Queens Hospital

Medical care is part of the division of medicine at Queens Hospital, Burton (QHB) which operates under University Hospitals of Derby and Burton NHS Foundation Trust. Medical care was provided across various inpatient wards and departments for adults. Medical specialties included acute medicine for older people, cardiology, diabetes, endocrinology, gastroenterology, renal, respiratory, rheumatology and stroke medicine. Each had a multi-disciplinary team including clinical nurse specialists. We inspected as part of our winter pressures programme on an unannounced basis (staff did not know we were coming) to enable us to observe routine activity.

We inspected on site from 9 to 10 February 2026. As part of our inspection, we inspected the Acute Medical Unit (AMU), Medical Same Day Emergency Unit, Short Stay Unit, a respiratory ward, a surgical ward where patients are placed when medical wards are over capacity/full, and 5 other medical ward/areas.

We spoke with 40 members of staff including senior managers, ward managers, registered nurses, health care assistants, discharge officers, domestic staff, catering staff and medical staff. We also spoke with 14 patients and their relatives and reviewed 20 patient records.

We looked at 27 quality statements across all 5 key questions: Safe, Effective, Caring, Responsive and Well-Led. The service managed safety incidents well and learned lessons from them. Staff understood how to protect patients from abuse and managed safety well. Staff assessed risks to patients, acted on them and kept good care records. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients and supported them to make decisions about their care. Staff treated patients, their relatives and visitors with compassion and kindness. The service prioritised patients’ individual needs. However, the service did not always have enough staff to care for patients and keep them safe. The governance around management of medicines and Control of Substances Hazardous to Health (COSHH) was ineffective.

At this inspection, medical care services remained good, but the rating for safe went down from good to requires improvement. Effective, caring, responsive and well-led stayed the same at good. We identified breaches of 3 regulations around the failure to provide timely treatment, management of substances hazardous to health, not always having safe staffing levels, and improvements needed in governance.

The Queen’s Hospital Burton is a type 1 emergency department situated in the town of Burton upon Trent in Staffordshire. It is part of the University Hospitals of Derby and Burton NHS Foundation Trust. Located in Staffordshire close to the borders of Derbyshire and Leicestershire, the Emergency Department (ED) receives ambulance patients from two different ambulance trusts across the midlands. Children were not ordinarily conveyed by ambulance to Queen’s Hospital Burton. Self-presenting patients attended from Staffordshire, Derbyshire and Leicestershire.

The ED had 2 entrances. One walk-in for self-presenting patients and one for ambulances. Patients not arriving by ambulance accessed the reception area located in the main waiting room. Seriously ill patients arriving by ambulance could be taken to one of 3 resuscitation bays or to a “pitstop” area where their condition would be assessed. From these areas patients with greater needs would be sent to the “majors” area while others were streamed to the Urgent Treatment Centre (UTC), the Primary Care Hub or the Same Day Emergency Care (SDEC) ward. SDEC was for patients who could be treated and sent home the same day and did not need a hospital bed.

Average attendances to the department were around 200 to 220 patients a day, of which 50 to 60 came by ambulance, the balance being self-presentations.

We inspected the department on 9 and 10 February 2026. The inspection team consisted of a lead inspector, a team inspector and a medicines inspector. We were accompanied by a senior nurse and an emergency department consultant and a paediatric nurse who acted as specialist advisors.

We carried out this inspection as part of our Urgent and Emergency Care Winter Pathway Programme. In line with this methodology, we inspected 25 quality statements across the safe, effective, caring, responsive and well-led key questions and have combined the scores for these areas with scores from the last inspection to give the rating.

During our assessment visit we visited all areas of the emergency department plus other areas relevant to the service provided such as the adjacent X-ray department. We ensured that patients who were being supervised by ambulance staff but were patients of the hospital were being kept safe and being well cared for.

During our assessment visit we interviewed 48 members of staff, spoke in detail to 13 patients and 3 relatives, and we looked at 20 sets of notes.

At this inspection the rating for Urgent and emergency services stayed the same as requires improvement. Effective and well led stayed the same as good. Caring went down from good to requires improvement, while safe and responsive stayed the same as requires improvement. We identified breaches of 3 regulations around the failure to provide timely treatment and suitable medicines storage; not always having safe staffing levels; and lack of privacy and dignity.

Date of assessment. 11 November 2025. This was a scheduled assessment as diagnostic imaging has never been inspected at Queen’s Hospital Burton. We looked at all quality statements across the Safe, Effective, Caring, Responsive and Well Led key questions.

Diagnostic imaging refers to non-invasive procedures using technology to create visual representations of the body’s internal structures. This aids medical staff in diagnosing, treating and monitoring diseases and injuries. During our inspection we visited: accident and emergency x-ray and computed tomography (CT), outpatient department X-ray and CT scanners, breast clinic, maternity outpatients, magnetic resonance imaging (MRI) and fluoroscopy. Accident and emergency X-ray and CT scanners are used to quickly check for injuries after sudden illness or accidents, while outpatient X‑ray and CT scans are done during planned appointments to investigate symptoms. Breast clinics provide tests for breast concerns, and maternity outpatients support routine pregnancy check‑ups. MRI creates detailed images of the body without radiation, and fluoroscopy is a moving X‑ray that shows how parts of the body work in real time.

Following this assessment, we rated the service as Good.

During the inspection we spoke with members of staff including radiographers, radiologists, physicists, imaging assistants, sonographers, receptionists, and managers. We also received feedback from patients who were using the service.

