Queen Elizabeth The Queen Mother Hospital

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture. However, staff did not always know the medical care (including older people’s care) service vision and values or how they were applied in the work of their team.

The service demonstrated a variable position across leadership, culture and engagement. Leaders were visible, experienced and promoted a supportive and learning-focused environment, with evidence of strong governance, partnership working and ongoing service improvement. However, there were inconsistencies in how clearly the service vision and strategy were communicated and understood, and some staff reported challenges in feeling confident to speak up.

Overall, the service showed effective systems for managing quality, risk and performance, alongside positive examples of collaboration, innovation and patient engagement, although further work was needed to strengthen staff involvement, communication and culture.

We have not awarded this service a score for Well-led.

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

The evidence showed some shortfalls. The service did not have a clear shared vision, strategy and culture which was based on transparency, equity, equality and human rights, diversity and inclusion, and engagement. They did not always understand the challenges and the needs of people and their communities.

Most staff we spoke with did not know the medical care service vision and values or how they were applied in the work of their team. Staff could tell us - the trust values were that staff and patients feel ‘cared for, safe, respected and confident’. Senior nurses and the practice development team told us about the trust strategic theme ‘the pillars of change’ but did not talk about a particular strategy for medical care.

Staff told us the leadership team had not communicated the departments vision and values to the frontline staff in this service. We saw many posters showing the trust values and strategic theme, but staff could not tell us anything about the vision and values for medical care.

While senior leaders emphasised their commitment to trust, kindness, and learning, some staff members reported a different experience. The senior leadership team shared that they actively engaged with staff on the wards, made themselves accessible for support, and provided guidance when needed. They aimed to foster an open and fair culture where staff felt safe. In cases of errors, leaders prioritised learning opportunities rather than placing blame on individuals. They communicated using clear, supportive language and helped staff experiencing anxiety, ensuring that learning could contribute to safer care.

The team also improved how doctors and other staff worked together. They made sure resident doctors felt included, valued and well supported. Leaders stayed in regular contact with them and involved them in daily discussions about patient care.

Leaders encouraged teams across the hospital to work more closely together, which helped staff feel more confident about raising concerns early. They also worked closely with patients and families. New initiatives included follow‑up phone calls after discharge, quicker ways for patients to share feedback, and stronger links with community services, GPs and ambulance teams. These changes helped patients get home sooner, reduced unnecessary emergency attendances, and meant concerns could be addressed quickly. Overall, the senior leadership team described a culture where people felt listened to, supported to make improvements, and focused on working together to provide the best possible care.

Staff did not have the opportunity to contribute to discussions about the strategy for their service, especially where the service was changing. Although there were regular meetings within the service the strategy for medical care was not an agenda item. Staff could explain how they were working to deliver high quality care. This very much related to their work on individual ward areas rather than the wider hospital.

The evidence showed a good standard. The service had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.

Leaders had the skills, knowledge and experience to perform their roles. The leadership team described a strong focus on developing people at all levels by recognising potential early and encouraging staff to see themselves as leaders. Managers actively recognised individuals in the moment, spoke with staff about opportunities, and supported career development through clear pathway planning and regular career conversations. The organisation strengthened leadership foundations through improved induction and a structured leadership programme, which helped staff build confidence and essential skills.

Leaders demonstrated a strong understanding of the services they managed and clearly explained how teams worked together to provide high‑quality care. During the assessment, senior nursing leaders spoke confidently and in detail about their areas of responsibility, including the purpose of the service and the outcomes they aimed to achieve for patients. They described current performance, key risks and challenges, and the actions taken to manage these effectively. Leaders also shared examples of achievements and improvements, and clearly articulated their short, medium and long‑term goals, showing how these aligned with patient needs, workforce priorities and wider organisational objectives.

Leaders were visible throughout the service and remained approachable to both patients and staff. We saw clear and accessible information displayed for patients and visitors, including posters with photographs and roles of the senior leadership team, which helped people understand who was responsible for the service and how to raise concerns. We observed clinical leaders attending daily safety huddles, ward rounds and board rounds, where they actively engaged with staff, discussed risks and patient care priorities, and supported decision‑making.

