King's College Hospital

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

We looked for evidence that people and communities were always at the centre of how care was planned and delivered. We checked that the health and care needs of people and communities were understood, and they were actively involved in planning care that met these needs. We also looked for evidence that people could access care in ways that met their personal circumstances and protected equality characteristics.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s needs were met through good organisation and delivery.

We have not awarded this service a score for Responsive.

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

The service made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

Children and young people could receive the most appropriate care and treatment for them. The service made reasonable adjustments where necessary, such as providing flexibility in patient appointments for patients who struggle with waiting or crowded areas. Staff were focused on delivering patient centred care and respected the individual needs of each child and young person. Patients were treated as individuals with treatment and care being offered in a flexible way and tailored to meet their individual needs. All staff we spoke with could explain the additional support available for children and young people with learning disabilities and autism.

Children and young people’s care plans fully reflected their physical, mental, emotional and social needs. The patient records we reviewed reflected that individual needs were assessed, and care planning was informed by this.

Children, young people and their families understood their condition, care and treatment options and any advice provided. Staff understood how to meet the information and communication needs of patients with a disability.

The service had access to an interpreting service for patients whose first language was not English and sign language interpreters if needed. This was available by telephone and visually via a portable screen.

The trust did not have a policy for learning disabilities at the time of the inspection. However, the policy for learning disabilities including reasonable adjustments was being developed for ratification.

The service understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

People’s care and treatment was delivered in a way that met their assessed needs and was coordinated and responsive. There was continuity in children’s care and treatment because services were flexible and joined up. Services ran joint clinics and children and young people on complex pathways would have a named consultant who had oversight of their care and would be a point of contact for patients and families. This improved the patient pathway by providing continuity in their care. Staff also told us there was greater coordination and collaboration with community health teams to facilitate babies going home directly from NICU.

Leaders also told us readmission rates to the PICU were low and attributed this to the work of the iMobile team. Staff were aware of how to escalate risks that could affect people’s safety, such as staffing and bed capacity issues. There was daily involvement by ward managers, clinical leads and matrons to address these risks.

The children’s outpatient department had an appropriate waiting area and sufficient treatment and consultation rooms. The service operated joint clinics for some services to improve the patient pathway for children and young people with complex illnesses. Clinics were scheduled in advance so care and treatment could be effectively planned and delivered.

The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Children and young people who used the service, and their family, and carers were provided with information that it is accessible, safe and secure and supports their rights and choices. We observed staff providing people with appropriate information about their care and saw this reflected in patient records. Most information was given verbally however we saw some leaflets available for people to take away.

Children and young people’s individual needs to have information in an accessible way were identified, recorded, and shared. These needs were met and reviewed to support their care and treatment in line with the Accessible Information Standard. People could expect information to be tailored to their individual needs. This included making reasonable adjustments for disabled people, interpreting and translation for people who did not speak English as a first language and for D/deaf people who use British Sign Language.

Information gathered about patients or others was held in secure systems which met data protection legislation requirements. Access to computerised patient records was password protected with a secure login. Staff we observed were aware of closing patient records on computers they were using before they walked away to maintain patient confidentiality.

The service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

Not all parents and relatives we spoke with knew how to share feedback and ideas, or raise complaints about their care, treatment and support. However, we saw signage encouraging people to give feedback with QR codes which people could scan to give digital feedback and contact information was displayed for the patient advice and liaison service. We were also informed of a young person’s group which allowed children to engage and have a voice.

Children and families were involved in decisions about their care. Staff told us they had parent led ward rounds in the NICU. This encourages parents to tell staff about their baby’s journey and to be actively involved in the decision making about their care.

Staff understood how to handle complaints and could provide examples of feedback from complaints. Complaints were used to improve care and treatment where possible. However, at the time of the inspection the complaints policy was out of date with a review date in November 2024.

