King's College Hospital

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• 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 the service met people’s needs and that people and communities were 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 to meet their needs. We also looked for evidence people could access care in ways to meet their personal circumstances and protected equality characteristics.

At our last assessment we rated this key question as requires improvement. At this assessment the rating has changed to good. This meant people’s needs were met through good organisation and delivery. However, we did find ongoing issues with access and referral to treatment times that were well below standard and not consistently in line with national averages.

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 evidence showed a good standard. 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.

Patients told us their needs and preferences were considered. Patients spoke positively about how they were treated by staff and how procedures were explained clearly.

Patients were treated as individuals with treatment and care being offered in a flexible way and tailored to meet their individual needs. Staff could explain the additional support available for people with learning disabilities and dementia.

Staff understood how to meet the information and communication needs of patients with a disability. The patient records we reviewed showed that individual needs were assessed, and care planning was informed by this. We also saw that additional tools were available to staff to aid communication. This included the use of equipment such as dementia clocks which made it easier for people with dementia to read the time and date. We also saw that hospital passports were consistently used for patients with a learning disability and autism. The passports contained information about likes, dislikes and reasonable adjustments to ensure people were comfortable and cared for in a way that suited their individual needs.

The service had access to an interpreting service for patients whose first language was not English and sign language interpreters if needed. The service used a mobile interpreter service where staff could access live interpreters using video or audio services. Data provided by the service showed that the completion of interpreter and signer support requests overall were between 99% and 100% between April 2025 and March 2026.

Staff said care was reviewed with patients to enable changes where needed. We observed positive interactions between staff and patients across theatres, recovery, imaging and outpatient areas.

We saw that staff understood people’s needs and provided appropriate care and treatment. Staff received mandatory training in equality and diversity, dementia awareness and learning disability and autism. Records showed most staff had completed this training.

There was mental health, learning disability and dementia support services for patients undergoing surgery. Staff told us they could access specialist staff for support, and this included preparing patients for surgery and providing additional support. We saw that staff spent additional time with a patient with a learning disability, providing additional support when their carer was unavailable to accompany them.

The hospital chaplaincy service was multi-faith and provided spiritual support 24-hours a day, seven days a week. Patients were given a choice of food and drink to meet their cultural and religious preferences.

Staff told us how they made reasonable adjustments for patients based on individual needs and were able to respond to people’s needs and make appropriate adjustments when required. Patients at the end of life were supported by ward staff and the specialist palliative care team when necessary. Patients with poor mental health received support from the mental health team, including one to one care when this need was identified.

Staff on adult wards and in theatres adapted the service to take account of the needs of young people between the ages of 16 and 18. This included ensuring they were accommodated with appropriate privacy, where parents could stay with them and could accompany them to theatre and from recovery as needed. In addition, there was a young person’s service developed within neurosurgery as a result of feedback from patients and family, where a dedicated space was designed for 16 – 24 years old’s.

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

People’s individual information needs and how they could be accessed were recorded within their individual patient record. These needs were met and reviewed to support their care and treatment in line with the requirements Accessible Information Standard. People had information 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 deaf people who use British Sign Language. People who had difficulty with reading, writing, or using digital services were supported with accessible information and support as needed. For example, we saw that volunteers were used to support patients who needed it to complete their pre-operative questionnaires.

Staff made reasonable adjustments to help patients access services. There was a 24-hour telephone translation service available for patients and carers and in person interpreters or signers could also be requested. Information leaflets were available in people’s individual spoken language when needed. Easy read information was available for patients with a learning disability.

There was information on ward notice boards about visiting times, staffing, ward performance and how to recognise staff by the uniform they wore. There was also information for patients and relatives on how to complain, chaplaincy services and hospital facilities available to them.

We observed staff providing patients with appropriate information about their care. Patients told us that communication with them was generally good, including information about discharge and follow up arrangements.

Staff made notifications to external bodies as needed. Staff were mostly aware of the storage of confidential information; however, we did see some computer terminals left open. This was raised with leads and action taken immediately to ensure security of information.

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

People we asked knew how to give feedback about their experiences of care and support including how to raise any concerns or issues. The service clearly displayed information about how to raise a concern in patient areas and we saw this in the ward areas we visited.

There was an up-to-date complaints policy and staff knew how to access this and the complaints process to follow.

We were given examples of action that had been taken following feedback. This included adding pain scores to the electronic patient record system following incidents of violence and aggression as it was identified that pain may be a trigger for this. The service treated concerns and complaints seriously, investigated them and shared lessons learned with all staff. The main theme from the complaints was around communication.

The service monitored how complaints were responded to, including where complaints had exceeded the due date for resolution. We saw that in February 2026 division C had no complaints exceeding their due date by more than 12 weeks and 25% exceeded their due date by 4 weeks and that 57% of complaints were within their due date.

We saw that improving response times to complaints was part of an improvement plan. This included a focus on improvements at divisional meetings and care group meetings, with data circulated to leads. We saw evidence of discussions around improvements and a target of only 10% of overdue complaints to be open by the end of April 2026.

Friends and family test responses for the quarter from January to March 2026 showed an average of 94% of patients cared for on surgical wards felt the care they received was good. Each ward compiled an action plan for any areas requiring improvement. This included an example where changes were made to cleaning schedules on one ward in order to improve patient experience.

