King's Mill 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

At our last assessment we rated this key question good. At this assessment the rating has remained good.

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.

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.

We did not look at Assessing needs during this assessment. The score for this quality statement is based on the previous rating for Effective.

The evidence showed a good standard. 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.

Staff had access to a comprehensive range of up-to-date policies and standard operating procedures which reflected current practice. Staff had access to guidance around collaboration with multi-agency teams and for delegation of clinical tasks to ensure the right people delivered evidence-based care and treatment. There were numerous clinical pathways which were well known to staff.

Systems were in place to ensure staff were up to date with evidence-based guidance and legislation. Clinical records we saw demonstrated care was provided in line with current guidance. For example, we reviewed the records of a patient who attended with a head injury. We saw care and treatment provided was in line with NICE guideline: Head injury: assessment and early management May 2023. Triage questions were appropriate for the patient and their needs for example, people presenting with emotional needs were properly and sensitively assessed and specialist help sought early.

Staff told us treatment plans were evidence based and monitored for outcomes. Patients care was reviewed and updated, and appropriate referral pathways were in place to make sure that needs are addressed. Staff were able to tell us about when treatment had led to learning following debriefs and mortality and morbidity meetings. This included a trauma checklist designed by a member of staff and a generic trauma booklet both of which improved care for trauma patients following an incident that had occurred.

Patients said they had been offered something to eat and drink. We observed staff offering patients refreshments. Patients were offered a range of food which met their dietary requirements. However, hot food was not generally made available to patients. Senior leaders spoke of how they had sought to get hot food for patients who had been in over 24 hours. We were told that the restriction on hot food availability was in response to an incident that had occurred in the past. No one we spoke with was entirely sure what this had been.

The service worked with others to direct patients to other departments and organisations for patients who did not require emergency care. Within the emergency department there was access to and use of treatment units, frailty services and same day medical and surgical units.

The evidence showed a good standard. 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 had access to the information they needed to appropriately assess, plan, and deliver care, treatment and support in line with people’s individual needs. However, this was often split across paper and electronic records. This meant staff had to review two documents to appraise themselves of the patients’ journey and changes in condition or observations. The service was moving to a new electronic patient record management system, and staff were keen for this to occur. This would enable teams and services to share information more readily.

The service worked well across teams and services to support patients. Leaders told us staff were responsive across the organisation when requested to support the ED. There were specialist teams, such as the psychiatric liaison support team and the substance misuse team who in reached into the department to provide advice and support to the staff working in the ED. The psychiatric team sent staff to undertake initial assessments within 4 hours when called by staff in ED. The internal specialist teams provided support to staff within the emergency department. Staff reported good working relationships with teams who supported the different strands of urgent care such as the Same Day Emergency Care unit and the frailty wards.

Care was coordinated, and everyone involved in their care worked well with together. We observed good quality, kind and compassionate interactions between staff and patients. Information was displayed on notice boards relating to care, advocacy access, information for carers, charities, mental health and feedback on care.

Staff worked well with external partners involved with patients. External partners, such as GPs, community nurses and social workers were involved to enable continuity of care and support for discharge. The ambulance service recognised that the emergency department was slower to implement the sit rep process. This led to slower updates during the day as more patients arrived in the department. However, they described working relationships as strong positive and collaborative. Staff reported good engagement with safeguarding partners.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

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.

Many patients told us that they were not kept up to date with how long they may wait. We noted that there was no signage in the wating room as to how long patients may need to wait to be seen. This was corroborated in the Urgent Emergency Care Survey 2024 results in response to were you kept updated on how long your wait would be rated 2 out of 10. The next survey is currently having data submitted to it.

The trust submitted data to the Royal College of Emergency Medicine (RCEM) three Quality Improvement Programmes (QIPs) in 2025/26. These included self-harm in patients with a mental health issue, care of the older person and time critical medicines. The data submission date had passed a few weeks before our inspection and the department was awaiting the results of their submission. The trust audited practice against evidence-based research. We noted from governance meetings that sepsis was a standing agenda item. We requested the audits presented at the January 2026 meeting however, these were not sent.

There was a joint site assurance meeting(called flow meetings) 5 times a day. We observed a meeting chaired by the Deputy Chief Operations Officer. The focus of the call was to increase capacity and flow in the hospitals, to improve ED capacity and focus on facilitating safe transfers or discharges for patients. The call provided updates from both hospital sites across directorates on staffing, bed capacity and site team updates around discharges and the use of escalation beds. There were updates from estates, infection prevention and control, pharmacy, pathology, psychiatric liaison and community services.

Patients were assessed and triaged in a timely way and escalated as appropriate to their clinical needs. Patients having an initial assessment within 15 minutes of arrival, as per the national standard, was occurring for around a third of patients. Between October 2025 and February 2026, the average time was around 30 minutes. However, this was an improving picture as in November and December 2025 waits were 35 minutes by February 2026 it was reduced to 25 minutes.

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

Patients understood their rights around consent to the care and treatment they were offered. Patients received information about care and treatment in a way they understood and had the appropriate support and time to make decisions. Staff had access to the trust consent policy and understood the relevant consent and decision-making requirements of legislation and guidance, including the Mental Health Act (1983), Mental Capacity Act (2005) (MCA), Deprivation of Liberty Safeguards, and the Children Acts (1989 and 2004). Staff knew who to contact for advice.

Staff had access to the mental health team to support them and patients. We were told the team were responsive and supportive. There were no mental health staff employed within the department. Staff said that the mental health team tried to see patients within an hour but this did not always occur if they were busy. However, staff within the department knew how to gain consent for treatment and work with patients who were detained under a section 2 or 3 of the Mental Health Act.

We observed staff gain consent from patients for their care and treatment in line with legislation and best practice guidance. Staff received training on the application of the Mental Capacity Act for staff who would need to assess patients to give consent. Staff received training on the Mental Capacity Act and understood how to apply this. Training compliance for level 1 training was 92% and level 3 training at 86%. Patients were assessed by doctors or senior leaders. Mental health partners assisted staff with compliance with the respective acts to protect patients such as the deprivation of liberty safeguards. We did not see any patients with a mental health issue in the department.

When patients did not have capacity to consent, staff made decisions in their best interests and documented them. Staff had access to translation services should they require these to ensure they gained a valid consent.