The Queen Elizabeth 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 kindness, empathy and compassion. We checked that people’s privacy and dignity was respected, that they understood that they and their experience of how they were treated and supported mattered. We also looked for evidence that every effort was made to take people’s wishes into account and respect their choices, to achieve the best possible outcomes for them.

At our last assessment we rated this key question good. At this assessment the rating had changed to requires improvement. This meant people did not always feel well-supported, cared for or treated with dignity and 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.

We scored the service as 3. The evidence showed a good standard. The service always treated people with kindness, empathy and compassion and respected their privacy and dignity.

During our onsite assessment we observed respectful, discreet and responsive staff attitudes and behaviours. For example, we saw staff rush to attend a patient that had vomited. Patients said staff pulled the curtains to maintain their dignity and gave them reassurance when they were scared or anxious.

Staff supported patients to understand and manage their care, treatment or condition. Nurses utilised specialist nurses to support patients with managing their conditions. For example, the renal nurse support transplant patients and setting up dialysis on discharge from hospital.

Staff directed patients to other services when appropriate and, if required, supported them to access those services. For example, therapists referred patients for specialist inpatient therapy following admission when they were medical fit.

Staff understood the individual needs of patients, including their personal, cultural, social and religious needs. Multifaith chaplaincy services were available to support patients and their families if they wished.

Staff maintained the confidentiality of information about patients. Within endoscopy the ‘breaking bad news’ room was situated by the exit of the building to provide immediate privacy and a dignified exit route for distressed patients, preventing them from having to walk back through crowded, highly public clinical areas.

We scored the service as 2. The evidence showed some shortfalls. The service did not always treat people as individuals or make sure people’s care, support and treatment met people’s needs and preferences.

Care plans were in place to support the delivery of individualised care, however, patients told us they were not always consulted on these to be able to make them more personalised.

Specialist services were not adequately staffed which impacted their ability to meet people’s needs and preferences. For example, there were significant delays in stroke follow up appointments and children transitioning into adult services were not always supported due to a lack of staffing within speciality areas.

Patients were not always supported to mobilise or sit out of bed over the weekend, in line with recommendations made by the ward therapists. This led to deconditioning of some patients.

The service supported the needs of pregnant women with acute medical conditions, for example the diabetic specialist nurses provided ongoing reviews for women with type 1 and 2 diabetes in pregnancy, seeing them every 1-2 weeks throughout pregnancy.

Risk assessments were not aways completed or actions were not taken to mitigate identified risk on admission leading to treatment not being specific to the patient’s needs. For example, a patient was not placed on an air mattress on admission and developed a pressure ulcer.

The service made adjustments for patients with communication needs. For example, patients with hearing impairment where able to access Sign Language via Mobile Video Interpreting provided by the Patient Experience Team.

Managers ensured that staff and patients had easy access to interpreters and/or signers. We saw evidence within patient records and staff were confident in how to access these services if required.

Patients had a choice of food to meet the dietary requirements of religious and ethnic groups and to account for allergies and intolerances. Most patients were satisfied with the options available to them.

We scored the service as 2. The evidence showed some shortfalls. The service did not always promote people’s independence, so people did not always know their rights and have choice and control over their own care, treatment and wellbeing.

The division used support tools to enable person-centred care such as hospital passports document and ‘this is me’ to support staff identify and document patient’s specific requirements, needs and wishes. The dementia team support workers provided the wards with the ‘this is me’ booklets but these were not always completed by carers or family to further support people’s independence and choice.

Some patients told us staffing numbers impacted on their ability to mobilise, sit out of bed or move safely when they called for support.

Outlier patients were not managed in line with policy which meant that there was no documentation of discussions with patients or families explaining the need to outlie, as required by policy.

Mental capacity assessments did not always support decision making to support people’s rights and choices to their care and treatment for those that had confusion or dementia.

The palliative care team supported patients making decisions regarding their end-of-life care and treatment. Peddars Way was a palliative care/end of life unit which supported patients in their last few days of life if they wished to remain in hospital. The division had seen an increase in use and choice of staying within the unit or where they were unable to be discharged from QEH at point of end of life.

Medical wards were supported by occupational therapists and physiotherapists to support timely discharge planning, mobility and rehabilitation. Patients and families, we spoke to told us that they were involved in treatment plans and goals for their admission.

We saw evidence of choice of types of sedation used and offered for patients attending the endoscopy service.

We scored the service as 1. The evidence showed significant shortfalls. The service did not listen to or understand people’s needs, views and wishes. Evidence did not show staff responded to people’s needs in the moment or act to minimise any discomfort, concern or distress.

Staff did not always deal with specific risk issues, such as falls or pressure ulcers and care planned for these accordingly. We reviewed patient records and divisional audit data that showed risk was not always mitigated resulting in avoidable harm. For example, a review of 10 care records showed that 6 patients did not have pressure‑ulcer risks mitigated in line with policy

Documentation was not always contemporaneous or in line with policy which meant we were not assured that staff always identified and responded to the changing risks to patients. For example, pain scores were not completed to demonstrate staff prioritised patient comfort and responded quickly when help was needed.

Patients told us when they called for assistance staff were not always able to respond in a timely manner. During the assessment we found that call bells were answered and that staff were responsive to people’s needs. A review of reported incidents showed at time, low staffing levels meant healthcare professionals could not respond to patient’s needs when acuity was high and when there were patients requiring enhanced care.

We scored the service as 2. The evidence showed some shortfalls. The service did not always support staff to promote the wellbeing of their staff. They did not always support or enable staff to deliver person-centred care.

Staff did not always feel supported by leaders and managers. For example, escalation of lack of staffing did not always result in additional support to manage high acuity and demands on them. Staff also felt incident reporting was used as a punitive measure against them and incidents were not always used to support 1:1 learning for medical staff.

Vacancies within speciality areas and posts meant that this put additional stress on the existing workforce. Staff told us this had a direct impact on them as they could not deliver a standard of care that they strived for. Incidents reviewed also demonstrated that staff were unable to provide timely care for patients due to a lack of staffing and acuity of patients.

Staff had access to support for their own physical and emotional health needs through an occupational health service. Employee assist programme and flexible working policy was used by staff and managers to support the wellbeing of their staff.

Recent 2025 NHS staff survey data showed the division scored below the rest of the organisation in 8 out of 9 for the people promise element. Results showed that across all wards scores were lower than the rest of the organisation for ‘we are safe and healthy and morale’. This indicated that staff had low morale, felt unheard and unsupported in their work.

Most staff we spoke to onsite told us they felt positive and proud to work for the provider and within their teams. Many had been long‑standing members of the division, describing good opportunities for development and progression.

The service’s staff sickness and absence were 5.9% which was higher than the trust target of 4.5%.

The provider recognised staff success within the service, for example, through staff recognition awards. We saw evidence of staff from all grades and disciplines who had been acknowledged for a variety of reasons.

There were a number of staff networks such as REACH (Race, Ethnicity, Culture & Heritage) and ENABLED (Disability & Neurodiversity). The Trust delivered a comprehensive, year‑round programme including Menopause support and Mental Health and Suicide Prevention awareness campaigns.