Glenfield Hospital

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• 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

This means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question as requires improvement. At this assessment the rating has changed to good.

Good: This meant people were 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.

Description: We have a proactive and positive culture of safety based on openness and honesty, in which concerns about safety are listened to, safety events are investigated and reported thoroughly, and lessons are learned to continually identify and embed good practices.

We scored the service as 3. The evidence showed a good standard. The service had a proactive and positive culture of safety, based on openness and honesty. They listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

The data indicated a number of ‘open’ incidents. The best performing department in the data submitted was the Clinical Decisions Unit which was at 100% every month for incidents being reviewed and closed. A trust report for February 2026 data showed cardiology had an improved position of 46% incident reviews being open (relating to 11 out of 24 incidents being overdue as not closed within the defined in the policy).

The overdue status meant that the incident had not been closed within the 28 calendar days (as per trust policy). Some of the learning responses were across Clinical Management Groups (CMG)/specialty and took longer to arrange or there were delays due to operational pressures where clinical care needed to take priority.

For all the most harmful incidents (moderate and above harm), there was a weekly executive led incident meeting where the senior team from each CMG bring all of their harm incidents (and any other of concern) to the meeting to discuss and advise the plan for review, so there is oversight from executive and CMG triumvirate level of these incidents. Any immediate actions were noted and any safety messages that were relevant were added to the handover messaging from this meeting.

Staff told us that they received feedback from investigation of incidents, both internal and external to the service. Staff said they were debriefed and received support after a serious incident.

We found safety was a priority that involved everyone, including staff as well as patients. There was a culture of safety and learning, which was based on openness, transparency and learning from events. Risks were dealt with and regarded as an opportunity to put things right, learn and improve. Patients and staff were encouraged and supported to raise concerns. Almost all staff felt confident that they would be treated with compassion and understanding, and would not be blamed, or treated negatively if they did so. Raising concerns helped to proactively identify and manage risks before safety events happened.

Incidents and complaints were investigated and reported. Lessons were learned from safety incidents or complaints, resulting in changes that improve care for others. We saw that estate issues were discussed at the hospital site meeting during the inspection. There was a clear focus on patient and staff safety shown at this meeting. We saw staff were provided with information about improvements in safety at every handover. All staff knew what incidents to report and reported all incidents appropriately. In the Same Day Emergency Care (SDEC) area, staff said estates issues were always reported.

Staff understood the duty of candour. They were open and transparent and gave patients and families a full explanation if things went wrong. Safety was effectively monitored using information from a range of sources (including performance against safety goals) and used to identify key risks.

Falls were reported across the medical wards, with, for example, Ward 15 recording 6 falls in January 2026 and 3 in February 2026. These figures were consistent with the expected risk profile for an acute medical inpatient population, which included older and more frail patients. Overall, falls were considered to be in line with national expectations for inpatient settings. We saw effective risk assessments in place in areas visited, and that appropriate footwear was used by patients.

Staff reported that staffing pressures had been present over the previous three quarters; however, incident reporting remained robust, and actions and learning were clearly shared. These were communicated through ward handovers, safety notice boards, staff huddles, meetings, emails, and safety bulletins. Most staff found that the safety boards were effective in sharing key messages and embedding learning to support ongoing improvements in patient safety.

We reviewed three recent serious incident reports. There was a clear record of the investigation with a detailed analysis of the root causes, and duty of candour policy was followed and reported on within the patient safety reports. Lessons learnt had also been identified and actions plans in place to support the cascade and embedding of the learning across the service.

Description: We work with people and our partners to establish and maintain safe systems of care, in which safety is managed, monitored and assured. We ensure continuity of care, including when people move between different services.

We scored the service as 3. The service worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

The service’s referral and admission processes ensured all essential information about the patient was available to determine if the patient’s needs could be met safely. Staff involved all the necessary healthcare and social care services to ensure patients had continuity of safe care, both within the service and post-discharge.

The service operated a Clinical Decisions Unit (CDU) which took some patients direct via ‘999’ calls to the local ambulance service, also by direct transfer from the trusts’ main emergency department (ED) at Leicester Royal Infirmary and also via GP referrals via the local ‘Bed Bureau’ system. This could create capacity and demand pressures at times of peak demand. Local leaders were fully sighted on these pressures and were planning to review the trust’s winter pressures programme shortly to ensure patient pathways worked effectively.

