King's College 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 the service involved people and treated them with compassion, kindness, dignity and respect. At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were treated with kindness and respect and involved as partners in their care. Staff worked hard to meet people’s immediate needs. Patients provided positive feedback about staff.

However, patient dignity was not always preserved for patients receiving care in the corridor. Staff faced high levels of violence and aggression from patients, which affected their wellbeing and morale.

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.

Patient dignity was not always maintained due to overcrowding in the department. However, the service treated people with kindness, empathy and compassion. Staff treated colleagues from other organisations with kindness and respect.

Due to systemic pressures on the service, patient dignity was not always maintained. We observed one patient in a trolley in the corridor who was receiving care dressed only in their underwear. We discussed this with service leaders who told us that staff should have used temporary dividers and that they would reinforce this with staff. Patients in chairs in the corridor of the majors area did not have a surface on which to eat the food provided to them. We observed one patient eating their lunch on the lid of a bin.

Staff treated patients kindly. We spoke with 10 patients and 2 family members of patients. They provided positive feedback about their interactions with staff. They told us that staff introduced themselves before providing care and that they listened to them. One patient told us, “I would never go to another hospital”.

We observed many positive and kind interactions between staff and patients. Nursing staff greeted and introduced themselves to every patient arriving by ambulance. We observed patients being triaged and noted that nurses providing this service were considerate and understanding. Paediatric staff were kind to children and explained to them what was happening.

During our initial visit in May 2026, the service did not have enough toilets for the number of patients in majors. There was 1 toilet available for 2 patients in mental health rooms, but otherwise all patients in majors had access to only 1 toilet. This resulted in long queues and patient frustration. We saw 1 patient lose control of their bowels while in the corridor queuing for this toilet, which did not preserve their dignity. At this time, the provider was already in the process of building a second toilet in majors. On our return in June 2026, the building work was complete, and the second toilet was functioning. We saw no patient queues on this visit.

We did not look at Treating people as individuals during this assessment. The score for this quality statement is based on the previous rating for Caring.

We did not look at Independence, choice and control during this assessment. The score for this quality statement is based on the previous rating for Caring.

The service listened to and understood people’s immediate needs, views, and wishes. Staff responded to people’s needs and acted to minimise any discomfort, concern, or distress.

The service provided food and drinks, including hot food options, to patients in cubicles and in corridors. Patients told us that they received enough food. Water tanks were available in waiting rooms for hydration, but we saw that they didn’t always have cups available.

Staff were responsive to the mobility needs of patients. Patients requiring wheelchairs told us that staff got these for them. We saw reception staff collect wheelchairs from a porter’s office to assist patients who were struggling to stand when booking in. Reception staff also assisted patients who struggled using the electronic booking-in system and instead booked them in directly.

The service used ‘flags’ on its electronic patient record system to alert staff of immediate patient needs. Examples of flags we saw included learning disability flags and flags informing staff of previous episodes of violence and aggression.

Staff often felt unsafe at work due to high levels of violence and aggression from patients, which was partly due to long waits for patients waiting for mental health beds. However, the service cared about and promoted the wellbeing of staff, and systems were in place to reduce the risk violence and aggression posed to staff.

Staff faced very high levels of violence and aggression from patients, a significant portion of which was from mental health patients waiting for a mental health bed. Many members of staff emphasised how they did not feel safe at work and how this impeded their work. We saw examples of violence and aggression while we were on site. For example, a member of staff was bitten by a patient during our May 2026 visit. The service only provided us with incident data for patient safety incidents (which did not include violence and aggression incidents), but senior staff estimated 250 incidents of patient violence and aggression were received each month. Staff members told us the real number was likely to be much higher because low-level incidents were not always reported.

These issues were reflected in the 2025 NHS Staff Survey, in which 119 Emergency Department (ED) staff (including staff at another ED run by the same trust) answered questions about their work. Over the previous 12 months, 60.5% of ED staff reported experiencing physical violence from members of the public, 82.4% reported experiencing harassment, bullying or abuse from the same group, and 33.1% reported experiencing unwanted behaviour of a sexual nature from the same group. Staff were more likely to report they found their work emotionally exhausting (91.5% said this occurred sometimes, often or always) or to feel burnt out (81.4% for the same responses) than the trust average. However, staff we spoke with told us that they enjoyed working in the department despite these issues.

The service had systems in place to reduce the risk violence and aggression posed to staff. Staff wore personal alarms, which they could activate if in danger. These automatically connected to sensors in an ED-wide system, so it was clear in which area an alarm was pulled. Security staff wore body cameras so that episodes of aggression and restraint could be reviewed. Patients with a history of violence or aggression had a ‘flag’ added to their electronic patient record so that this could be easily identified at the start of the next presentation. Psychology support was available to staff, including security, and this was promoted through newsletters. The service had a ‘violence and aggression’ lead clinician who oversaw work to reduce the impact of violence and aggression on staff and who worked with police and ambulance services. However, we were told that trust-wide initiatives that were intended to reduce the risk of violence and aggression were not working as intended. For example, a senior member of staff told us that exclusion panels (meetings in which senior trust staff can decide to deny a patient access to non-life-saving medical services following incidents of violence) were often delayed or not held. This led to ED staff having to continue to treat patients that had been extremely aggressive or violent towards them (we were given an example of a patient who had sexually assaulted a member of staff, for whom staff had not been able to get an exclusion panel discussion).

Staff within the service ran social activities to promote wellbeing. Examples included volleyball and running clubs for doctors, and study groups open to all members of staff.

The service had a positive reporting system named ‘King’s Stars’ which allowed staff to nominate colleagues they thought had provided exceptional care. Staff had submitted 40 reports from May 2025 – May 2026, highlighting rapid diagnoses and patience in difficult situations.

Resident doctors within the department took part in self-rostering, which allowed greater flexibility in working times.