Queen Elizabeth The Queen Mother Hospital

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Staff fostered an open and honest culture, using incidents as opportunities to learn and improve care. They went above and beyond to meet the needs of neurodiverse adults, including older people, helping them access treatment with minimal distress. Staff understood their safeguarding responsibilities and acted to protect adults at risk, their families and carers. Leaders maintained effective systems to ensure staffing levels and skill mix kept people receiving medical care, including older people, safe. We saw some improvements in medicine management, infection prevention and control, the ward environment and staff training although some improvements were still needed.

At our last assessment we rated this key question requires improvement. At this assessment the rating has remained requires improvement. This meant people were generally safe and protected from avoidable harm.

We have not awarded this service a score for Safe.

Find out about when we will not publish a key question score and what we look at when we assess Safe.

We scored the service as 2. The service showed some shortfalls. Safety investigations did not always fully explore underlying causes or demonstrate how learning would be embedded and sustained over time. However, staff understood how to report incidents, learning was shared across teams, and action had been taken following incidents to improve patient safety and reduce the risk of recurrence.

The service used learning from PSIRF (Patient Safety Incident Response Framework) to investigate patient safety events. PSIRF sets out the NHS’s approach to developing and maintaining effective systems and processes for responding to patient safety incidents for the purpose of learning and improving patient safety. As part of PSIRF, local learning reviews were used to learn from patient safety events. A local learning review is a blame free, system-focused process that involves staff and patients, identifies why things went wrong, and produces clear, practical actions that leads to real improvements in patient safety. We reviewed 3 local learning reviews as part of the assessment. The learning reviews described incidents and identified some actions but did not explore underlying system factors and relied heavily on training. They did not show staff or patient involvement, define clear ownership, or include measurable outcomes, which meant they provided limited assurance that learning would lead to sustainable improvements in patient safety.

Records showed that staff reported 1694 safety events in the last 12 months. The majority were recorded patient harm as no or low harm. There had been 36 incidents in the last 12 months which were recorded as moderate or severe harm. Themes included hospital acquired pressure ulcers, infection and broken bones. All staff we spoke with knew what incidents to report and how to report them. Staff now reported all incidents including near misses and incidents that caused harm.

Senior staff understood the duty of candour. They were open and transparent and gave patients and families a full explanation if things went wrong. Records showed that a verbal explanation of what had gone wrong was given to the patient and their family at the time of the incident and this was followed up in writing.

Staff received feedback from investigation of incidents, both internal and external to the service. Staff met to discuss that feedback. Records showed that all grades of staff met in person and virtually to discuss learning following the investigation of incidents on a regular basis. Minutes of the meetings were displayed in staff rooms and emailed to staff who were unable to attend the meetings.

Learning from patient safety incidents did lead to some improvements across the service. For example, after a patient was discharged with medication, they no longer needed, a ward changed the process from 1 trained nurse checking patient discharge medication to 2 nurses checking. This reduced the likelihood of errors. A review of patient fall incident data showed that staff had not followed the correct procedure following a fall, leading to refresher training to ensure the right actions were taken in future. On the acute medical unit, staff feedback highlighted that, in a busy environment, staff found it difficult to identify which patients were at risk of falls. In response, the team introduced a yellow blanket and yellow socks system to make at-risk patients easily identifiable and improve patient safety. Staff used yellow blankets on beds and yellow socks for patients to quickly recognise those at increased risk of falling.

Staff were debriefed and received support after a significant incident. Leaders told us there was a no blame culture when things went wrong. The emphasis was on reviewing the incident and reducing the risk of it happening again in the future. Staff were supported to reflect and learn from incidents.

The evidence showed some shortfalls. The service worked well with people and healthcare partners to establish and maintain safe care systems. They managed or monitored people’s safety. They did not always make sure there was continuity of care, including when people moved between different services or discharge from hospital.

During the assessment, we saw many patients who were medically fit for discharge, particularly on the acute medical unit, but unable to leave because they were waiting for care packages or residential placements. This created a significant backlog, reducing the availability of beds for patients who required acute medical admission and placing further pressure on patient flow across the hospital.

