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

Staff provided evidence-based care and treatment in line with current legislation, good practice and standards. Staff worked well across health care disciplines and with other agencies to care for patients. They supported people to live healthier lives. Staff obtained consent before they delivered care, support, or treatment.

However, audit outcomes were variable. Two recent national audits showed that the hospital performed better than expected in one while it performed worse than expected in another.

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.

Patients were involved in the assessment of their needs. Assessments considered patients’ health, care, wellbeing, and communication needs, to ensure they received care or treatment which achieved good outcomes. Staff had access to various tools and information to assess patients’ needs. This included current and past medical history, health, and care passports (such as ‘This is me’ booklets for dementia patients), communication booklets and communication tools. Staff also had access to translation services when necessary to ensure that patients were involved in their care.

The electronic system used by the service flagged patients with additional needs. This included patients with complex or communication needs, among others.

Staff routinely assessed patients’ psychological and social needs and reviewed this in preparation for discharge.

Specialist support from staff such as dietitians was available for patients who needed it. We saw patients were regularly reviewed by dietitians and had dietary supplements and specific diets prescribed as required.

We saw that patients had their meals provided to allow for religious, cultural, and personal preferences.

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.

Patients received care, treatment, and support that was evidence-based and in line with good practice standards. This included individualised risk assessments to support holistic patient care.

Staff followed policies to plan and deliver care according to best practice and national guidance. Guidelines were developed in line with the National Institute of Health and Care Excellence (NICE) and national evidence-base practice.

Clinical guidelines and policies were available on the hospital intranet. We reviewed a sample of the hospital policies and found they were compliant with current guidance and evidence-based practice. However, we noted that two of the six policies we reviewed during our inspection were out of date. (This included the adult safeguarding policy (3 August 2024) and complaint review policy (23 November 2024). Following our inspection, the trust provided us with copies of eight policies including safeguarding adult and complaint review policy. Those that were out of date had been updated.

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.

Staff worked across health care disciplines and with other agencies when required to care for patients. We saw that information was appropriately shared with community teams such as GPs, district nurses and care homes.

Plans for transition, referral and discharge considered people’s individual needs, circumstances, ongoing care arrangements and expected outcomes. 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 held multidisciplinary meetings to discuss patients and improve their care. Staff told us nursing staff, allied health professionals and consultants attended these meetings.

Patients had their care pathway reviewed by relevant consultants.

The service supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

People were supported where they could to manage their own health, care, and wellbeing needs by staff who understood their needs and preferences.

Staff assessed each patient’s health on admission and provided support for any individual needs to help them live a healthier lifestyle. Patients had access to therapy staff (including physiotherapists and occupational therapists) to assist with their recovery where necessary.

People were encouraged and supported to make healthier choices to help promote and maintain their health and wellbeing. People were provided relevant information to live healthier lives. Patients had access to leaflets for a range of health-related issues.

Patients had access to smoking cessation services from the Tobacco Dependence Team. The team offered treatment and support to patients who smoked while an inpatient at the hospital. They also provided regular telephone support on discharge and referral to community stop smoking services.

The service provided respiratory specialist support to patients with chronic obstructive pulmonary disease in two local boroughs. This was carried out through liaising with wider community teams including district nurses, therapists, social services, GPs, and care agencies.

The service routinely monitored people’s care and treatment to continuously improve it.

Staff monitored care effectiveness and used findings to improve outcomes. Managers and staff conducted repeated audits and quality improvement projects to improve patient outcomes.

The trust had implemented a new electronic patient record system that enabled all staff members to contribute to care planning, treatment and diagnostics. For example, the platform enabled staff to record medical photographs of pressure areas on admission and compare these with weekly updated photographs to track improvement or identify a change in treatment required.

Patients at risk of falls had risk assessments produced by staff to follow and to mitigate the risk.

One of the quality improvement projects undertaken in the last year was an acute speciality medicine falls project. The project reviewed falls data from March 2024 to February 2025. This showed there were 621 falls across 13 wards during the period. The project outlined common investigation themes including staffing, documentation, and patient cognitive impairment, among others. An action plan was set out to improve patient care and reduce the number of patient falls. This included staff education and training, personalised care plans, and collaborative risk assessments. Our review of records showed the electronic record system highlighted patients at risk of falls.

Staff used risk assessments to identify patient needs and their preferred options. Doctors and multidisciplinary teams assessed patients on daily ward rounds and meetings. Care plans were clearly identified and documented. Patients’ individual needs were considered and implemented.

Medical care services participated in a range of local and national audits based on clinical specialities. The hospital performed better than expected in the National Lung Cancer Audit. Local audit outcomes for the management of patients with acute coronary syndromes were variable and several learning points were identified. This included improvement in recording relevant risk assessments and discussion with relevant teams.

The patient outcomes team monitored mortality through the use of new online death verification recording and the completion of a structured judgement review (SJR). An SJR was an independent review of a death to determine if it was avoidable or whether there were any shortcomings in the care and treatment provided. It also referred to good practice which was identified. The trust required an SJR for 100% of deaths for patients with certain conditions and a minimum of 20% in other categories.

The service told people about their rights around consent and respected these when delivering person-centred care and treatment. However, there were low completion rates for training around Mental Capacity and Deprivation of Liberty Safeguards.

People understood their rights around consent to the care and treatment they were offered. People told us staff explained care and treatment options and gained verbal consent for physical assessments.

We observed patients being supported by staff, who took time to explain treatments and options available to them.

Staff we spoke to understood the relevant consent and decision-making requirements of legislation and guidance, including the Mental Health Act and Mental Capacity Act 2005, and they knew who to contact for advice.

Staff could describe and knew how to access the policy and get accurate advice on the Mental Capacity Act and Deprivation of Liberty Safeguards (DoLS).

Most staff had completed Mental Capacity Act training. Nursing and allied staff had a completion rate of 90.3% and 90.9% respectively. However, we noted low completion rates (65.5%) for medical staff.

The service was not assured all staff had the appropriate knowledge to support patients with dementia and delirium or needing any deprivation of their liberty. Dementia and delirium training tier 2 included DoLS training for all nursing staff within acute and speciality medicine. Sixty-seven per cent of nursing staff had completed dementia and delirium training.