Archived: King Edward VII's Hospital

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We looked for evidence that people and communities had the best possible outcomes because their needs were assessed. We checked that people’s care, support and treatment reflected these needs and any protected equality characteristics, ensuring people were at the centre of their care. We also looked for evidence that leaders instilled a culture of improvement, where understanding current outcomes and exploring best practice was part of their everyday work.

At our last assessment we rated this key question good. At this assessment the rating has remained good. We found that people received effective care and support that met their needs and promoted good outcomes.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff ensured effective care by assessing and reviewing people’s health, wellbeing, and communication needs.

Clinical Nurse Specialists (CNS) conducted daily patient reviews, pre-operative assessments, personalised care plans, and early discharge planning.

Staff followed pre-assessment processes where they identified risks early, preventing same-day surgery cancellations. For example, pregnancy testing and multi resistant staph aureus (MRSA) testing in advance and on the day of surgery.

Staff assessed and managed pain with neurodiverse patients using visual pain scales. Pain was proactively managed using techniques, such as clinically proven cooling and compression therapy systems. These methods helped reduce swelling and discomfort, supporting faster recovery. Pre-operative education by physiotherapists and occupational therapists also helped patients prepare for surgery and understand their recovery journey.

Staff carried out functional ability assessments to evaluate patients’ capacity to follow post-operative instructions. Staff shared with patients’ digital instruction recordings for complex surgery.

Staff planned and delivered care and treatment with patients, including what was important and mattered to them. Staff did this in line with legislation and current evidence based good practice and standards.

Staff consistently applied structured clinical tools such as the National Early Warning Score (NEWS), and pain assessments to monitor patient status. These tools were endorsed by the Royal College of Physicians and National Institute for Health and Care Excellence (NICE) for early detection of deterioration.

Documentation was thorough and consistent across the patient journey, enabling real-time care adjustments. This practice aligns with NICE quality standards on person-centred care and supports effective clinical audit.

A culture of learning was evident using After-Action Reviews (AARs) and the Patient Safety Incident Response Framework (PSIRF), as recommended by NHS England to reduce harm and promote continuous improvement.

Collaborative working with external partners (e.g. local hospitals, social services) ensured continuity of care, reflecting NICE guidance on integrated care for individuals with complex needs.

Leadership played an active role in service planning, helping to reduce variation in care. This approach is supported by evidence from the Care Quality Commission (CQC) and the King’s Fund on the importance of leadership in quality improvement.

Surgical site infections were monitored through structured audits in line with NICE Clinical Guideline 74 (CG74). The use of care bundles and the One Together toolkit, based on NICE guidance and expert consensus further supported best practice in infection prevention.

Staff clearly communicated patients’ rights around consent, ensuring these were respected in line with NICE guidance on decision-making and mental capacity. Consent was embedded in the patient pathway, with formal confirmation on the day of admission to ensure decisions remained current and informed.

Risks were discussed and documented, with evidence of shared decision-making in care notes. This demonstrated transparency and alignment with NICE recommendations on person-centred care planning.

Clinical policies were readily available on the intranet, and all in date with regular reminders issued to staff to ensure they remained up to date with best practices. This supported consistent and safe care delivery.

Staff worked well across teams and services to support people. Staff made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Staff worked collaboratively across clinical, surgical, and non-clinical roles to plan and deliver safe, person-centred care. The multi-disciplinary team (MDT) included nurses, physiotherapists, occupational therapists, Clinical Nurse Specialists (CNS), Resident Medical Officers (RMOs), consultants, and non-clinical teams such as procurement, administration, and estates. This integrated approach ensured that patients' needs were considered holistically from pre-operative assessment through to discharge.

Patients with complex social or mobility needs were identified early, with discharge planning beginning at the pre-operative stage. Staff worked with families, social services, and GPs to ensure safe discharge, even when patients lived in challenging environments. Joint sessions were held with family members to prepare them for their role in supporting recovery.

When resources were delayed or unavailable, teams pulled together to find solutions. The stores and procurement teams worked closely with clinical staff. Staff were mindful of financial constraints but remained focused on patient safety and continuity of care.

Communication and escalation pathways were clear and well-practiced. If a patient's condition deteriorated, ward staff would escalate to the RMO or critical care outreach team, who would liaise with intensivists as needed. This ensured timely intervention and avoided unnecessary transfers to other healthcare providers.

Staff supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

Staff supported patients to live healthier lives by promoting recovery, independence, and informed decision-making. Pre-operative education sessions, including physiotherapy and occupational therapy input, helped patients understand their procedures and prepare for recovery. This proactive approach empowered patients to engage in their own care and make lifestyle adjustments where needed.

Patients with complex social or mobility needs were identified early, and staff worked with families, GPs, and social services to ensure safe discharge planning. This included assessing home environments and supporting adaptations or care arrangements, helping patients return home safely and maintain independence.

The use of patient rounding and person-centred documentation ensured that patients’ comfort, pain management, and wellbeing were prioritised daily. Staff also supported family members through joint sessions, helping them understand how to care for their loved one’s post-discharge, which contributed to healthier outcomes at home.

Staff routinely monitored people's care and treatment to continuously improve it. Staff ensured outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Staff used structured tools and consistent documentation to monitor patient progress and identify areas for improvement. Daily assessments using the National Early Warning Score (NEWS), neurovascular checks, and pain monitoring enabled early intervention and supported safe, responsive care.

Thorough documentation across the patient journey, from the pre-operative stage to discharge, allowed staff to reflect on outcomes and adjust care plans accordingly.

Audit and surveillance processes were embedded in practice to support continuous improvement and patient safety. Surgical site infections were closely monitored, and any unusual increase triggered investigation to identify patterns or risk factors. Although benchmarking could be challenging due to the low volume of operations, audits were regularly conducted to assess prevention measures and outcomes.

Staff used audits to follow the patient journey and included the use of care bundles and the One Together toolkit. This structured approach ensured that audit questions were relevant and comprehensive. Outcomes from these audits had been positive, with no significant themes or recurring issues identified.

Staff told people about their rights around consent and respected these when delivering person-centred care and treatment.

Consent was clearly embedded in the patient pathway. A formal consent form was completed on the day of admission, with confirmation that the patient had not changed their decision. Staff ensured that consent was current and informed.

Risks were discussed and documented, with evidence of shared decision-making recorded in the care notes. Care records reviewed showed clear documentation of risks and consent, reflecting a person-centred and transparent approach to care planning.