Ward teams recognised and spoke positively about the leaders, who were well known within the clinical areas and worked closely together across professional groups. This visible and collaborative leadership supported effective communication, timely escalation of concerns and a shared focus on patient safety and quality of care.

Leadership development opportunities were available, including opportunities for staff. Leaders created practical development opportunities, including link roles, mentorship, apprenticeships and clinical development posts, while also providing targeted support to address recruitment challenges. Throughout, leaders prioritised visible leadership, listened to staff, valued their ideas, and supported progression across all roles and bandings, with a clear emphasis on growing future leaders and improving the quality of patient care.

The nursing career pathway ‘Atlas’ was developed to provide nurses with every opportunity to advance their careers within the trust. It linked to the nursing and midwifery career framework and the Nursing and Midwifery Ambitions 2024-2029. The team also worked on an Allied Health Professional career framework and Allied Health Professionals Ambitions.

The evidence showed some shortfalls. People did not always feel they could speak up and that their voice would be heard.

The service had Freedom to Speak up arrangements. Information about the guardian and how to contact them was available on both the internet and the intranet. Whilst staff were not always able to tell us who the Freedom to Speech Up Guardian was, they knew how to find out and how to access them. However, some staff told us they did not feel able to speak up when they had concerns about the service.

East Kent Hospitals achieved a high level of engagement in the 2024 NHS Staff Survey, with 6,220 staff responding, representing a 63% response rate. The results indicated that staff experience was consistently below that of comparable trusts, particularly in relation to morale, feeling valued, workload pressures, and access to learning and development opportunities. While respondents continued to report positive experiences around teamwork and professional autonomy, fewer than half said they would recommend the organisation as a place to work. Many staff also described high levels of burnout, discrimination and lack of confidence in raising concerns. Taken together, the findings reflected a dedicated workforce working under prolonged pressure and demonstrated the importance of strengthening culture, wellbeing and staff support. The data was collected at trust level and was not broken down by department.

Patients and carers had opportunities to give feedback on the service they received in a manner that reflected their individual needs. For example, patients who were part of the virtual ward had the opportunity to give feedback as part of a survey. Feedback from 54 patients showed very high levels of satisfaction with the virtual ward service. Most patients said staff clearly explained the service, found the technology easy to use, felt safe, and valued being able to recover at home with regular monitoring and easy access to support. Nearly all respondents would recommend the service. Some patients noted areas for improvement, including clearer discharge information, more consistent communication, and greater use of video or face‑to‑face contact at key points.

Over the last few months, feedback from patients, friends and family about medical care had been generally positive. Around 8 out of 10 people said they would recommend the service to others. Most comments were positive, showing that many people felt they received good care. Some feedback from December 2025 and January 2026 was still being reviewed, but overall, the results show that people are mostly satisfied with the service and that staff take feedback seriously and use it to improve care.

We did not look at Workforce equality, diversity and inclusion during this assessment. The score for this quality statement is based on the previous rating for Well-led.

The evidence showed a good standard. The service had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver good quality, sustainable care, treatment and support. They act on the best information about risk, performance and outcomes, and share this securely with others when appropriate.

There was a clear framework of what must be discussed at a ward, team or care group level in team meetings to ensure that essential information, such as learning from incidents and complaints, was shared and discussed. Records we reviewed demonstrated meetings with a planned agenda and monitored actions because of the discussions about risk in the service.

Staff made improvements based on learning from deaths, incidents and complaints. Patient and family feedback showed better listening and use of feedback, with medical teams now aligned with the wider trust. Listening to diverse communities led to practical actions, including homelessness training and improved support for veterans. Patient stories shared with senior leaders increased understanding, reduced stigma and promoted compassionate care, with progress reviewed regularly.

We reviewed the governance report from 2025 and found incident reporting levels remained stable, with delays, tissue viability and falls the most common issues. A small number of moderate harm incidents highlighted gaps in documentation, risk assessment and timely care. Performance improved, with fewer overdue actions, reduced complaints and full Duty of Candour compliance.

