King's College 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 requires improvement. At this assessment the rating has changed to 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.

Women were involved in the assessment of their needs and were supported by staff where needed to maximise their involvement. Women had access to specialist clinics where required, including those who were subjected to, or at risk of, female genital mutilation and those who had specific medical needs, such as sickle cell disease.

Staff understood and applied the policy on meeting the information and communication needs of women with a disability or sensory loss.

Women had access to a pelvic health clinic, which provided additional support and education to women at risk of pelvic floor dysfunction.

The service held parent education sessions for Black, Asian and minority ethnic couples.

Managers made sure staff, women, loved ones and carers could get help from interpreters or signers when needed.

Staff discussed women’s ’s care needs at daily handover meetings.

The service had in place maternity triage guidelines, which were in date and had clear guidance to ensure women received appropriate care when they presented to triage on the labour ward. This was dependent on clinical urgency and reviews by obstetricians, to determine the appropriate escalation point to take according to the needs of the women and birthing person.

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 service had relevant guidelines and protocols in place and in line with national guidance. For example, policies and procedures were available relating to diagnostic testing for amniocentesis for women, of which the policies were version controlled and in date. This also applied to other areas, including the safe management of babies born to mothers who were Hepatitis B positive. The service monitored policies via clinical audits and risk and incident monitoring meetings.

The service carried out regular clinical audits relating to various areas such as antenatal and postnatal care, diabetes in pregnancy, NHS inpatient survey results and CQC maternity survey results. The service benchmarked their survey results and performance against all acute providers nationally, which were largely found to be in line with the national average.

Staff ensured that women were informed about their anaesthetic and pain relief options in advance and staff made women aware about potential risks and side effects, including post-operative pain management. The service carried out regular pain relief audits to evaluate patient satisfaction. From the audit carried out in April 2025, all respondents confirmed that they were informed about their anaesthetic and analgesia options in advance and were made aware of potential risks and side effects. A high level of satisfaction was reported, particularly with postoperative analgesia (100% satisfaction) and the clarity of communication before and after the anaesthetic care (100%).

The service had quality improvement (QI) initiatives in place, for instance the safe and effective use of opioids in postpartum women following caesarean section. The service had also launched the ‘Baby Friendly Initiative’, which, is an evidence based external accreditation programme to provide optimal infant feeding support. The service had achieved stage 1 of the accreditation process.

The service 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.

The service worked well across teams, services and with external stakeholders to support women, birthing people and babies. Staff had access to the information they needed to appropriately assess, plan and deliver people’s care, treatment and support. For example, staff had access to local GP and health records. This was of specific importance to staff when the patient had mental health needs, long term condition, complex needs or there were safeguarding or child protection concerns.

There was a good multidisciplinary team (MDT) approach to patient care with assessments, planning and coordination being key to effective care and treatment. Staff held regular and effective multidisciplinary meetings and joint MDT clinics to discuss women, provide treatment and improve their care. There was good multidisciplinary working between staff, resident doctors and consultants. We observed good team briefing meetings in theatres, ward rounds and staff handovers. The handovers were also used as a teaching opportunity for staff.

There was good multidisciplinary working in the fetal medicine unit (FMU)and the maternity staff worked well with counsellors and other specialist teams in the diagnosis, support and delivery of care.

Information was shared between teams and services to ensure continuity of care. The maternal medicine team held regular meetings related to elective caesarean sections. These meetings discussed high-risk pregnancies, including conditions such as liver disease, cystic fibrosis and sickle cell disease, which were attended by the multidisciplinary team including anaesthetists, physicians, obstetric doctors and midwives.

All MDT staff we spoke to spoke highly of each other and the focus on collaborative care to improve care and patient outcomes. Staff including the midwives and support staff told us they were treated as professional equals by other MDT staff, medical staff listened to midwives opinion and which helped inform joint decision of plan of care.

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, reduce their future needs for care and support.

The service had relevant information promoting healthy lifestyles and support on wards. Staff assessed each woman’s and birthing person’s health when admitted and provided support for any individual needs to live a healthier lifestyle.

Staff supported women to live healthier lives – for example, through participation in smoking cessation schemes, providing infant feeding support and perinatal mental health support. Infant feeding information was displayed throughout the maternity service. Women we spoke to told us staff had supported them with their choice in how to feed their baby including breastfeeding support and how to prepare bottles and formula feed.

The service had a midwife in post who provided smoking cessation advice to women. Women who smoked were given stop-smoking support and treatment at their antenatal appointments, so they were given support to reduce or stop smoking. If they had a partner who smoked, they were also offered a referral for stop-smoking support and treatment.

The service also engaged with the South East London integrated care system (SEL ICS) to provide foreign language parent education antenatal class and public health workstream that focused on health needs and inequality. The public health workstream covered areas such as folic acid intake, complex social factors, pre-conception health, healthy lifestyle and obesity and infant feeding.

The service also promoted events such as Black Maternal Mental Health Awareness Week, an initiative raising awareness about the mental health challenges faced by Black women.

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.

Incidents were appropriately referred to the Maternity and Newborn Safety Investigations (MNSI) team and findings were discussed by the senior leadership team. There were 7 referrals made to MNSI between April 2024 and March 2025. These referrals were reviewed at maternity governance meetings once submitted to the trust to ensure that actions and learning were picked up and actioned appropriately.

Following the trust’s exit from the NHS England Maternity Safety Support Programme (MSSP) in December 2024, the trust received a visit by the regional team and the Southeast London (SEL) Local Maternity and Neonatal System (LMNS). No safety recommendations were made, and the trust received positive feedback focused on evidence presented for meeting MSSP exit criteria and sustainability plan.

The Mothers and Babies: Reducing Risk through Audit and Confidential Enquiries (MBRRACE) report data for Kings College Hospital, published in February 2025, showed that compared to similar trusts, stillbirth rates remained average, and 15% lower than the national average. The trust’s rate of unexpected neonatal unit admissions remained consistent with the 6% KPI across both Denmark Hill and Princess Royal University Hospital sites (4.7% at DH, 4.05% at PRUH). The service had a significantly lower percentage of large for gestational age (LGA) babies compared to the national average, indicating better control over outcomes in diabetic pregnancies. The service also achieved better results compared to the national average, with a lower percentage of preterm births, indicative of effective ‘birth optimisation’ programme.

The maternity service had fully implemented the Saving Babies’ Lives Care Bundle Version 3, which is part of the national initiative to reduce stillbirths and neonatal deaths.

The trust had carried out recent audits on the induction of labour, and the trust was committed to improving effectiveness, learning and outcomes for women.

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

People we spoke with during the inspection were aware about the importance of consent.

Staff understood how and when to assess whether a woman or birthing person had the capacity to make decisions about their care. Staff made sure women consented to treatment based on all the information available. Staff gained consent from women for their care and treatment in line with legislation and guidance, and clearly recorded consent in the women’s and birthing person’s records reviewed.

The service had completed several audits looking at consent and whether this was appropriately documented by staff, including recent audits relating to elective caesarean sections. The risks were fully explained to women and these were clearly documented. The consent audit results and review of incidents, complaints and CQC feedback did not highlight any serious systemic problems relating to consent. No Trust-wide improvement actions were identified, as local areas identified actions and recommendations to improve their practice where needed. The audit results of elective caesarean sections were that the majority of women had regional analgesia as per NICE guidelines.

The service also carried out audits within the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS), to support best practice in MCA and the best interests decision-making of an individual.