University College Hospital & Elizabeth Garrett Anderson Wing

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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

This means we looked for evidence that the service met people’s needs. We checked that the health and care needs of people and communities were understood, and they were actively involved in planning care that met these needs. We also looked for evidence that people could access care in ways which met their personal circumstances and protected equality characteristics.

At our last assessment we rated this key question Requires Improvement. At this assessment the rating has changed to Good.

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 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.

People received care which was kind, respectful and focused on their individual needs. Staff treated people with compassion and dignity, and patients consistently described staff as reassuring, welcoming, and attentive. Staff listened to patients and took account of their preferences when planning and delivering care.

Staff involved family members and supported people in decision-making where appropriate. Relatives told us they felt included and informed, and records showed staff documented family involvement in discussions and care planning. This approach ensured that patients’ wishes and preferences remained central to decisions about their care.

The service met the specific needs of children and young people. Staff assessed paediatric patients in a dedicated area with a separate waiting space, which helped create a more suitable and less stressful environment. The department provided toys for a range of age groups and employed a play specialist to support children during their care and treatment.

Staff and teams worked together to provide coordinated, person-centred care. The acute frailty service operated across the department, identifying patients aged 65 and over through regular screening and providing early assessment and intervention. The team worked across all clinical areas and with community and social care partners to ensure patients received care in the most appropriate setting, with a focus on maintaining independence and avoiding unnecessary hospital admissions.

Following the assessment the trust achieved autism accreditation.

We did not look at Care provision, Integration and continuity during this assessment. The score for this quality statement is based on the previous rating for Responsive.

Staff provided patients, their families, and carers with information that was accessible, and supported their rights and choices. Most patients and relatives said they were provided with relevant information about their condition, follow up care and treatment as required. We observed staff regularly keeping patients and their families informed.

Staff provided patients with appropriate information and support in ways which promoted inclusion and understanding. They used a range of communication tools to meet individual needs, including Language Line interpreters, face-to-face British Sign Language interpreters, and hearing loops. Staff also provided easy read materials, hospital communication books, and sensory bags to support patients with additional needs. Autism champions and staff trained in the learning and disability training supported patients with learning disabilities and autism, alongside the use of learning disability passports.

Staff identified and recorded patients’ communication needs in line with the Accessible Information Standard. They used electronic flags to highlight additional requirements such as visual, hearing, or mobility impairments and shared this information across teams to ensure consistent care. Patients were able to request information in alternative formats, including braille, large print, email, or easy read.

The department displayed clear signage, which supported patients to move around easily. Volunteers assisted in waiting areas by guiding patients and offering additional support. Patient information screens displayed content in multiple languages, and multilingual leaflets could be accessed and printed when required. Staff considered individual needs at the point of clinical navigation and made reasonable adjustments, such as providing quieter spaces where possible.

Patients and relatives told us staff communicated well and provided regular verbal updates about care, investigations, and treatment plans. Staff also maintained clear communication with families and next of kin, ensuring they remained informed and involved in decision-making.

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.

Staff listened to and involved people in their care and provided clear opportunities for feedback. Patients and their relatives told us they understood how to raise concerns or make complaints and felt comfortable doing so. The service promoted feedback through visible QR codes across the department, enabling patients to share their experiences easily.

The service followed an up-to-date complaints policy, and staff understood how to manage and escalate concerns appropriately. Managers investigated complaints thoroughly, identified themes and trends, and discussed outcomes at monthly clinical governance meetings. Staff told us they received regular feedback on complaints through team briefings, including morning meetings, and used this learning to improve care and patient experience.

Between April 2025 and March 2026, the Emergency Department received 714 complaints. The most common themes related to communication (197), clinical treatment (157), and staff values and behaviours (140). Other themes included patient care (77), waiting times (29), and trust administration (27). Key concerns raised by patients included communication with patients and relatives, delays in treatment, perceived lack of professional behaviour, and patients feeling they were not always listened to. The service used this information to identify areas for improvement and drive changes in practice.