Audit was used to learn, improve and innovate. The sleep service implemented one‑stop clinics to streamline the patient pathway. Patients received assessment, results, and treatment in a single visit or minimal appointments, reducing delays and hospital visits while improving patient experience. The audits were sufficient to provide assurance and staff acted on the results when needed. We saw wards completed comprehensive clinical audits that reviewed key areas of patient safety, including infection‑control practices, medication management, documentation accuracy, and the management of patient deterioration. Staff feedback, patient experience, safe‑staffing levels, and training compliance were included, and the outcomes informed action plans and assurance processes, with routine spot checks contributing to each ward’s overall accreditation rating. Ward accreditation is a quality improvement scheme in NHS hospitals that assesses ward performance

Staff concerns matched those on the risk register. Leaders explained that medical wards faced a high level of environmental risk, with the caring for confused patients being a daily challenge, particularly when patients were cared for in unsuitable areas. This placed ongoing pressure on nursing staff. Leaders felt that restricted areas would reduce the risk and confirmed they had submitted a bid for magnetic lockable doors. To support staff in caring for confused patients the service recruited mental health staff to support teams, including with mental capacity assessments. The appointment of a mental health lead strengthened support for staff and improved confidence through de‑escalation training.

Leaders described workforce pressures, including previous reliance on locum doctors, which had ceased in October of the previous year with services now using bank staff only. At the time there was a single consultant vacancy. Teams also managed outpatient activity and all respiratory diagnostics, adding to staffing demands. Although challenges remained, leaders secured approval for a business case for 14 additional whole‑time‑equivalent posts with support from the Integrated Care Board.

Staff understood the arrangements for working with other teams, both within the trust and external, to meet the needs of the patients. Leaders introduced a new Same Day Emergency Care model based on evidence‑based practice, which supported safer care and more effective risk management. This included safe staffing levels and a rota, which clearly defined daily roles, ensured senior clinical decision‑maker availability, and provided consistent consultant oversight. Teams regularly reviewed incidents and risks, held twice‑daily board rounds, followed effective handover processes, and worked closely with specialist and tertiary services. Leaders used staff and patient feedback to inform ongoing improvements. Leaders maintained and had access to the risk register at ward or care group level. Staff at ward level could escalate concerns when required.

The service had plans for emergencies for example, adverse weather or a flu outbreak. Records reviewed during the assessment including the business continuity policy outlined the actions to be taken in the event of an emergency.

Staff had access to the equipment and information technology needed to care for patients. Information governance systems included confidentiality of patient records. Each area we visited had static and mobile computer terminals for staff to use. The terminals were locked when not in use to prevent unauthorised persons accessing confidential information.

Leaders had access to information to support them with their management role. There was a good range of accurate and timely data and information available to understand performance and quality and improvements were made as needed. This included information on the performance of the service, staffing and patient care. Information was in an accessible format, and was timely, accurate and identified areas for improvement. We were told about the recycling scheme for plastic inhalers run by the trust. The inhaler recycling scheme reduced environmental impact and carbon emissions by enabling the safe recycling of inhaler components and capturing harmful propellant gases that significantly contributed to the NHS carbon footprint.

The evidence showed a good standard. The service understood their duty to collaborate and work in partnership, so services work seamlessly for people. They share information and learning with partners and collaborate for improvement.

Care group leaders engaged effectively with external stakeholders, including commissioners, to support joined‑up working across the system. They worked closely with both primary and secondary care partners, including GPs, urgent care centres and the local ambulance trust, to improve how patients accessed care. This collaborative approach helped reduce avoidable hospital admissions by supporting people to remain at home where appropriate, making greater use of the virtual ward, and enabling direct admission to clinical areas when hospital care was needed. These arrangements helped avoid unnecessary attendance at the emergency department and reduced waiting times for patients.

Patients and staff could meet with members of the senior leadership team to give feedback. Listening to people from a wide range of communities resulted in practical changes, such as training staff to better support people experiencing homelessness and veterans. Sharing patient stories with senior leaders improved understanding, helped challenge stigma, and reinforced caring attitudes, with progress reviewed regularly.

