerns to the nursing team.

Anaesthetists

• They assess fitness for surgery and manage you during it.
• They also lead pain management afterwards.
• Tell them about previous anaesthetic problems.
• Tell them about loose teeth, reflux and sleep apnoea.

Specialist nurses

• Many conditions have a dedicated specialist nurse.
• They often have more time than doctors do.
• They explain treatment and coordinate appointments.
• They are frequently the most useful long-term contact.
• Ask whether one exists for your condition.
• Ask for their direct contact details.

Radiologists and laboratory staff

• They interpret imaging and tests behind the scenes.
• You rarely meet them but their reports drive decisions.
• Ask who reported your scan if a question arises.
• Ask whether a second review is possible in difficult cases.

Chaplaincy and psychological support

• Available in many hospitals regardless of belief.
• Useful for difficult conversations and decisions.
• Ask whether psychological support exists for patients.
• Ask whether it extends to family members.
• These services are consistently under-used.

Patient liaison services

• Help resolve concerns and complaints.
• Explain processes and rights.
• Useful when normal channels have not worked.
• Ask whether such a service exists and where it is.
• Raising a concern early is usually easier to resolve.

Students and observers

• You may be asked whether students can be present.
• You may decline without affecting your care.
• Ask who everyone in the room is if you are unsure.
• It is reasonable to ask for a smaller group.

Matching question to role

• Change in symptoms — tell the nurse now.
• Why a test is being done — ask the resident doctor.
• The overall plan and prognosis — ask the consultant.
• Medicines — ask the pharmacist.
• Going home safely — ask the discharge coordinator.
• Money and home support — ask the social worker.

Asking for a family meeting

• Request one for complex or serious decisions.
• Ask for the responsible consultant to attend.
• Prepare questions in advance as a family.
• Ask for the conclusions to be documented.
• Request an interpreter if needed.

Write the names down

• Note each person's name and role as you meet them.
• Note the date of important conversations.
• Shifts rotate; memory fades quickly.
• Being able to name someone speeds up any follow-up.
• It also helps if you later need to raise a concern.

The point to remember

Three things:

1. Ask on day one who the responsible consultant is and when rounds happen.
2. Ask for the discharge coordinator early, not at the end.
3. Write down names and roles as you meet them.

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