Queen Elizabeth The Queen Mother Hospital

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

We assessed 3 quality statements.

We looked for evidence that patients were always treated with kindness, empathy and compassion. We checked that patient's privacy and dignity was respected, that they understood that they and their experience of how they were treated and supported mattered. We also looked for evidence that every effort was made to take patient’s wishes into account and respect their choices, to achieve the best possible outcomes for them.

At our last assessment in 2023 we did not rate this key question. At this assessment we rated caring as requires improvement. This meant patients did not always feel well-supported, cared for or treated with dignity and respect.

When we assessed urgent and emergency services in March 2023, we found a breach in Regulation 10 in relation to dignity and respect, due to overcrowding.

At this assessment, the breach remained. Overcrowding and capacity pressures meant patients were not always cared for in environments that protected their privacy, dignity or confidentiality. Patients experienced delays in accessing personal care, food, hydration and pain relief, and some were unable to summon assistance when required. Patients with mental health needs were not always cared for in appropriate environments and did not consistently have timely access to personal care facilities. While staff continued to treat patients with compassion and professionalism, staffing shortages, overcrowding and prolonged waits adversely affected the service’s ability to consistently meet patients’ basic needs and maintain their privacy and dignity.

We have not awarded this service a score for Caring.

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

The evidence showed some shortfalls. The service did not always treat patients with kindness, empathy and compassion, or respect their privacy and dignity

The service did not always ensure that patients were treated with kindness, compassion, and respect for their privacy and dignity. The service regularly experienced crowding within the emergency department, which led to lengthy delays in admission and the use of areas not intended for patient care. These very busy areas lacked facilities to adequately maintain patients’ privacy and dignity.

The service used temporary escalation areas that were brightly lit and noisy, which affected people’s ability to rest or sleep. Some patients told us they experienced prolonged delays in receiving food, hydration, pain relief and opportunities to rest. Some patients described repeatedly requesting food without a timely response, while others reported long periods without sleep or access to hygiene facilities.

The service was unable to consistently meet fundamental standards of care due to crowding and limited oversight. Staff positioned patient trolleys against corridor walls, leaving narrow walkways in a busy area. This meant staff passed very closely to patients awaiting assessment or admission, with no opportunity for privacy.

The service did not consistently protect confidentiality. We noted that private and confidential conversations were overheard by other patients, both within the department and by others outside the immediate care area, compromising patients’ right to confidentiality.

The service did not consistently protect the dignity of patients who spent extended periods in the mental health lounge. Limited staffing reduced access to shower facilities and fresh air. The lounge contained only 1 bed, and more than 1 person had remained there for over 24 hours, resulting in patients sleeping in close proximity to each other.

The CQC Urgent and Emergency Care Survey 2024 showed that service scored worse than expected when patients were asked whether they were given privacy when speaking with reception staff and during examination or treatment.

However, staff interacted with patients in a polite and professional manner and spoke compassionately about the importance of supporting people with mental health needs. Staff engaged positively with patients in the mental health lounge during the inspection, despite reduced staffing levels on the day.

We observed staff admitting a child in a calm, coordinated and compassionate manner. Staff communicated clearly with the child and their family throughout the admission, providing reassurance, explaining procedures and ensuring they felt informed and supported during a potentially distressing experience.

Staff were being kind and trying to do their best within challenging circumstances. We observed kind, caring interactions between patients and staff. Staff explained to patients what they were doing when providing care and treatment. Patients said staff treated them well and with kindness.

We did not look at Treating people as individuals during this assessment. The score for this quality statement is based on the previous rating for Caring.

We did not look at Independence, choice and control during this assessment. The score for this quality statement is based on the previous rating for Caring.

The evidence showed significant shortfalls. The service did not listen to or understand people’s needs, views and wishes. Staff did not respond to patients' needs in the moment or act to minimise any discomfort, concern or distress.

The service did not always respond appropriately to patients' immediate clinical needs. Staff used the Nationally Early Warning System 2 (NEWS2) to recognise and escalate deteriorating patients. We reviewed patient records and found an example where staff assessed a patient with severe breathing difficulty and a pre-hospital (NEWS2) score of 9. This indicated they were at serious risk of becoming suddenly more unwell. Despite their high-risk presentation, the service assigned the patient an Emergency Severity Index (ESI) priority of 3 and did not treat the patient as an urgent priority. This meant the patient did not receive immediate assessment and escalation in line with the level of risk identified. Following escalation by Inspectors, a multidisciplinary review was undertaken, ESI scores were corrected, and appropriate care plans established. Following escalation by Inspectors, a multidisciplinary review was undertaken by the trust, ESI scores were corrected, and appropriate care plans established.

The service did not consistently support patients to get help when needed. This included a vulnerable patient who had lost their hearing aid and was being cared for in the corridor without any reasonable adjustments. We observed that call bells were not answered promptly and patients in the temporary escalation areas did not have personal call bells to gain the attention of staff. This posed a risk to patient safety in the event of an emergency. Call bells were available for staff to gain attention if needed.

Patients remained for extended periods in unsuitable areas. Temporary escalation areas did not include piped oxygen. Many patients remained on trolleys, for prolonged periods, increasing the risk of pressure damage

On 7 January 2026 we observed several patients had breakfast placed on their trolley, but staff did not encourage them or support patients to eat it. One patient told us they were hungry and thirsty but needed to sit up to eat and drink.

Leaders told us that following our assessment they had introduced a housekeeper safety standard operating procedure (SOP) and a mealtime safety huddle. The service remains a risk during periods of high demand, as patients may not be consistently supported with nutrition and hydration needs.

Staff were aware but did not consistently assess and deal with some specific risk issues, such as falls or pressure ulcers. In the 12 months prior to our assessment, data from the National Audit of Patient Falls (NAIF) showed that the whole trust scored well in 3 of the measures, but at 58% was below the national average of 64% for patients receiving a medical assessment within 30 minutes of a fall.

The paediatric emergency department provided a child-friendly environment, with age-appropriate toys, colouring books, sensory lighting, and an interactive floor projection system available to support children's engagement and wellbeing.

The evidence showed some shortfalls. The service did not always care about and promote the wellbeing of their staff. They did not always support or enable staff to deliver person-centered care.

Not all staff felt respected, supported and valued. Staff survey results showed consistently low scores relating to staff not feeling valued or supported. All staff survey responses had declined compared to the previous year.

We looked at the NHS Staff Survey 2025 for East Kent University Foundation Trust (EKUFT) and saw that had a response rate of 49%. For the question, “The extent to which my organisation values my work” of the 5,354 responses only 55% felt satisfied.

We looked at trust Board papers for 2025 and saw that medical workforce appraisal rates were 74.6% in comparison to the target rate of 80% trust wide. Nursing and midwifery appraisal compliance in December 2025 was 94%, indicating that most staff were receiving regular performance review and development discussions.

Some staff told us they experienced verbal and physical abuse from patients. Staff said they reported these incidents using the trust’s incident reporting systems, but they did not feel this resulted in action or meaningful change to reduce the risk of further incidents or improve their safety and wellbeing.

However, staff we spoke with told us that they had access to informal support for their physical and emotional wellbeing. For example, through playing football once a week. The told us that they had recently raised money for charity by challenging the local NHS ambulance service to a football match.

Staff had access to support for their own physical and emotional health needs through an occupational health service. We saw that a range of services were available that staff could self-refer and access., Nursing staff sickness rates were 4.94%, which was better than the national average.