- NHS hospital
Chelsea and Westminster Hospital
Assessment report published 7 August 2026
Contents
Ratings
Our view of the service
On 28 and 29 April 2026 we carried out an announced inspection at Chelsea and Westminster Hospital. This assessment looked at urgent and emergency care which we rated as outstanding, children and young people’s and end of life services which we rated as good. The ratings for these services has been combined with the ratings of the other services from our previous inspections. See our previous reports to get a full picture of all the other services at Chelsea and Westminster Hospital.
In our assessment of Urgent and Emergency Care, we found.
Staff had a strong and open safety culture. They reported and investigated incidents and used them to improve practice. Learning from incidents was shared through governance systems. This led to changes, including improvements to medication safety, escalation processes and communication. Safeguarding systems were effective, training compliance was high, and staff worked well with local partners to protect vulnerable people. Staffing levels were generally maintained. Environments were safe, and infection prevention and control processes were well embedded.
Care and treatment were delivered in line with national guidance and evidence-based practice. This was supported by a structured audit and quality improvement programme. Staff participated in national audits and used benchmarking data to improve services, including mental health care, frailty and time-critical medicines. Multidisciplinary working was strong. Staff worked effectively across teams and with specialty services, which supported positive outcomes.
Staff monitored outcomes using clinical data. Re-attendance rates were stable, and there was evidence of continuous improvement.
Staff treated people with kindness, compassion and respect. People reported positive experiences of care. People were involved in decisions about their treatment and were supported to understand their care and next steps. Staff adapted communication to meet individual needs and considered cultural, social and emotional factors. Staff focused on maintaining dignity and supporting vulnerable groups, including people with mental health needs.
Care was organised to meet the needs of the local population. Pathways supported different groups of people and helped maintain flow. Staff delivered personalised care through holistic assessment. They worked closely with other services to ensure coordinated care and timely discharge. People were able to provide feedback, which the service used to improve care. This included changes to communication, waiting time information and flow processes.
Systems supported equitable access to care, including reasonable adjustments and timely access to senior clinical review.
Leaders had a clear and shared vision. There was a positive and inclusive culture that promoted high-quality, person-centred care. Governance systems were well established. Leaders had clear oversight of risks, performance and quality through regular meetings and structured reporting. Staff were engaged, supported and encouraged to take part in quality improvement, learning and innovation. There was strong partnership working with system partners, and feedback from staff and people who used the service was used to drive improvement.
In our assessment of end of life services we found;
The service had a positive culture of safety based on openness and honesty. Staff investigated incidents and shared learning to promote good practice and continuous improvement. People were cared for in a safe environment and protected from avoidable harm.
Staff were qualified, skilled and experienced and had received relevant training in end of life care. People’s care and treatment were routinely monitored to continuously improve it. The service worked effectively across teams and services to support people and ensure continuity of care. The service understood people's rights around consent and respected these when delivering person-centred care and treatment.
Staff treated people with kindness, empathy and compassion. The service made reasonable adjustments for people with additional needs, including those with learning disabilities or communication needs.
The service made sure people were at the centre of their care and treatment choices. People could access care in ways that met their personal circumstances and protected equality characteristics.
Leaders were experienced, skilled and knowledgeable. They were inclusive and embodied the culture and values of their workforce and organisation. Leaders maintained oversight of risks and performance through established governance processes.
In our assessment of children and young people we found;
The service had appropriate staffing levels, and a suitable skill mix to deliver safe, high‑quality care. This was supported by extensive specialist input from NHS clinicians.
The service worked closely with patients and partners to maintain safe systems and ensure continuity of care. Staff understood how to report incidents, felt confident to raise concerns and described an open, no‑blame culture.
The service supported people to understand and manage risks in a holistic way. Equipment and technology were well maintained, and infection risks were consistently assessed, managed and controlled. Medicines and treatments were managed safely and were aligned with people’s needs and preferences.
The service provided care and treatment based on national guidance and evidence of effectiveness. National Institute for Health and Care Excellence (NICE) guidance was routinely discussed and reviewed at clinical governance and team meetings. Leaders told us NICE guidance was followed during pre‑assessment and throughout the care pathway. Staff used up‑to‑date policies to plan and deliver high‑quality care in line with best practice. The trust had a policy in place for implementing NICE guidance and quality standards.
Children, young people and their families were actively involved in pre‑operative assessments. Staff communicated clearly about risks, treatment options and expected outcomes. Assessment processes supported staff to identify and respond to individual health, wellbeing and communication needs. Families were encouraged and supported to be involved in their child’s care.
Leaders supported joined‑up team working. The service used clinical outcomes, audit findings and performance data to identify areas for improvement and develop action plans.
Children and young people were treated with kindness and compassion, and their privacy and dignity were respected. Staff understood that how children and young people were treated and supported was important. Children and young people were treated as individuals and given choice and control wherever possible.
The hospital took a comprehensive approach to supporting CYP staff wellbeing across all clinical areas. A range of staff initiatives were in place to support emotional resilience, boost morale, and reduce workplace stress. This included a monthly presentation shared across all sites, called the ‘Monthly Team Brief’, which provided updates on quality, safety and performance, while also celebrating successes. Most staff we spoke with felt that the team brief, along with governance awareness half days study sessions, supported staff to contribute to setting strategic priorities and shaping the service’s annual work plan.
Children, young people and their families were at the centre of decisions about care and treatment. Staff worked in partnership with families to respond to changing needs and ensure care was coordinated and person‑centred.
Leaders and staff demonstrated an understanding of the diverse needs of the local population. They used this information to identify and address inequalities and to deliver care that was joined up, flexible and responsive. Children and young people were also supported to plan for important life transitions, enabling informed decision‑making about their future care.
Leadership, management and governance arrangements supported the delivery of high-quality, person-centred care. The service was well managed and well led. Leaders promoted an open and fair culture that supported learning and innovation. Governance processes were effective in maintaining quality and safety.
The service followed the trust’s values of “Putting patients first”. Leaders encouraged staff to place children, young people and families at the centre of their practice. The service vision was “Healthier futures for all children and young people in North West London”. Leaders had the skills, knowledge and experience required to manage the service and deliver this vision. They valued diversity, encouraged innovation and worked closely with local communities.
Leaders contributed positively to people’s experiences of care through a clear vision and values. They demonstrated the ability to manage risk while supporting continuous improvement.
Leaders promoted an open and inclusive culture. Staff were encouraged to provide feedback and raise concerns. Regular team meetings, safety huddles, reflections and debriefs supported learning and improvement. The service had a quality assurance framework that supported policy compliance, audit activity and accreditation, helping to identify areas for development and maintain standards.