The evidence showed some shortfalls in relation to access. The service did not always make sure that people could access the care, support and treatment they needed when they needed it.

The service’s performance in surgical referral to treatment times (RTT) was mostly below the England average, and the national 92% standard for RTT within 18 weeks. The 18-week standard was achieved in breast (95%) and endocrine (93%) surgery. Figures for March 2026 showed that general surgery achievement was at 44%, colorectal surgery at 53% and bariatric surgery at 27%. Leaders described ongoing work to improve referral to treatment times. This included work to undertake demand and capacity reviews, implement additional operating lists, improve efficiencies with theatre utilisation and improve cross site management of theatre lists throughout the trust.

We saw some examples of recent improvements. This included an initiative implemented to eliminate the 65+ week waiting list. At the end of 2025 the trust had 6,450 patients waiting for elective surgery. The trust had a target of zero patients on this list by the end of March. Their strategy for elimination included weekend surgical lists over a 3-month period. At the time of our assessment in April, we were told there were 5 patients remaining on the list.

We also saw recent improvements in 52 week waits. For example, in general surgery there had been a reduction from 13.2% to 10.1% between December 2025 and March 2026. For bariatric surgery there had been an improvement from 24.3% to 13.6% and colorectal from 5.5% to 3.8% for the same time period.

The service monitored last minute theatre cancellations of which there had been 80 in the last 12 months. We saw that 40 of these had not been treated within 28 days of the cancellation. This meant there was a 50% breach rate of the 28-day cancelled operations standard where patients are not re-admitted and treated within 28 days of their original operation date.

The service monitored late starts and delays in theatres where there were delays of 10 minutes or more. Data showed that on average 61% of lists were delayed. 78% of late starts were in main theatres and the primary reason for this was incomplete or no consent. In the day surgery unit 48% of lists started late, with the primary cause cited as due to surgeon lateness.

As a major trauma centre (MTC) Kings College Hospital is the central hub for the South East London, Kent and Medway major trauma network. Staff we spoke with told us there were issues with not enough trauma and orthopaedic theatre capacity. They also cited issues with multisite working and transfer delays within trauma and orthopaedics that impacted the flow of patients. For example, we were told that patients with closed fractures would sometimes have their surgery rescheduled several times and could be waiting for up to 3 weeks for surgery, including patients waiting at home.

We viewed a 2024 Get It Right First Time (GIRFT) report that cited 60 – 80 trauma patients outlying into surgical beds and no orthopaedic trauma ward. Recommendations of the report included cohorting patients in the same space and job planning for specialist trauma procedures across 7 days. We spoke with service leads about actions to address the issues raised. They told us that action had been taken to cohort patients within Twining ward, where staff had received training and upskilling to be able to care for patients with higher dependency needs than they were used to. In addition, there was a demand and capacity piece of work being undertaken to review resources and increase trauma capacity. Leads acknowledged that sometimes patients experienced multiple theatre cancellations.

Average length of stay was higher than average for surgical patients at Kings College Hospital. Service leads told us they had strategies in place to reduce the length of stay. The average length of stay for elective admissions was 3 days compared with peer and national averages of 2.8 days. For non-elective admission the average length of stay was 8.9 days compared with peer and national averages of 7.2 days. Actions to reduce length of stay include the roll out of criteria led discharges where a senior doctor sets personalised clinical goals for a patient and when these are met, trained nurses and allied healthcare professionals can discharge the patient without waiting for a medical review.

Staff made reasonable adjustments for patients for example, people with mobility issues were provided with walking aids.

Staff planned for patients’ discharge, including good liaison with care managers and co-ordinators. We saw that safe discharges were planned and recorded in the patient records we reviewed. These included liaison with community services and multidisciplinary discussion and review of patient’s individual needs.

The evidence showed a good standard. 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.

We saw evidence that health inequalities were being considered throughout the service. The trust had a health inequalities programme that included participating in research to better understand and address any inequalities within the local population. We saw that people’s care, treatment and support promoted equality and protected their rights.

We saw evidence that feedback on patient experiences was taken seriously and changes to practice were considered and implemented as a result, to remove barriers to care and improve people’s experience. For example, in response to feedback from a patient’s family, staff recognised there were particular difficulties and barriers for young people transitioning from children to adult services in neurosurgery. As a result, a dedicated young person’s unit was created within Murray Falconer ward. This was designed as a less clinical space with games and space for family members to stay, for young people with complex neurosurgical conditions.

The provider had routinely undertaken equality impact assessments of their policies and procedures to ensure they did not place vulnerable people or people with protected characteristics at a disadvantage. We saw examples of staff supporting patients with protected characteristics, this included staff taking the time get to know a patient with a learning disability. Staff used their hospital passport and discussed their needs with their family. Staff took time where possible to spend with the patient, focusing on their interests and activities to keep them calm and relaxed while in hospital.

Staff were trained in equality, diversity, inclusion and human rights (EDI). We saw that medical, nursing and additional clinical staff groups had all achieved above the 90% in EDI training. Staff completed training in learning disability and autism awareness. Compliance was at 76% due to operational difficulties releasing staff for the face-to-face element of the training. However, there was a plan underway, and all training sessions were fully booked and leaders told us the compliance will increase over time as more staff complete the training as planned.