Staff told us that patient transfers from the acute medical unit or same day emergency care units were not always discussed with the receiving ward. On occasion patients arrived on the ward without the staff expecting them. This meant that staff had not assessed the safest and most appropriate bedspace on the ward for the patient to be placed. The wards often had extra patients in the bays who were waiting for the bedspace of a patient being discharged. This process supported the flow of patients through the hospital but meant staff had more patients to look after than planned for part of the day. The area patients waited in for their bedspace did not have a piped oxygen, a privacy curtain or a call bell for the patient to use. Ward staff told us they made sure patients spent as short a time as possible in these areas. Mobile privacy screens were available if needed.

Staff did not always involve all relevant health and social care services when discharging patients, which meant continuity of safe care was not consistently maintained. Safeguarding records showed an ongoing issue where staff discharged patients from medical wards without notifying community carers about important changes, such as medication adjustments, pressure damage, or an increased need for support with personal care. The service recognised these issues and shared a quality improvement project aimed at improving the discharge process.

There were 2 same day emergency care (SDEC) units and a virtual ward which accepted patients from the Emergency Department (ED) as well as direct referrals from the community. One unit treated medical patients, and the other focused on patients living with frailty. Frailty means someone is less able to cope with illness or stress, so even small problems can cause their health to deteriorate quickly. Data from the 3 months prior to the assessment showed that, on average, 10.37% of Category 1 patients (those requiring immediate, life‑saving treatment) who attended ED were transferred to and treated in the SDEC unit.

The trust designed the SDEC model to reduce the number of patients managed within the emergency department and to avoid hospital admissions where patients could receive care on the same day. At the start of each shift, SDEC consultants identified suitable patients in ED and transferred them promptly to the unit for same-day care, which helped to ease congestion and improve patient flow.

Both the medical and frailty SDEC units operated from 8am to 8pm, 7 days a week. The teams accepted the last patients at 5pm to allow enough time for treatment and discharge on the same day.

Virtual wards (also known as hospital at home) allow patients to get hospital-level care at home safely and in familiar surroundings, helping speed up their recovery while freeing up hospital beds for patients that need them most. The virtual ward was open from 8am to 6pm between Monday and Friday and between 8am and 6pm at the weekend.

Site meetings were held regularly throughout the day to monitor patient flow and proactively identify or mitigate emerging risks to safe patient care. We saw these meetings reviewed key operational pressures including emergency department (ED) activity, planned discharges, closed beds, temporary escalation areas, staffing levels, availability of intensive care beds, infection prevention and control issues, Operational Pressures Escalation Levels (OPEL) status, and the number of patients medically ready for discharge but awaiting placement. (OPEL) are a nationally recognised NHS framework used to monitor and manage the level of operational pressure across services—ranging from OPEL 1 (low pressure) to OPEL 4 or 5 (severe or critical pressure requiring significant system-wide action).We saw attendance at these meetings was multidisciplinary, with clinical teams, managers, allied health professionals and discharge coordinators contributing to real-time decision‑making and problem‑solving.

There were effective processes to manage patients who were admitted to wards outside of the clinical speciality sometimes referred to as 'medical outliers'. The service tried to avoid placing patients on other wards where possible. When this did happen, the responsible specialty reviewed them every day. Patients stayed under their original medical team, and staff used the electronic system to clearly identify which team was responsible for their care. The General Medicine Operational Team kept the outlier list. Medical teams were expected to review these patients every day.

During the assessment we observed ward handover meetings, safety huddles, board rounds. We reviewed patient records and visited enhanced care areas and the discharge lounge. All staff involved in the patient’s care while in hospital contributed to the assessment, treatment and discharge of patients.

The evidence showed a good standard. The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. They concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The service shared concerns quickly and appropriately.

Staff could give examples of how to protect patients from harassment and discrimination, including those with protected characteristics under the Equality Act. Staff we spoke with during the assessment understood the importance of protecting patients and how having a protected characteristic made some patients more vulnerable. Staff used their safeguarding training to identify and report concerns, as shown in the patient records, we reviewed.

Staff knew how to identify adults and children at risk of, or suffering, significant harm. This included working in partnership with other agencies. The team had access to expert advice and support from a safeguarding team 5 days a week. The internal internet had current policies and procedures about safeguarding for staff to refer to at any time. Safeguarding concerns were discussed by the ward teams during handover and safeguarding referrals were made promptly to keep patients safe.

