Queens Hospital

On this page

• 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

We looked for evidence that the service provided care and treatment which was responsive to patients’ needs.

Access to outpatient clinics was straightforward and patients generally experienced positive outcomes. We saw that patients were involved in planning and receiving their care. Patients received care in ways that met their personal circumstances.

Staff ensured that information was shared with other agencies to enable continuity of care for patients. Relevant information was provided in a way people could understand, and patients could provide feedback and raise concerns. The service had an inclusion and belonging policy which covered staff, volunteers, patients and families.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s needs were met through good organisation and delivery.

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.

Staff made sure that patients understood their condition and their treatment options. This helped patients feel in control of their care. Some clinics had regular patients and were able to arrange specific requirements to make that patient as comfortable as possible. They requested chaperones or specialist teams to provide extra support if appropriate. The service also considered patients’ religious and cultural preferences during their appointments.

Staff in some clinics told us they aimed to keep to the same appointment day and time for repeat patients. This also helped minimise the risk of patients forgetting their appointment. Staff aimed to organise appointments which were long enough to have a thorough discussion about a patient’s current situation. However, this was not always possible due to the pressure of patient numbers and clinic availability.

Patients could obtain phone or face to face outpatient appointments. One patient said they preferred to have an in-person consultation as this enabled them to book the next appointment as they had missed appointments in the past by relying on postal communications. Leaders told us the service was using technology to improve appointment communications to minimise the risk of these being missed by patients.

The urology department had a dedicated area for staff have difficult conversations with patients and their families. Staff told us these areas weren’t ideal but provided a better environment that enabled patients time and space to ask questions and have a full discussion with staff about their options. Leaders told us they had recently repurposed an office into a quiet room in outpatients areas A and B. This provided a place to take patients for a discussion about their prognosis and allow them time and privacy to come to terms with the news they had received. 

Patients told us they felt involved in their treatment and plans for their care. They told us doctors were happy to discuss changing medication or treatment options as their conditions changed. Others noted that staff offered guidance and training to help them manage their condition at home.

The service understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

Clinic staff worked closely with other teams and referrers so that patients experienced a smooth pathway and joined up care. Most departments liaised directly with local GPs, as this was often the main referral pathway for patients. Some clinics, such as the respiratory outpatient clinics, had patients who had originally been on a ward in the hospital. They were seen prior to their discharge in the outpatient clinic to continue their treatment. Staff updated records and shared information with other stakeholders to make sure patients’ current situation was recorded accurately. Clinic teams worked with external services and ancillary staff to enable patients to continue their recovery back in the community.

Staff considered patients’ backgrounds when organising appointments. They could arrange for advocacy support if patients required this. They could also arrange for interpreters, and some clinics had access to an online translator service. Staff in one team told us they provided signposting for patients to local community groups providing support for specific issues, such as prostate and bladder cancer.

Clinics were usually fully booked and occasionally ran over time. If clinics ran late, staff worked together to ensure the impact on patients was minimised. They advised waiting patients of any delays and offered alternative appointments, if patients preferred this.

The existence of clinics and departments across the Queen’s and Royal Derby Hospital sites sometimes impacted the continuity of care for patients. Some patients told us that they preferred to visit Queen’s hospital as this was easier for them. Other people noted that they had to go to other sites for different aspects of their care which was inconvenient for them. However, patients acknowledged that this was beyond staff’s control.

The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Staff gave appropriate and accurate information to patients during their appointments. Patients and their families were kept informed of the next steps in their care and could ask questions to help them understand their options. Staff also provided training in using equipment which enabled patients to manage their conditions at home.

Patients told us staff gave information about their treatment and choices in a way they could understand. Patients told us they appreciated that medical staff made efforts to explain things to them. One patient noted: “I think the consultants are good at explaining things slowly and clearly – they have an excellent bedside manner”.

Leaflets were available in various languages and translation services were offered to patients. We saw posters advising patients that information was available in various languages. Staff also provided guidance on patients’ rights. Leaflets were available which explained the complaints process.

The service had guidance to ensure it complied with the Accessible Information Standard (AIS). AIS is a legal requirement in England that ensures people with disabilities, impairments, or sensory loss receive health and social care information in formats they can understand. It has been mandatory for NHS and adult social care providers since 2016. There were also trust wide policies providing guidance on the Freedom of Information (FOI) Act, and the service noted responses to formal FOI requests in trust board papers.

We saw that hearing loops were available in some areas and staff used interpretation services, both in person and online when required. The signage in the ophthalmology outpatient area displayed black writing on a yellow background for clarity and large print leaflets and letters were used.

The outpatient clinics had governance systems to ensure patient records were kept confidential. The trust was moving towards linked electronic appointment booking and records systems. Staff told us they welcomed this as it would improve patient experience through more efficient appointments, follow up and information sharing.

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.

The service involved patients in decisions about their treatment and made sure they knew about the treatment options available. They encouraged patients to share feedback about their care.

Staff provided guidance for patients about raising complaints. We saw patient feedback cards in clinics and posters with QR codes. Staff in the ophthalmology department told us that 96-98% of their patients and families were satisfied with their care.

