Queen Elizabeth The Queen Mother Hospital

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• 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 assessed 4 quality statements. We looked for evidence that patients and communities were always at the centre of how care was planned and delivered. We checked that the health and care needs of patients and communities were understood, and they were actively involved in planning care that met these needs. We also looked for evidence that patients could access care in ways that met their personal circumstances and protected equality characteristics.

At our last assessment in 2023 we did not rate this key question. At this assessment we rated responsive as requires improvement. This meant patients' needs were not always met.

We found the service did not consistently respond to patient’s needs in a timely or person-centred way. Patients were not always involved in decisions about their care, and care planning and record-keeping did not consistently reflect patient's preferences or changing needs.

The service did not consistently provide clear, accessible, or real time information about waiting times, and patients reported limited communication about delays. These factors reduced patient’s ability to understand what was happening and make informed decisions about their care.

Access to care was not always equitable, particularly for patients with mental health needs. People experienced prolonged waits in the mental health lounge, including waits of several days for onward admission due to the unavailability of inpatient mental health beds. This limited timely access to appropriate care and support.

However, psychiatric liaison staff responded promptly to referrals, completed assessments in parallel with emergency department staff, and supported risk assessment and care planning.

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 evidence showed significant shortfalls. The service did not always make sure patients were at the centre of their care and treatment choices and they did not always work in partnership with patients, to decide how to respond to any relevant changes in patient’s needs.

The service had an inconsistent approach to record keeping within patient notes. We saw examples of care plans that lacked evidence of patient input or personalised goals. Staff completed records that were sometimes incomplete or generic, and these did not always reflect patients’ changing needs or preferences.

The service was experiencing significant crowding, which affected patients experience of care. We observed around 52 patients waiting in the waiting room and around 22 patients waiting to be seen. Total department occupancy was reported as approximately 135 patients. We saw that chair-based and specialty waiting areas were operating beyond their intended capacity, with relatives present due to prolonged waits. Therefore, staff capacity to provide individualised support was limited.

We observed streaming nurses managing queues of 7 to 8 patients at a time and being unable to leave their desks to provide additional oversight.

We did not look at Care provision, Integration and continuity during this assessment. The score for this quality statement is based on the previous rating for Responsive.

The evidence showed some shortfalls. The service did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

The service did not consistently provide patients with clear, real‑time information about waiting times on arrival at the emergency department. We did not see digital displays available for patients waiting to be treated, which limited patients understanding of expected waits and reduced support for person‑centred decision‑making.

Patients told us the highest concern for them was being kept updated about what was happening to them. This was particularly with patients who were in waiting areas. A key theme in comments from patients we spoke with (patients and family) was that they needed more information or at least to be acknowledged, even when there was nothing new to tell them.

Staff said there were various ways in which they could provide information in a way patients could understand. This included being able to provide interpretation for patients who did not speak English as a first language or requiring British Sign Language.

We saw that the layout through the department did not have clear signage which made the patient journey through the department difficult.

However, we observed an information board, that included staffing numbers, useful contacts, and “You said we did” which was examples of action taken by the service in response to patient feedback.

The evidence showed some shortfalls. The service did not always make easy for patients to share feedback and ideas, or raise complaints about their care, treatment and support. They did not always involve patients in decisions about their care and told them what had changed as a result.

During the assessment we observed patient care and spoke directly with patients who used the service, which allowed us to capture the experiences of patients who received care.

The trust shared feedback from their Family and Friends Test (FFT). Of the 658 responses 495 were rated 4 and 5 stars. Many responses rated between 1 and 3 stars but still praised the care provided by staff but gave lower ratings due to wait times. Patients gave the most positive feedback about the care provided by staff, their attitude and how efficiently they worked.

The trust’s own survey feedback showed that the top 3 themes from complaints were overcrowding, communication and waiting times. However, we could not find any examples of learning from complaints in the evidence submitted.

However, staff gave patients opportunities to give feedback and supported them to raise concerns or make complaints were needed.

The service actively encouraged feedback and placed equal importance on positive and negative comments, using this information as an opportunity to learn and improve.

Staff were able to clearly explain the complaints process and their role in handling complaints appropriately.

The evidence showed some shortfalls. The service did not always make sure that people could access the care, support and treatment they needed when they needed it.

The service struggled to provide timely care because the hospital consistently operated at full capacity, leading to severe overcrowding. During our assessment the trust was on critical incident standby due to the number of attendances and lack of flow throughout the whole hospital. Wards were required to expedite discharges as early as possible and senior doctors supported decisions. The local system partners, on tactical calls, were asked to support the trust with prioritising discharges of patients and alternatives to admission. Leaders told us the hospital often ran at full capacity, meaning patients got stuck in the emergency department with nowhere to go.

As a result of overcrowding and poor flow through the hospital, patients were frequently cared for in escalation areas, corridors, and other inappropriate spaces not designed for patient care. Many remained in these busy environments for extended periods, sometimes for days. Patients with mental health needs were particularly affected by these delays and unsuitable care settings

The trust had developed services to help manage demand and reduce attendance within urgent and emergency care pathways, including medical and surgical Same Day Emergency Care (SDEC) services. However, we found patients were being accommodated overnight within the SDEC unit despite the area not being designed or equipped for overnight stays. This meant patients were receiving care in an environment that was not intended for prolonged admission and did not fully meet their needs.

However, the psychiatric liaison team responded promptly to referrals for patients in the emergency department. Senior departmental leaders escalated prolonged waiting times through joint oversight calls.

Staff from the psychiatric liaison team completed assessments in parallel with emergency department staff and completed an initial risk assessment and plan of care.

The service had clear processes to escalate concerns when a person requiring an inpatient mental health admission remained in the department for extended periods. This included escalating to senior managers once a person had been in the department more than 12 hours.

Staff directed people to other resources in the community where appropriate.

The median total time that admitted patients spent in emergency department between October 2024 and September 2025 was 4 hours 16 minutes, which was better than the national average.

Ambulance handover performance for December 2025, were 94% under 30 minutes and 6% over 30 minutes, which was better than the national average.

The trust’s rate of re-attendance to the emergency department within 7 days of a previous attendance was higher than the England average. In the 12 months to September 2025, the trust’s re-attendance rate averaged 11.7%, which was worse than the national average.

We did not look at Equity in experiences and outcomes during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Planning for the future during this assessment. The score for this quality statement is based on the previous rating for Responsive.