We were given examples of action that had been taken following a complaint. The service treated concerns and complaints seriously, investigated them and shared lessons learned with all staff. Between February and April 2025 there were 7 complaints made within child health. The main theme from the complaints were around communication and attitude of nursing staff.

The service did not always make sure that people could access the care, support and treatment they needed when they needed it.

Between April 2024 and March 2025, the average percentage of people treated within 18 weeks at the trust was 70.4%. This was below the NHS standard of 92% of patients receiving treatment within 18 weeks, but better than the average (49.7%) across all providers in England for the same period. Data we reviewed between April 2024, and March 2025 showed an overall improving trend in reducing waiting lists for treatment within the service. However, waits over 52 weeks in the paediatric ophthalmology service and the paediatric dentistry service remained high within this period. The paediatric dentistry service was especially challenged, as the volume of the waiting list over 52 weeks showed a month on month increase from November 2024. Leaders told us patient tracking list meetings took place to identify delays in procedures and diagnostics, allowing senior managers to escalate concerns and ensure timely patient care.

Children and young people could generally access care, treatment and support when they needed. Arrangements to admit, treat and discharge people were in line with most national standards. For example, children and young people had access to rapid access clinics which could be accessed the same day or next day, in line with Royal College of Paediatrics and Child Health standards. The NICU team also had a process for babies to be reviewed the next day.

Managers and staff worked to make sure patients did not stay longer than they needed to. Leaders told us they had meetings to discuss and address the flow and management of beds within the service which had brought about improvements such as discharging babies home from the NICU. The flow meetings took place every weekday and were attended by the hospital at home team and safeguarding team once per week. The Hospital at Home service facilitated faster discharges for patients by allowing patients to get the care they need at home safely and conveniently, rather than being in hospital.

Staff told us of improvements in the length of stay in the NICU, however they recognised this remains a challenge due to difficulties repatriating babies to other units and sometimes due to delays with internal transfers. Staff also told us the Short Stay Unit was intended to care for patients for up to 48 hours, however there were occasions when the length of stay significantly exceeded this due to factors such as social care delaying discharge.

People who used the service told us they received treatment in a prompt and timely manner. They told us they were given clear information around appointment and treatment times. Although some people told us they sometimes experienced long waiting times in the outpatient department.

We saw there were systems in place to ensure appointment cancellations were communicated and rescheduled efficiently. The service ensured children, young people, and their families who did not attend appointments were contacted. We saw there was a process in place to ensure each missed appointment was followed up to safeguard children and young people. This included offering new appointments, informing the family and GP in the first instance and informing the safeguarding team and completing a safeguarding referral on subsequent occasions.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

There was no indication that children and young people experienced inequalities in experience and outcomes. Data from the children and young people’s experience patient survey showed of the 80 questions answered by parents and children the trust performed the same or better than other NHS trusts.

The service sought to remove barriers to care and improve people’s experience. There was a regular forum for all children and young people to be a part of. This provided an opportunity to suggest changes and make improvements to the service.

Most staff (96%) across the children and young people’s services had completed mandatory training in equality, diversity and human rights. Staff told us they treated people equally and without discrimination and were able to provide examples of how they respected the individual wishes of people with protected characteristics.

However, audit data we reviewed showed parents whose primary language was not English were 3 times more likely not to have parental concern documented as part of PEWS. We saw that the audit results would be shared to build an awareness of the findings and ward staff were encouraged to document the concern conversations, although more robust actions would be necessary to assure the service that parental concerns were fully explored.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

Children and young people and their families and carers were supported to make informed choices about their care and staff discussed their long-term care and treatment plans, expectations and outcomes with them. Staff told us they used advanced care plans for neonates and children’s palliative and end of life care, and we saw peoples’ preferences were considered.

We reviewed the trust Do Not Attempt Cardiopulmonary Resuscitation Policy which included decision making considerations for children and young people, however the policy was out of date and due for review in October 2023. Staff completed end of life care awareness training to manage such patients as part of mandatory training. However, compliance with this training module was especially low amongst medical staff at 64.8%.