Strong relationships between the hospital end‑of‑life care team, clinical networks, and community providers directly improved the coordination and quality of care. By working closely together, these teams shared vital information, aligned care plans, and ensured that patients experienced continuity and dignity as they moved between services. This collaborative approach enabled earlier identification of needs, more responsive symptom management, and better support for families and carers. Ultimately, these partnerships, prevented avoidable hospital admissions, and helped ensure that patients received the right care, in the right place, at the right time.

What patients told the service led to clearer communication, kinder staff behaviours and new support tools such as patient portals and communication and stroke passports. The service demonstrated active engagement with patients, families and carers through surveys and direct involvement, using feedback to identify strengths and areas for improvement, particularly in communication and discharge planning. It also showed a clear commitment to co-production by working with carers and families in forums and targeted engagement activities, ensuring their experiences directly influenced service development and improvement.

The evidence showed a good standard. The service focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contribute to safe, effective practice and research.

Staff were given the time and support to develop opportunities for improvements and innovation and this led to changes in care delivery. Staff at all levels contributed to quality improvement and leaders explained they remained accessible to staff and built positive, trusting relationships. This approach encouraged open discussion and ensured staff felt comfortable sharing ideas. Leaders used their influence to turn ideas into action and engaged wider hospital teams to support improvement initiatives. They strengthened staff engagement through team briefs, staff forums, and improvement huddles. In response to feedback that administrative staff felt unheard, leaders created admin forums and secured funding for initiatives such as a dedicated doctors’ space on Deal ward.

Staff participated in national audits relevant to the service and learned from them. For example, following the death of a person in the hospital those close to the person who died were invited to participate in the National Audit of Care at the End of Life. This audit gathered information about the quality of care experienced by people who died in hospital in England, Wales and Jersey.

Wards participated in accreditation schemes relevant to the service and learned from them. Wards we visited on the assessment proudly displayed the accreditation they had received, and staff wanted to share how they had achieved their award. The Ward and Clinic Accreditation Scheme is a framework that standardises and improves patient care by assessing wards and clinics against 13 key standards. Using a Bronze–Silver–Gold rating system, teams identify strengths and target improvements, supporting a strong safety culture.

The Same Day Emergency Care (SDEC) project introduced new and expanded units to improve patient flow and reduce pressure on emergency departments. It enabled patients to be assessed, diagnosed and treated on the same day where appropriate, avoiding unnecessary hospital admissions. The project aimed to reduce waiting times, overcrowding and corridor care, while increasing capacity and improving the speed and quality of care. It also supported better discharge processes and overall system flow, contributing to improved patient experience and more efficient use of hospital resources.

The Respiratory Sleep Service opened in October 2025, seeing its first patient and establishing new local access to diagnostics. Teams worked collaboratively with the local NHS community service provider to develop the facility, aligning with the 10-year neighbourhood hub model and integrating relocated GP services, demonstrating strong partnership between primary and secondary care. The centre delivered respiratory sleep studies and lung function testing alongside wider diagnostic services in pathology, radiology and cardiology, improving access to a range of investigations closer to patients’ homes.

A regional multidisciplinary team (MDT) was created to plan care and treatment for patients diagnosed with hemophagocytic lymphohistiocytosis (HLH), a rare but serious illness. It brought together multiple specialties to deliver collaborative care. As the first MDT of its kind in the UK, the service received a national Best Practice Award and significantly improved outcomes, reducing mortality rates from almost 100% to around 33–35%.

The MDT fostered strong teamwork, education and shared learning across disciplines, demonstrating a highly effective and sustainable model of collaborative working that improved both patient care and staff development.

As part of system integration and the Ageing Well programme, 7 social care nurses from a care home undertook a shadowing programme with the Acute Trust Frailty Team to strengthen their understanding of patient pathways across hospital and community settings. This experience enhanced their knowledge of frailty and end-of-life care, enabled them to apply learning to improve care home practice, and strengthened collaboration with the Frailty Team to support admission avoidance, safe discharge planning, and dignified end-of-life care.