The Queen Elizabeth 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.

At our last assessment we did not rate this key question. At this assessment the rating is good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

We have not awarded this service a score for Effective.

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

The evidence showed some shortfalls. The service did not always make sure people’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them.

We reviewed 10 sets of patient records and were unable to locate up to date risk assessments in 6 of these. We were not assured risk assessments led to effective care plans to ensure patient needs were met.

Staff did not always make sure patients’ nutrition needs were assessed and met in line with current guidance. Not all patients on the surgical wards had a Malnutrition Universal Screening Tool (MUST) assessment completed or a care plan to meet their nutritional needs. The menu offered to inpatients included patient choice with a range of diets and textures.

We observed boards at patients’ bedsides used to highlight individual patient needs, such as visual impairment, additional communication needs or requiring assistance at mealtimes, these boards were not completed and did not provide staff with information on individual patient needs. Staff we spoke to said the boards would be useful but were rarely completed.

Pre-operative assessments involved detailed patient reviews, which included past medical history and patient preferences. However, patients told us they often had to repeat this information to different staff. For example, one patient told us they had made the service aware of their need for an altered textured diet, but they were regularly offered unsuitable food and drink.

The evidence showed a good standard. The service planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

The trust’s intranet contained a comprehensive range of policies and standard operating procedures which provided guidance for staff that reflected best practice.

Staff gave patients clear information about their care and treatment needed to support both their physical and mental health. Patients told us they felt their expectations and needs were considered during decision making.

Staff we spoke to told us they could access a range of specialists, if required, to meet the needs of patients such as physiotherapists, dietitians and pharmacists. Staff told us these reviews happened in a timely way when requested.

We observed patient theatre lists and saw effective systems in place to promote and protect the safety of patients. The service followed National Safety Standards for invasive procedures and World Health Organisation (WHO) surgical safety checklists. We reviewed clear consent processes and allergy checks as part of the preoperative checklists.

Our observations in theatre highlighted adherence to best practice. For example, we observed staff counting disposable items, including gauze, needles and other instruments as a safety measure to prevent retained surgical items in line with guidance from the Association for Perioperative Practice (AfPP).

The service involved people in surgical treatment planning. Audit data showed 89% overall compliance for the correct completion of consent forms.

The evidence showed a good standard. The service worked well across teams and services to support people.

We saw evidence of good multidisciplinary team (MDT) working. When people were due to move between services, all necessary staff, teams, and services were involved in assessing their needs to maintain continuity of care.

Staff informed us they worked well with other staff. Nursing staff told us medical staff were available for advice and support including overnight and on weekends and there were good working relationships between colleagues.

Theatre teams were observed to work well together for the safety of the patients.

We observed staff sharing appropriate patient information when they moved between departments. Staff told us patient information was shared between staff at shift handover.

Leaders told us about weekly MDT meetings for orthopaedic patients that ensure patient concerns were listened to, discussed and plans taken to address barriers to care. Length of stay for orthopaedic trauma patients has reduced from an average of 22 days to 11 days.

We observed the surgical divisions therapy team, comprising of physiotherapists and occupational therapists, actively supported multidisciplinary care. They provided patient rehabilitation across surgical wards, coordinated discharges and worked to reduce inpatient deconditioning.

We observed staff from the surgical wards meet with senior leaders to discuss patient safety concerns and delays in care in real time and ensure plans were made and enacted to ensure timely reviews. Leaders told us these meetings occurred daily.

The evidence showed a good standard. The service supported people to manage their health and wellbeing to maximise their independence, choice and control. The service supported people to live healthier lives and where possible, reduced their future needs for care and support.

Health promotion was part of care provided to patients. Staff worked collaboratively to assess all aspects of general health, and to give advice and support to promote healthy lifestyles.

People’s health was assessed at pre-assessment and staff could make referrals relevant to the patients' needs e.g. smoking cessation at any point in the pathway. On discharge patients were signposted and given advice on where and when to seek help.

Patients told us they were given information and advice about their physical health, including the benefits of taking regular exercise, smoking cessation and weight loss.

We observed staff effectively communicating with patients about treatment options and care plans. Staff explained expected recovery timescales post-surgery.

The evidence showed some shortfalls. The service did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.

The trust showed inconsistent performance within clinical audits. While they seemed to perform better within the National Joint Registry (NJR) data, the National Emergency Laparotomy Audit (NELA) data showed 7 metrics below the expectation. The National Hip Fracture Database (NHFD) data also showed inconsistent patterns, in 8 metrics the trust was in the 25% best performing hospitals and in 3 metrics it was in the 25% of worst performing hospitals. These clinical areas could therefore represent areas of improvement for patient experience and outcomes.

The trust had an appropriate Learning from deaths policy, approved in January 2024 and completed Structured Judgement Reviews (SJRs) where appropriate. We reviewed the last three Learning from Deaths reports which identified learning themes. Learning from Death reports are shared with staff at the monthly divisional learning event. Data for February 2026 showed there were 10 SJRs awaiting review. The oldest outstanding SJR was from February 2025, there is a risk in implementing learning being delayed as a result. Leaders told us SJR groups would meet every two weeks to reduce this backlog.

The evidence showed a good standard. The service told people about their rights around consent and respected these when delivering person-centred care and treatment.

People told us staff explained care and treatment options in a way they understood and gained verbal consent before carrying out procedures.

Consultants would gain written consent before any surgical procedure. Staff reviewed consent forms in theatre as part of the checklist.

Staff considered patients’ capacity and ability to consent. Patients,’ or a person lawfully acting on their behalf, were involved in planning, managing, and reviewing their care and treatment. Staff showed understanding of when and how to assess whether a patient had the capacity to make decisions about their care, and the Mental Capacity Act (MCA) 2005. Audit data from the last 3 months showed 100% of staff questioned across the division were aware of what to do if a patient lacked capacity.

Staff followed the trust policy and procedures when a patient could not give consent. We reviewed the consent policy, which was in date and accessible to staff.