Staff followed the policies on patient restraint and rapid tranquilisation. Restraint, restrictive practice and blanket restrictions were reported as incidents and learning was shared widely in the department. Leaders audited the use of restraint and rapid tranquilisation by staff to check the policy was being followed.

Most staff had completed safeguarding training and knew how to raise a safeguarding alert when required. Records showed that 90% of staff had completed the required safeguarding training. The exception was Safeguarding Adults Level 3 training, where compliance was 80%. Leaders had plans in place to improve compliance and expected it to increase to 93% by April 2026. The trust’s target for mandatory training was 85%. The service also planned to deliver mandatory training on the wards to make it easier for clinical staff to attend without needing time away from patient care. Staff had access to Mental Health Awareness and Therapeutic Support training which included training on looking after patients with Understanding Neurodevelopmental Disorders and Learning Disabilities. It was unclear from the data supplied by the hospital the number of staff who have completed this training.

The evidence showed a good standard. The service worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Staff used the National Early Warning Score 2 (NEWS2) to identify patients at risk of clinical deterioration. Records reviewed showed that observations were completed consistently in line with local guidance, supporting early detection and timely escalation of care. The service checked compliance through audits and reviews, but these did not provide enough evidence that patient deterioration was always recognised and escalated correctly. The NEWS2 audit and ward audits gave some assurance, but focused on those patients who NEWS2 escalated and required admission to critical care to determine appropriateness. To improve this, a digital tracking board and dashboard was being developed to help wards monitor NEWS2 scores, escalation, and response. This will be audited once in place.

Risk assessments included falls, frailty, dementia, skin integrity, malnutrition, sepsis and risk of venous thromboembolism (VTE). Staff completed monthly audits led by matrons and ward managers to check that risk assessments were done accurately and on time. These audits covered key areas of care, including falls, bed rails, tissue viability, nutrition, mouth care and VTE. We reviewed recent audit results and found that wards usually performed well. Where improvements were needed, staff shared feedback straight away with the ward teams. For example, one audit showed that a mouth care assessment had not been completed within 6 hours of admission to the ward. This was completed by the nurse as soon as it was identified.

Staff communicated with patients so that they understood their care and treatment, including finding effective ways to communicate with patients with additional communication needs. Staff had access to a range of services to support effective communication with patients. These included leaflets in other languages and interpretation services which included British Sign Language. We saw that staff used communication charts and picture cards to support patients who had additional communication needs.

Staff enabled patients to give feedback on the service they received. As well as the friends and family feedback forms, medical care had a pilot to actively seek feedback after a patient was discharged from a ward. Senior nurses spent time checking with the patients that they knew their diagnosis, treatment planned and expected discharge date. If a patient was not aware time was spent discussing the plans and expected day of discharge out of hospital.

Staff supported patients to make advance decisions where appropriate and involved patients, families and carers in discussions about treatment escalation. The trust used ReSPECT (Recommended Summary Plan for Emergency Care and Treatment) plans to record personalised recommendations for future emergency care and treatment. ReSPECT is a national process that creates a personalised plan for a person's future emergency care and treatment, based on conversations about their clinical condition, preferences and wishes.

A multidisciplinary palliative care team supported the ward staff to work collaboratively with the patient and their family at the end of a patient’s life. Staff told us the team were very responsive and provided expert education to the team and clinical supervision to help them reflect on their feelings and experiences caring for dying patients. Sandwich Bay Ward provided specialist side rooms, including designated end-of-life beds and themed rooms such as a sunflower room, to create a calm and comfortable environment. It used fully adjustable electric beds with lateral tilt to support patient comfort and dignity. Wards also provided upgraded televisions, recliner chairs for relatives, and access to hot drinks, snacks, and overnight stay options for family members.

Staff ensured that patients could access advocacy and followed the All Age Mental Health Policy. Data showed that there had been 34 referrals to independent mental health advocates in the previous 12 months. Mental health advocates provide free, confidential, and independent service designed to support patients—particularly those detained under the Mental Health Act—in understanding their rights, expressing their views, and participating in decisions about their care.

