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 had the best possible outcomes. We checked that people’s care, support and treatment reflected their needs and ensured 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 did not rate this key question. At this assessment we have rated it 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 service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. Staff listened to people and assessed their health, care and communication needs in line with good practice. They used information from assessments to plan care that met people’s needs and supported good outcomes.

Healthcare assistants completed height and weight checks immediately after check‑in, ensuring baseline observations were not delayed. Clinicians then carried out comprehensive health assessments so that people’s physical and clinical needs were fully explored.

Translation support was available in more than 170 languages, enabling effective communication with people who spoke different languages or dialects. This helped ensure assessments were accurate and inclusive. Translation services were clearly promoted in the department, and information resources encouraged people with communication needs or autism to share their preferred communication style so assessments could be tailored to individual needs.

Care plans reflected the needs identified during assessment, and people were routinely reassessed at each appointment to identify any changes in their health, preferences or support needs. Staff encouraged people to recognise and report changes in their own health, which supported timely help‑seeking and promoted independence.

A review of 15 care documents showed they were clear, complete and accurately recorded, demonstrating a consistent approach to documenting assessed needs and updating care plans appropriately.

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.

Nurses in the OPD clinics ensured protocols aligned with recommendations from the National Institute for Health and Care Excellence (NICE) guidelines. Staff took part in clinical audit, including the Central Venous Access Devices (CVAD) audit, which showed 100% compliance across key standards for aseptic technique, line care and IPC, demonstrating consistent adherence to evidence-based processes.

The service had access to a broad range of specialists who supported patients across OPD pathways. Active multidisciplinary (MDT) working across clinics, with input available from doctors, nurses, allied health professionals and pharmacy teams to ensure coordinated care.

Staff were trained and competent. They completed mandatory subjects such as safeguarding, infection control and health and safety, and nurses described gaining wider clinical skills by working across different OPD specialties. All new staff completed corporate and local induction, and nursing staff were aware of their responsibilities to maintain current professional registration and revalidation. Pain relief was available when minor procedures were undertaken, for example, in dermatology clinics, and staff checked that patients were comfortable and informed.

However, we found several trust policies, including the dress code, discharge, RTT access, falls prevention and patient identification policies were out of date. Although the impact on OPD was low, these gaps created a risk that staff might not be working to current clinical guidance and the trust not routinely checking policies against national standards.

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

The service demonstrated good practice in how staff and services work together. Staff described strong teamwork within their own clinical areas. They held regular huddles two to 3 times a week to share updates, discuss incidents to share learning, and they used these meetings to coordinate care and respond to issues arising during clinics.

Teams reported effective working relationships with consultants and specialist nurses, with clinicians readily available for advice and support when needed. Some specialities held their own multidisciplinary meetings, which included senior nurses and consultants, and staff were invited when their patients were being discussed.

Handover within teams was clear and took place through regular huddles and direct communication between nurses, HCAs and medical staff. Staff also described good links with site managers, safeguarding teams and other teams involved in patient flow or onward referral, helping ensure coordinated care when patients needed admission or additional support.

However, staff did not always experience consistent communication between specialties, and some teams described gaps in cross‑specialty working that affected information flow across OPD pathways. Staff also said that reception changes and the removal of local desks increased the number of patient queries directed to clinical teams, adding pressure and affecting effective handover in busy clinics.

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.

Staff supported people to live healthier lives by offering clear health information and signposting patients to reliable support services. Posters in OPD areas encouraged patients to check their blood pressure during their visit, promoting early detection of cardiovascular risk. Staff also provided accessible dietary guidance, including information for people using GLP‑1 weight‑loss or diabetes medicines, helping them manage side effects safely and maintain a healthy diet

Patients were supported to stop smoking through the Lewisham Stop Smoking Service, which offered free, specialist behavioural support, nicotine‑replacement therapies, and e‑cigarette‑based quitting options. OPD staff signposted patients to local drop‑in clinics, phone support and culturally tailored resources such as the Ramadan‑focused smoking‑cessation flyer.

People living with or beyond cancer were directed to the “Next Steps” programme, a structured course providing advice on nutrition, fatigue, emotional wellbeing and self‑management following treatment. Staff also made accessible health information available for specific groups, including an easy‑read children’s blood test guide and antenatal notes designed for people with learning disabilities, helping patients understand their care, appointments and screening needs.

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

The service demonstrated good practice in improving outcomes. Audits were routinely carried out across OPD services to check whether staff were following good clinical practice. When audits identified areas that needed improvement, actions were agreed and reviewed at re‑audit points, showing a clear cycle of monitoring and improvement. Each clinical service unit was responsible for its own programme of clinical audits and benchmarking, which helped ensure that specialty‑specific risks and outcomes were monitored by the most appropriate teams.

The patient booking team used effective digital systems to monitor clinic attendance, identify missed appointments and improve the use of clinic slots. Staff also used electronic systems to access investigation results promptly, including blood test results, which helped them provide timely information and support to patients. This use of technology enabled staff to respond more quickly to changes in a patient’s condition and supported safer clinical decision‑making.

The service told people about their rights around consent and respected these when delivering person-centred care and treatment. They assessed mental capacity appropriately and acted in people’s best interests when required.

Staff supported people to make their own decisions about their care. Clinicians explained the purpose of appointments, the nature of examinations and any proposed procedures, ensuring patients had enough time and information to understand their options before agreeing to treatment. We observed doctors clearly explain each step of an examination and apologise for delays before checking whether patients were happy to continue.

Staff appropriately assessed and recorded mental capacity for people who may have impaired capacity. Assessments were decision‑specific and reflected each person’s ability to understand, retain and weigh information at the time decisions were made. When patients lacked capacity, staff acted in their best interests, considering their wishes, feelings, culture and personal history, and involving relatives or carers where appropriate. Staff also followed the trust’s escalation processes for more complex cases.

Chaperones were available for intimate examinations, and staff understood when to offer one. We saw good practice where clinicians asked patients whether they wanted a chaperone and confirmed they were comfortable with the person provided. On occasions where a chaperone was brought in automatically, staff corrected this when prompted and ensured the patient’s preference was respected.