The service had a direct pathway from the emergency department (ED) to the respiratory support unit (RSU) to improve patient flow and reduce delays in accessing specialist care. In April 2024, a dedicated respiratory support unit was introduced on Ward 20. This allowed emergency department resuscitation clinicians to transfer patients directly to the RSU at any time. The unit was supported by a respiratory registrar on site to clerk, admit and review patients promptly. This change had improved patient experience and outcomes by reducing unnecessary delays, relieving pressure on the clinical decision unit, and ensuring patients accessed specialist led care quicker. Staff considered this a positive development and an improvement in the safety and efficiency of the service. Respiratory medicine consultants were very engaged with the acute emergency care, particularly for respiratory patients, together with a cardiologist on CDU. They had on average 170 patients in their bed base, 40% of them were respiratory tract infections that needed to be managed so the service was being innovative by engaging with NHS initiatives, including the virtual wards, and had developed care models that were relatively unique in terms of subspecialty virtual wards for respiratory patients with conditions like COPD, asthma,
and pneumonia.

The service achieved strong outcomes for patients requiring non‑invasive ventilation (NIV) during COPD exacerbations. Chronic Obstructive Pulmonary Disease (COPD) is a progressive, long‑term condition associated with significant morbidity and mortality due to acute respiratory failure. Medical staff said, while national mortality rates for COPD exacerbations were reported to be around 24%, the service consistently recorded lower mortality rates of approximately 14% over the past three years. This improvement was supported by timely access to specialist respiratory care, including a dedicated respiratory pathway and rapid transfer to areas with appropriate clinical expertise, enabling early reassessment and initiation of NIV where required. In addition, the service had embedded research into everyday clinical practice, participating in randomised controlled trials focused on NIV weaning and prone positioning, which supported the adoption of evidence‑based approaches to managing respiratory failure. Staff were appropriately trained and competent in delivering specialist respiratory care and obtaining informed consent, contributing to a consistent and high standard of treatment. Together, these factors supported improved clinical outcomes for patients with COPD exacerbations.

Discharge planning was embedded within patient pathways and typically commenced within 24 hours of patients attending the service, patients were given their estimated date of discharge which supported flow through the service. Staff described a multidisciplinary approach to discharge, involving staff in the hospital and the wider community, with a focus on discharging patients to their usual place of residence where clinically appropriate. Patients received discharge documentation and information to support continuity of care, including onward referrals and follow‑up arrangements. Processes such as the use of discharge lounges were in place to support timely patient flow and release of inpatient beds.

Description: We work with people to understand what being safe means to them as well as with our partners on the best way to achieve this. We concentrate on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect, and we make sure we share concerns quickly and appropriately.

We scored the service as 3. 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 safely, free from bullying, harassment, abuse, discrimination, avoidable harm, and neglect. The service shared concerns quickly and appropriately.

There was a good understanding of safeguarding and how to take appropriate action. Staff understood what being safe meant to patients and helped them know how to raise concerns when they didn’t feel safe, or they had concerns about the safety of other people. There was a commitment to taking immediate action to keep people safe from abuse and neglect. This included working collaboratively with other agencies. Staff knew how to access the trust’s safeguarding policies and who to contact for advice.

All staff were trained in safeguarding and knew how to identify adults and children at risk of harm. Safeguarding training compliance for all staff groups was at or above 91% at the time of the inspection. Staff were fully aware of the trust’s safeguarding procedures, which complied with national standards, and knew how to raise a concern and also who to contact for support.

People were supported to understand their rights relating to the Mental Capacity Act 2005 and the Equality Act 2010. There was a clear understanding of the Deprivation of Liberty Safeguards (DoLS) requirements which were only used when appropriate and following proper consideration of the patient’s best interests. Staff knew how to access the trust’s DoLS policies and who to contact for advice.