The service had implemented Martha’s Rule and during the assessment we saw all areas we visited displayed posters informing patients and their family about Martha’s Rule and how they could access this service if they had concerns. Martha’s Rule is a patient safety initiative that supports the early recognition and escalation of deterioration by ensuring that the concerns of patients, families, carers and staff are listened to and acted upon. It gives patients, families and staff the right to request a rapid review if they are worried that a patient’s condition is getting worse.

We observed during the assessment that staff regularly asked patients how they felt and used this with clinical observations to identify concerns early, and we saw this documented in patient records. Staff, patients and families could request an urgent review at any time, with clear routes to the critical care outreach team. The service supported this with digital systems, training and information, and planned further improvements to monitoring, record keeping and access. In the 12 months before the inspection Martha’s Rule was used 4 times by family members concerned about their relative.

The previous inspection identified concerns that systems and processes did not adequately manage risks related to fire safety, infection prevention and control, and patients’ privacy and dignity. During this assessment, we saw improvements across these areas. The service had strengthened its systems and processes, and we found that the environment, premises and equipment were managed safely, with better oversight to support patient safety and dignity. Patients generally no longer received care in the corridor, fire exits were free of clutter and staff kept the premises and equipment clean.

The evidence showed some shortfalls. Although the equipment and technology were safe; the aging infrastructure did not always support the delivery of safe care.

The design of facilities did not always keep people safe. The hospital estate was aging, and not all the medical wards were able to control access to the wards as needed. Senior nurses had raised this as a risk and there was a plan to install magnetic doors that could - control people entering and exiting ward areas. On the day of the assessment on Sandwich Bay Ward, the ceiling in the corridor had fallen in due to heavy rainfall.

At the last inspection staff told us they did not have enough suitable equipment to help them safely care for patients. We now saw staff had access to equipment when needed. The equipment we saw was visibly clean. Planned preventive maintenance and electrical appliance tests were completed annually and recorded centrally. We checked equipment and it had all undergone electrical safety checks within the last 12 months. Staff were trained to use equipment they needed, including syringe drivers and managers monitored compliance with this training.

Equipment stored on resuscitation trolleys was easily accessible to staff in all wards and departments. At the last assessment we found that some resuscitation trolleys were unsecured and the contents of the trolley were at risk of being tampered with or missing when required in an emergency. Resuscitation trolleys were now checked daily and had tamper evident seals, were in date, and stored in the correct place and had a standardised layout.

Sterile equipment was stored in a way that prevented contamination. We looked at 20 items of sterile equipment all of which were in date, sealed and dust free. At the previous assessment we found personal protective equipment such as gloves and aprons in the domestic and recycling bins, which was not in line with national guidelines. Staff now disposed of waste safely and separated it correctly into clinical and non-clinical bins, with clear signage to support this. We saw that all substances subject to Control of Substances Hazardous to Health (COSHH) Regulations were stored securely, to prevent unauthorised access and ensure safe use. At the last assessment there were concerns around fire safety identified. Fire safety equipment and fire exits were now clear of obstructions and had been serviced as per national guidance. Staff had access to emergency call bells in the event of an emergency.

The evidence showed a good standard. There were now enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

Managers had calculated the number and grade of nurses and healthcare assistants required. The number of nurses and healthcare assistants matched this number on all shifts. The ward manager could adjust staffing levels daily to take account of case mix. Daily “Are We Safe?” meetings reviewed site staffing and maintained patient safety.

When necessary, managers deployed agency and bank nursing staff to maintain safe staffing levels. When agency and bank nursing staff were used, those staff received an induction and were familiar with the area. Managers and bank staff showed us the competency booklets and orientation temporary workers needed to complete before being allowed to work in the service. Efforts were made to book regular temporary staff who were familiar with the ward area.

Audit data showed that there were generally enough permanent staff within the department. Data showed 4% average vacancies, 7.7% average turnover and 7% average sickness absence as percentages within the last 12 months. This is above the trust threshold of 5%. However, there were high numbers of nurses, allied health professionals and clerical staff who were premature leavers in the Discharge Lounge, Sandwich Bay Ward and respiratory medicine. Premature leavers are employees who leave within a short period after joining (e.g. within their first year or probation period).