Patients told us they were happy with their care but knew how to raise complaints. Patients could request contact from the service if they had any specific concerns. When patients provided feedback, the outpatient experience team reviewed these and created monthly reports. These were then discussed with teams to consider where improvements could be made.  Some clinic staff told us they did not get many complaints through the Patient Advice and Liaison Service (PALS), but any that were received were discussed in team meetings, so that all staff were aware of the concerns raised. They said that most complaints were about delays in clinic running times. They said they tried to keep patients informed and provide alternative options but sometimes patients remained unhappy with the delays.

Managers told us that clinic managers were encouraged to deal with complaints when became aware of the issue rather than wait for them to go to the formal complaints system. If formal complaints were received, they were handled by the relevant speciality. These specialties used their own processes to investigate and respond to patients directly.  

Queen’s Hospital had received 62 formal complaints from people attending outpatient departments from October 2024 to October 2025. The service upheld 7 of these with 1 referred to Patient Safety Incident Response Framework (PSIRF). This is an NHS wide framework which ensures healthcare providers review incidents in a consistent way to maintain effective patient safety. The complaints reflected concerns about communications, appointment delays and lack of follow up to initial consultations or treatment.

Leaders told us that some of these concerns are being addressed across the outpatient department as part of the trust’s outpatient transformation programme which was in progress at the time of the inspection. This would streamline pathways, make patient communication easier and ensure outpatient departments were more consistent in how they provided patient care.

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

Outpatient clinics were set up and managed by the respective specialties, including dermatology, ophthalmology, urology and orthopaedics in designated areas across the hospital. Some of those clinics were held in the main outpatient department, comprising of areas A and B. This meant clinics for patients requiring appointments for ear, nose and throat concerns, respiratory issues, rheumatology and general medical care would come to the main reception and be directed to the relevant waiting area.

All patients including those using wheelchairs, could access the outpatient areas at the hospital. We saw entrances with ramps and auto opening doors in some clinics. Although the outpatient area A and B was on the first floor, there was an accessible lift available.

We did not see any specific bariatric equipment or facilities in the outpatient area A and B at the time of our inspection. However, outpatient leaders told us they had improved access for patients in the department by altering a room could provide suitable furniture and equipment for those patients who required bariatric facilities.

Outpatient leaders told us that they had regular meetings to analyse referral to treatment times across the clinics. They said that pressures on clinic running times, the location of the various treatment areas and staff capacities had impacted these referrals. However, the outpatient transformation programme plan was aiming to reduce these delays by streamlining pathways and increasing the capacity and frequency of clinics.

Patients told us their referrals were usually straightforward, and appointments booked in good time. However, some felt that the locations of the various clinics and hospitals in the meant it could be challenging for them to attend appointments. Some patients noted that they had appointments at sites further away than their local hospital and that car parking availability was an issue at some hospital sites.

Outpatient leaders told us that the service used various methods to inform patients of their appointments, including by post, text and the service’s online portal, “Patient knows best”. There was ongoing work to improve the appointments system. The service was trialling artificial intelligence (AI) technology which staff could use to send reminders to patients shortly before appointments. This reduced the number of people missing appointments Leaders said that the service recognised this as a priority improvement.

Data gathered from October 2024 to June 2025 showed that missed appointments across all outpatient clinics varied between 6% and 7.25%, with an increase over the summer up to 8%. However, within 2 months of the roll out of the outpatient transformation programme in early August, missed appointments fell to between 5.5 and 6%.

Patients said that occasionally clinics had been cancelled but they were able to re-book at another time convenient to them. Some clinics were available on Saturdays and patients could select telephone appointments if they were more convenient. Staff said that they planned clinics up to 3 weeks ahead. This meant appointment duration could be flexed to suit patients. It also enabled staff to check patient records for any special requirements and arrange for interpreters or learning disability or autism specialists to attend.

If clinics did not run to time, staff usually kept patients updated and would offer alternative appointments if this suited those waiting. They could also offer patients short notice cancellations to ensure full clinics and quicker appointments. Clinic durations and availability had been expanded to provide a more accessible service for patients.

Most patients said their appointments were on time. However, staff and patient feedback indicated that several complaints in the previous 12 months focused on late running times of clinics and the impact this had on patients’ plans or had resulted in further car parking charges for patients.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

Outpatient staff promoted a culture in which the patients felt confident to ask questions and share their views. Staff were trained in equality, diversity and human rights. The service had an inclusion and belonging policy which covered staff, volunteers, patients and families. The provider undertook equality impact assessments of their policies and procedures to ensure they did not place vulnerable people or people with protected characteristics at a disadvantage. They also reviewed patient’s experience needs and aimed to address any equality issues appropriately.

Staff had got to know longer term patients in the various clinics. This meant they were able to adapt the care provided to ensure those patients received care appropriate to their specific needs. For example, where patients were diagnosed with a learning disability, staff arranged for a specialist learning disability nurse to assist at their appointments and asked family members to accompany them to provide support. Outpatients staff had also completed training to be more aware of the more complex needs of people with a learning disability or autistic people and so provide more individualised care.

Patient feedback from May to October 2025 showed 92% of patients considered their experiences good or very good, while 2.4% felt their experience had been poor or very poor.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

Staff helped patients to make decisions about their care and treatment and supported long term patients to manage their conditions. They gave patients information about services provided by external providers and support groups. They also ensured GPs and other healthcare professionals were kept informed of patients’ progress.

Some clinics had quiet rooms and offered support when patients had received upsetting news. Consultants and nursing staff took time to offer practical advice as well as emotional support. They also discussed patients’ longer-term plans and provided information about support groups or end of life services, such as local hospices.