Newham University Hospital

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

We looked for evidence that people were always treated with empathy, kindness and compassion. Patients and relatives’ feedback was also overall positive. However, people’s privacy, dignity and immediate needs were not consistently maintained. Due to overcrowding and the prolonged use of escalation areas, patients were frequently cared for in environments that compromised privacy and confidentiality.

At our last assessment we rated this key question Good. At this assessment the rating remained good. This meant that people felt supported, cared for and treated with respect.

We have not awarded this service a score for Caring.

Find out about when we will not publish a key question score and what we look at when we assess Caring.

The service always treated people with kindness, empathy and compassion, but did not always respect their privacy and dignity.

Staff treated people with kindness and compassion. Patients told us they felt confident and safe in their care. All the patients we spoke to described staff as “friendly” and “caring”. We observed compassionate care being delivered by a nurse and doctor to a child with additional needs and their family. Staff acted promptly and appropriately to provide timely support. The family felt the care was “responsive and effective”.

Waiting times were displayed on a whiteboard in the waiting area; however, this was not clearly visible to patients or updated in a timely manner. Some patients we spoke with had been waiting for long periods of time without any updates. Leaders were aware of these issues and had included actions within improvement plans for the department. These included: to introduce structured patient updates, visible waiting information, and regular communication rounding within the emergency department areas.

Staff directed patients to other services when appropriate and, if required, supported them to access those services.

Staff faced difficulties when caring for patients in temporary escalation spaces. Due to the lack of patient flow, there were limited options for patients to ensure privacy and dignity. This meant medical assessments were sometimes carried out in non-clinical areas where privacy and dignity could not be maintained. This also meant conversations could not always be held confidentially. However, we observed patients being treated with kindness and respect. Staff were knowledgeable about accessing interpretation services and confirmed these were used to ensure patients understood their care.

Staff collaborated with other colleagues to provide support for people with mental ill health and physical conditions. The service had an enhanced care team which provided therapeutic support to patients with mental health needs. The members of staff we spoke with all spoke compassionately about the need to support people with mental health needs.

The trust participated in the NHS urgent and emergency care survey benchmark report. The patient response rate was 17%, which was lower than that of similar organisations. Response rates for the A&E Friends and Family Test were also the lowest in the trust. To improve this, the service had identified potential actions including reviewing access to QR codes and considering a trial of paper surveys. The NHS patient survey showed that 82% of patients felt involved in decisions about their care, which was lower than the average, indicating that not all patients felt fully supported or engaged in their care. Only 79% of patients reported that their family or carers were able to speak with healthcare professionals, suggesting some limitations in inclusive communication and support. The service scored lower in comparison to other similar organisations.

We did not look at Treating people as individuals during this assessment. The score for this quality statement is based on the previous rating for Caring.

We did not look at Independence, choice and control during this assessment. The score for this quality statement is based on the previous rating for Caring.

Staff listened to and responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress. However, increased demand, delays in triage, limited oversight of waiting areas and insufficient capacity meant some patients waited too long in environments that were not suitable for their needs.

Processes were in place to assess and triage patients to the correct pathway. We observed patients being streamed appropriately. However, during periods of increased demand, some patients experienced extended waiting times for triage. We observed a lack of oversight of the waiting area, this meant staff were not able to identify and respond to changing risks to patients. Most of the patients we spoke with told us they were seen quickly and spoke positively about their interactions with staff.

Staff had a clear process to identify patients with mental health needs and alert the onsite psychiatric liaison team. Staff told us they had an electronic system to flag patients with additional needs such as autism, dementia, and learning disabilities. We observed staff respond promptly to patients with additional needs and supported them to access timely care through the department.

The ED had a designated mental health space, but this was insufficient to meet demand at the time of our inspection. This was because the designated mental health space could not always accommodate the number of patients who needed it. For example, on the second day of our inspection there were 9 mental health patients in majors, 3 of which were receiving corridor care. This meant some patients experienced waits of over 6 hours in non‑therapeutic environments.

Staff informed us that they provided food and drink to patients in the emergency department. We also observed staff offering food and drinks such as sandwiches and hot drinks to patients who were in escalation spaces.

The paediatric emergency department had access to the Children’s Adolescence Mental Health Service (CAMHS) for assessment and treatment for children and young people. There was designated space for children and young people with mental health needs. Staff told us there was limited CAMHS support available overnight due to staffing shortages, resulting in nurses being required to care for patients without consistent access to specialist guidance. There did not appear to be any clear mitigation in place to address this gap overnight.

In waiting areas, we saw QR codes displayed for patients to scan on their phones to link them to information on common illnesses, symptoms, and treatments. Additional QR codes were positioned across the department to enable patient feedback.

The service cared about and promoted the wellbeing of their staff and supported and enabled staff to deliver person-centred care.

Most of the staff we spoke to felt respected, supported, and valued. We spoke to many long serving staff members who referred to their team as “family” and felt a sense of togetherness. Staff felt able to raise concerns with senior staff and had confidence their concerns would be escalated.

Leaders informed us that staff well-being was a priority and staff now had access to psychological support. Sessions were also being held with nursing teams to support their development.

Data reviewed from the service showed staff had access to trust wide well-being initiatives through the intranet. For example, the Employee Wellbeing Service (EWS) for workplace health-related enquiries. Staff could access services such as the Sports Injury Clinic, free physiotherapy, exercise and fitness advice, a joint pain programme, gym offers, and alcohol and smoking support.

We were told staff or patients were able to nominate staff for their hard work, this was an initiative that had been reintroduced called Greatix. For example, a staff member was given a certificate to acknowledge how empathetic and supportive she was to a patient. Alongside this the trust holds the Barts Health Heroes Awards ceremony every year to showcase staff achievements. The service demonstrated a caring and supportive culture through recognising and celebrating long-serving staff at 15, 25 and 40 years of service through formal awards.

The department had seen an increase in staff retention and improved staffing levels. Leaders told us how this had a positive impact on staff morale. There was a trust focus on improving staff satisfaction and offering a better work life balance, and flexible working patterns. The staff survey results from 2025 showed an improvement in staff morale, flexibility and team culture. However, the survey raised concerns around staff safety, workload pressure, and confidence in organisational change.

We saw QR codes displayed around the department requesting staff feedback. Staff had access to facilities and a well-being room. We found the furniture in need of replacing; however, leaders informed us they were in the process of consulting staff on the redesign of this area.

Leaders acknowledged the increase of violence and aggression towards staff in the emergency department and all the staff we spoke to also raised this concern. Several staff indicated that they would like more security staff to be available. Initiatives had already been put in place to reduce the risk towards staff. For example, staff were issued with body cameras, provided with pinpoint alarms, security had been increased and staff were issuing red/yellow cards to patients who were hostile. However, we observed that not many staff were wearing the body cameras and there was some reluctance among staff to use them.