There was adequate 24-hour medical cover. On Fordwich Ward they had a named consultant for a 7-days a week. This helped with continuity of care as the same consultant reviewed the patients. On the weekend there was a ward-based doctor to look after the patients who had access to a consultant for advice, by telephone. The service had 28 permanent consultants and 3 temporary (locum) consultants in this specialty. Five of the permanent consultants were either in the process of joining the General Medical Council specialist register or were due to start that process in 2026. The GMC Specialist Register is an official list of doctors who have completed specialist training and are qualified to work as consultants in a specific field in the UK.

Most staff had completed the training they needed for their roles and were up to date. Overall, more than 85% of staff were compliant, in line with the trust’s target of 85%. Clerical staff, nurses, and allied health professionals had good compliance (between 87% and 100%). Medical staff had lower rates (between 77% and 90%). Each month, managers shared a list of staff who had not completed their training and worked with them to agree a plan to get it done.

The practice development team provided support, supervision and development to staff of all grades. The team included clinical skills facilitators, practice development nurses and allied health professionals. International trained nurses received support to prepare for the Nursing and Midwifery Council (NMC) Objective Structured Clinical Examination (OSCE)—a practical, 10‑station assessment that international nurses and midwives must pass to gain UK registration.

The practice development team ensured that new staff received an appropriate induction tailored to their role and grade. Managers supported staff through regular supervision sessions, which included discussions on care management, opportunities to reflect on and learn from practice, and support for personal and professional development. Staff also received appraisals to review their work performance, with an average of 90% having completed an appraisal within the last 12 months.

The practice development team led the Ready to Care programme for healthcare support workers, enabling those who passed to gain the Care Certificate. The Ready to care programme is an East Kent initiative designed to recruit and train people for health and social care roles without requiring prior qualifications. The program focuses on compassion, providing training for entry-level positions like healthcare assistants. The team taught appraisal skills, delivered the mandatory training programme, and supported apprentices undertaking both the nursing associate apprenticeship and the registered nurse degree-level apprenticeship. They worked with local colleges to offer T Level qualifications in health, supported neurodiverse staff with tailored learning and reasonable adjustments, and guided student nurses on placement. In addition, they delivered advanced clinical skills training, ensuring the workforce developed the competence and confidence required for safe and effective practice.

There were opportunities for staff development. Staff had received enhanced training as needed for their area of work. For example, nurses on Fordwich Ward had enhanced competencies to care for unwell respiratory patients and patients with a tracheostomy tube. A tracheostomy tube is a small tube inserted through a surgical hole in the neck into the windpipe to help patients breathe. Staff rotated into the intensive care unit to learn to care for these patients and achieve the competency. Fordwich Ward also had ‘Training Tuesday’ and specialist teams provided staff training.

The Professional Nurse Advocate (PNA) role supported nurses through restorative clinical supervision, using the A‑EQUIP model (Advocating and Educating for Quality Improvement) )—a framework that combines restorative reflection, education, personal action for quality improvement, and monitoring of professional practice. PNAs strengthened wellbeing and led improvements in care. Posters in staff rest areas displayed the available PNAs, the support they offered, and how to contact them, ensuring staff knew how to access timely help.

The evidence showed some shortfalls. The service did not always assess or manage the risk of infection. They did not always detect and control the risk of it spreading or share concerns with appropriate agencies promptly.

In most areas we visited staff consistently complied with the Five Moments of Hand Hygiene. All areas provided personal protective equipment, such as disposable aprons and gloves, and staff now used these correctly. There were clinical handwashing sinks and hand gel available. Posters promoted staff, patients and visitors to clean their hands regularly.

However, on St Augustine’s Ward and the Acute Medical Unit, we observed that staff did not consistently comply with the Five Moments of Hand Hygiene. These steps require hand cleaning before patient contact, before aseptic procedures, after body fluid exposure, after patient contact, and after contact with the patient’s surroundings. We saw a staff member perform a bladder scan without cleaning their hands before or after the procedure. Another member of staff checked a patient’s blood glucose level without carrying out hand hygiene. However, on all other wards we visited, staff demonstrated good hand hygiene practice.

Staff now maintained equipment well and kept it clean. All ward areas were now visibly clean and had suitable furnishings. Cleaning records were up to date and demonstrated that the ward areas were cleaned regularly.