The service demonstrated a strong learning culture where people felt able to raise concerns, and staff routinely reported incidents which were investigated thoroughly. People were protected from harm through effective risk management.

Facilities and equipment were clean, safe, and well maintained.

Care was aligned with current evidence and good practice, and people were given clear information to support healthy living and to help them make informed decisions about their treatment.

Care was delivered with compassion and kindness. Staff treated people with dignity and respect and supported one another.

However, staff did not always feel supported by leaders and in some areas. Some staff felt they didn’t have the right mix of people with the right skills to do the job properly.

We undertook an assessment of the outpatient services at Queens Hospital Burton and Royal Derby hospitals on 11 and 12th November 2025. These assessments were carried out as the provider was last inspected in 2019, under a previous inspection model. Therefore, we conducted a comprehensive assessment of this service group at these locations.

On this inspection, we inspected outpatient A and B areas which encompassed a wide variety of clinics including gynaecology, ear, nose and throat (ENT), general medicine, rheumatology, cardiology, respiratory, dermatology and surgery. We also looked at activity in the ophthalmology, urology and orthopaedics outpatient clinics which were in a separate building, known as the treatment centre.

The service had made improvements in the key areas of safe and well led since the last inspection. We rated this assessment service group as good overall.

Outpatient leaders encouraged a positive culture of safety. At this inspection we found that staff had completed relevant mandatory training and leaders had made plans to maintain staff numbers and improve succession planning. Staff understood how to protect patients from abuse and recognised incidents and reported them appropriately. The environment was clean and tidy. We saw an improvement in infection control since the last inspection and the department handled medicines and prescriptions safely and securely.

Staff assessed patients’ conditions and provided treatment promptly which meant patients had more positive outcomes. Patients’ care and treatment was tailored to their individual requirements. Staff monitored patients’ outcomes and worked together to provide support and guidance which helped patients with their ongoing recovery.

The service cared for patients with compassion, kindness, dignity and respect. Staff treated patients as individuals and tailored their care to their specific needs. Patients had choice over their treatment and staff were quick to respond to their changing needs. Outpatients staff had received the appropriate chaperoning training, and this was pro-actively offered to patients. This showed an improvement since the last inspection. Leaders were approachable and cared about colleagues’ wellbeing and staff were encouraged to develop in their careers.

Access to outpatient clinics was straightforward and patients generally experienced positive outcomes. Patients were involved in planning and receiving their care which meant this met their personal circumstances. Staff ensured that information was shared with other agencies to enable continuity of care. Relevant information was provided in a way people could understand, and patients could provide feedback and raise concerns. Clinic availability had been expanded to provide a more accessible service for patients

Leaders promoted a positive culture which enabled staff to develop and were encouraged to speak up if they had concerns. However, some staff felt that there was still inconsistency with information sharing across teams in different specialty clinics, but work was underway to improve the cross-specialty communications and long-term effectiveness of the department.

Teams worked closely with other services and local communities to build relationships and improve people’s care. Leaders encouraged innovation within the departments to enhance staff and patients’ experience.

Date of assessment: 16 December 2024. This was an unannounced assessment to review compliance against the urgent enforcement action we took in August 2023.

University Hospitals of Derby and Burton NHS Foundation Trust provide maternity services for women in Derbyshire at Royal Derby and Queen’s Hospital. This service was last inspected in August 2023 and was required to take urgent action to as the Commission believed a person will or may be exposed to the risk of harm if we did not do so.

The service did not have a coordinated approach for the care they provided. Visible leadership by the obstetric medical team was poor which meant appropriate actions and prompt responses to issues with the service were delayed at times. We were concerned that the system in place to identify, escalate and manage women, birthing women and their babies who require induction of labour was ineffective and not in line with national guidance. Handovers of care were also ineffective as the Situation, Background, Assessment, Recommendation (SBAR) tool was not fully completed or entered in to care records.

However, the trust had met some of the conditions placed on their registration at the inspection in August 2023. Senior midwives were in post, hourly ‘fresh eyes’ were completed hourly during intrapartum care, audits of PPH and MOH were completed monthly. Midwives had completed annual mandatory fetal monitoring training.

The culture within the service did not always promote the values of the trust or support staff to speak up. Whilst leaders had the required knowledge and experience, they did not promote a culture where staff felt empowered to speak up and/or raise concerns.

Date of assessment. 13 March 2025. This was a scheduled assessment as the service had not been assessed since June 2019.

University Hospitals of Derby and Burton provide critical care for people in Derbyshire at Royal Derby Hospital and Queen's Hospital Burton. Critical care at Queen's Hospital Burton was last inspected in June 2019 and was rated as requires improvement.

During this assessment we assessed all quality statements across the safe, effective, caring and well-led key questions.

During this assessment we assessed 31 quality statements across the safe, effective, caring and well-led key questions. Following this assessment the rating has improved and critical care is now rated as good.

Staff were positive about the culture of the service and worked well together as a multidisciplinary team to provide safe care in line with best practice. There were clear processes in place for shared learning with a focus on continuous learning and improvement.

The environment was mostly safe and medications were managed appropriately

The service ensured they had the right number of staff to meet people's needs and nurses worked in line with national guidance for critical care nurse staffing, which states one nurse is required for each patient requiring level 3 care and one nurse for two patients requiring level 2 care. However, they had not ensured that staff were trained in line with national guidance. Only 46% of nursing staff had received post registration critical care awards. Although the trust had a clear plan in place to exceed the minimum guideline by the end of 2025.

Staff did not always manage hazardous substances in line with Control of Substances Hazardous to Health Regulations 2002.