The service also captured compliments to recognise positive patient experiences. From June 2025 to March 2026, the department recorded 32 compliments. Patients most frequently praised staff for compassion and kindness (28 mentions), professionalism and clinical excellence (26), reassurance and emotional support (23), and effective teamwork. Other feedback highlighted respect, dignity, and clear communication as key strengths of the service.

The service made sure that people could access the care, support and treatment they needed when they needed it.

The Emergency Department experienced sustained pressure, with monthly adult attendances ranging from 10,705 to 12,733 and paediatric attendances between 1,463 and 2,140. Although staff used structured processes to manage demand, the level of activity challenged their ability to maintain consistent and equitable access and flow.

Staff carried out initial assessments in a timely way; however, performance varied. The average time from arrival to triage remained between 10 and 13 minutes over the 12-month period, but the proportion of patients triaged within 15 minutes fluctuated between 62% and 79%. This variation indicated that patients did not always receive a consistent response, and staff did not fully mitigate delays during periods of peak demand.

Staff used structured triage processes supported by trained staff to assess patients and identify those requiring urgent intervention, including screening for mental health needs. While these processes supported equitable decision-making, they did not consistently translate into timely access to care for all groups, particularly for patients with complex needs.

A small proportion of attendances related to mental health, with between 515 and 650 patients presenting each month. Staff recognised that these patients faced additional barriers; however, patients with mental health needs did not always receive care within expected timeframes. Delays occurred due to limited availability of specialist mental health assessments, bed shortages, and constraints in community and social care provision. These factors resulted in inequitable experiences for this group of patients.

The service monitored flow and achieved timely care for many patients, seen, treated and discharged or admitted within 4 hours. The performance over the preceding 12 months was between 69% and 80.9%. In March 2026 the trust achieved 80.9%. The trust had recognised a variation in performance and developed an improvement plan which delivered and exceeded the national end of year target of 78%. Admission rates remained stable at around 10% to 11%. However, this performance was inconsistent and meant a proportion of patients experienced delays. Admission rates remained stable at around 10% to 11%, but this did not fully reflect the challenges in accessing onward care.

Length of stay data showed variation, particularly for patients with mental health needs. Average stays ranged from 5 to 9 hours for adults and 4 to 8 hours for children and young people. Some patients experienced significantly extended waits, with the longest recorded stays reaching up to 145 hours for adults and 54 hours for children and young people. These delays demonstrated that the system did not consistently provide equitable access, particularly for vulnerable patients, even where contributing factors sat outside the immediate control of the department. Staff managed high demand but did not consistently ensure equitable access for all patients.

The service monitored extended waits, with between 70 and 101 mental health patients each month waiting more than 12 hours. Although staff used this information to escalate pressures and inform improvement actions, these measures did not consistently reduce delays or improve access for affected groups. However, the trust delivered the Camden Adult Pathway Partnership (CAPP) service and the Homeless Intermediate Care Team (HICT). These services supported patients facing the most complex health and social inequalities receive co-ordinated, holistic care. This included patients who may be experiencing homelessness, living in unstable or temporary housing, seeking asylum or with immigration concerns. This improved continuity of care and reduced avoidable emergency department attendances.

The trust also introduced the 987 initiative, which enabled Inclusion Health patients with urgent health needs to access assessment through the Ambulatory Emergency Care Unit. Staff referred patients directly to the Inclusion Health Team, which ensured patients received specialist support from professionals with expertise in inclusion health.

Overall, staff used data and processes to manage access and demand, but variation in performance and prolonged waits, particularly for patients with mental health needs, meant the service did not consistently achieve equitable access. External system pressures continued to impact timely care, and the service did not fully mitigate these risks, resulting in variable patient experiences and outcomes.

We did not look at Equity in experiences and outcomes during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Planning for the future during this assessment. The score for this quality statement is based on the previous rating for Responsive.