From November 2025 to January 2026, the wards generally followed good infection prevention standards. Hand hygiene and cleaning of commodes were consistently strong, and care of lines and catheters was usually good.

Audits were carried out every month, looking at cleanliness, the ward environment, and nursing care. Results were shared with ward managers and used to make improvements. Teams reviewed their audit findings in meetings, recognised good performance, and agreed what needed to improve.

Notifiable infectious diseases remained low overall. Single rooms were used for patients who had infectious illnesses. Posters were displayed on the doors advising staff and visitors of any precautions to take when going into and leaving the room. This included using personal protective equipment such as disposable gloves and aprons. During the assessment we observed staff and visitors following these precautions.

The evidence showed some shortfalls. The service did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. They did not always involve people in planning.

There was mixed level of clinical pharmacy support in the service. Some areas had embedded pharmacy teams which involved pharmacists and pharmacy technicians. In areas where pharmacy support was limited, the service used effective processes to identify and prioritise higher risk patients. This included areas with limited weekend cover. This process was supported by clear policies and risk assessments which had improved the pharmacy service since the previous inspection. However, not all patients had their medicines reconciled in line with national guidance. Medicines reconciliation is the process of accurately listing a person's current medicines and comparing them with the current list in use. The service had identified this issue as a known risk and included it on the risk register, with actions in place to mitigate the impact.

We saw instances on St Margaret's ward where 3 patients did not have their medicines reconciled and had been on the ward for over 5 days. Data provided by the service showed that people generally did have their medicines reconciled whilst admitted, but this was not always done in line with national guidance recommendations. Prompt reconciliation allows for early identification of discrepancies, reducing harm from omissions or incorrect doses.

Where pharmacy teams were embedded, we saw positive interactions and interventions. Their input was positively recognised by the wider multidisciplinary team (MDT). Medicines were given as prescribed in records we reviewed. However, prescribing of medical gases was inconsistent. On 1 ward, 2 out of 3 patients, we reviewed, receiving oxygen therapy had no corresponding medical prescription recorded, despite the therapy being clinically indicated. Oxygen should be prescribed as it is medicine. There was a risk that people would not receive required oxygen. This was highlighted as a legacy issue by pharmacy leaders. There was ongoing work to improve the prescribing of medical gases.

Medicines "to-take-away" (TTAs) were generally supplied in a timely manner which support in the timely discharge of patients. Medicines “to-take-away” (TTAs) were generally supplied in a timely manner, which supported the prompt discharge of patients. However, staff told us that medicines were sometimes supplied late when discharge prescriptions were not written and sent to the pharmacy promptly, which led to occasional delays in discharge. Leaders also told us about previous concerns regarding a high number of incidents related to medicines supplied at discharge. We saw that staff had taken action and made improvements to ensure the safe supply of medicines on discharge.

The chief pharmacist acknowledged these issues and described work undertaken to change the culture so that discharge notifications were written earlier. He also discussed the incidents related to discharge supplies, and we saw evidence that staff took action and made improvements.

There were effective governance processes that oversaw the medicine related risks in medical care. We saw regular review of risks and mitigations. We saw learning and actions were taken in response to incidents and audits. For example, we saw education and learning articles on the management of liquid controlled drugs because of an incident.

Staff stored medicines securely using electronic storage systems. Only authorised staff accessed these systems, and they maintained oversight of stock used across the medical wards. Pharmacy top-up support remained consistent and staff across the wards regarded it positively. Staff followed an effective ordering process. The service supplied medicines required at weekends from a centralised dispensary located away from the hospital. Staff told us this generally did not impact accessing medicines in a timely way.

Controlled drugs (CDs) were stored and managed safely and securely in areas we visited. CD Registers and stock levels were reviewed regularly, and we saw regular CD audits and oversight from pharmacy teams. Staff told us they had easy access to medicines information including the BNF (British National Formulary), the Medusa injectables guide, trust guidelines and policies. Medusa provides guidance on the preparation and administration of injectable medicine. VTE (Venous Thromboembolism) assessments were generally completed in a timely manner. Data provided by the trust showed that across 2025 there a compliance rate of completion of the assessments of 96%. However, performances varied across the specialties. For example, the acute internal medicine speciality had a compliance rate of 74% whilst the gastroenterology speciality had a compliance rate of 99%.