- NHS hospital
Chelsea and Westminster Hospital
Assessment report published 7 August 2026
Contents
Ratings - Urgent and emergency services
Our view of the service
We undertook a comprehensive assessment of the urgent and emergency care service on 28 and 29 April 2026. The assessment was undertaken using our winter pressures assessment framework and we assessed 25 quality statements.
We rated the service as outstanding.
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.
While the service did not meet the royal college of emergency medicine’s (RCEM) recommendation for a minimum ratio of emergency department (ED) whole-time equivalent (WTE) consultants per 4,000 attendances, ratios had improved since our last inspection. .
People's experience of this service
Peoples and families experienced care that was compassionate, respectful and kind. Staff listened to people, introduced themselves and responded sensitively to pain, distress and mental health needs. Overall, children and young people were supported well. Staff provided clear and accessible information and engaged positively with families.
Staff demonstrated awareness of individual needs, including the use of interpreters and reasonable adjustments to support communication. People described positive interactions with staff and said they felt cared for throughout their time in the department.
Despite the pressures associated with a busy urgent and emergency care environment, staff worked to maintain a positive experience for people using the service.
Systems supported flow and helped manage demand. Staff took steps to support people’s comfort, dignity and understanding of their care. Staff kept people informed about their care, including waiting times, delays and discharge arrangements. They used communication tools to support this, particularly in the paediatric department. Staff supported people with mental health needs and learning disabilities. They demonstrated awareness of their needs and used appropriate pathways and specialist input to deliver person-centred care.