People with protected characteristics were protected from discrimination in relation to the Equality Act 2010. On the Coronary Care Unit, we found that people who do not speak English as a first language were always kept informed of their planned care and condition via an interpreter or staff member who spoke their language. Being spoken with in their preferred language allowed people to raise any concerns or worries about their safety. People were appropriately supported when they felt unsafe or experienced abuse or neglect.

Training compliance for PREVENT was 98% for nursing staff. PREVENT is one part of the government's overall counter-terrorism strategy.

Description: We work with people to understand and manage risks by thinking holistically so that care meets their needs in a way that is safe and supportive and enables them to do the things that matter to them.

We scored the service as 3. 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.

People were informed about any risks and how to keep themselves safe. Risks were assessed, and people and staff understood them. There was a balanced and proportionate approach to risk that supported people and respected their choices. Risk assessments viewed were person-centred, proportionate, and regularly reviewed with the person, when possible. Feedback from patients and their relatives was generally positive about their involvement in their care and treatment plans.

On Ward 20, patients were able to be cared for by staff who had supported them in their own home or care home. This allowed patients to receive care from staff who were familiar and knew their needs and preferences. It also ensured patients would be supported by the same staff after they left the hospital.

When people communicated their needs, emotions or distress, staff managed this in a positive way that protected their rights and dignity. Staff received training and were able to manage people presenting with difficult behaviours, due to cognitive impairments. Some staff told us that it was rare for patients who might need some level of care restrictions for safety reasons to be admitted to their wards, but felt competent that they could use appropriate techniques, when needed.

Staff communicated with patients and understood their care and treatment. This included finding effective ways to communicate with patients who had difficulty expressing themselves. Including the use of interpretation services. Patients were supported to give feedback on the service they received. There were QR codes around the hospital waiting areas and corridors for patients and family members to leave feedback. Staff enabled patients to make advance decisions (to refuse treatment, sometimes called a living will) when appropriate. Staff ensured that patients could access advocacy such as Lasting Power of Attorney’s (LPA) and Mental Health Advocates.

Staff used a range of recognised assessment tools to identify, monitor and respond to risks to patients. This included the National Early Warning Score (NEWS2) and Martha’s Rule concern processes to support the early recognition and escalation of clinical deterioration. We reviewed patient records and found NEWS2 observations were recorded appropriately and escalated in line with local processes where required. Risk assessments and associated care plans were completed and reviewed for areas including pressure damage, moving and handling, mobility, continence and falls. Documentation demonstrated that identified risks were assessed, and care was planned to support patients' individual needs. We reviewed patient records and did not identify concerns regarding the management of NEWS2 scores, falls prevention measures or the completion of risk assessments and care plans. Patients with higher needs due to cognitive impairments were cohorted together in a bay with constant staff supervision. Overall, records had been completed to a high standard. In terms of dietary requirements, menu choices also considered people’s individual allergies and intolerances.

Description: We detect and control potential risks in the care environment and make sure that the equipment, facilities and technology support the delivery of safe care.

We scored the service as 3. The service detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

We reviewed a range of environmental records, including audits, risk assessments and incident documentation. All records were current, appropriately maintained, and demonstrated regular oversight, with evidence of monthly review through governance meetings. A full tour of the medical wards was undertaken to assess environmental safety. No significant concerns were identified during this walkthrough, and the environment appeared to be safe and well maintained.

Facilities, equipment and technology were well-maintained and consistently supported staff to deliver safe and effective care. Equipment was regularly checked and all equipment we observed was in date for its next check. A few staff said whilst they had the technology to perform their duties, they found it difficult at times to access enough computers or equipment to complete administration tasks. For example, some staff members said that they would need to use the ward round computer to review X-rays. Staff felt that this was a worse visual screen and worried they could miss something and would need to take extra care. At times staff felt this delayed patient care or could not be fully assured of their diagnosis.

We observed that fire safety arrangements were appropriately managed, with fire doors in place and appearing to be maintained to support their intended function. Access to ward areas was secure, helping to ensure that only authorised individuals could enter clinical environments. Signage throughout the wards was clear and visible, supporting safe navigation for patients, visitors and staff. Overall, the layout and access arrangements contributed to a safe and well‑organised environment. Fire doors were mostly clear and closed where necessary, allowing people to exit if needed. However, on ward 24 we observed that the fire door at D block was blocked from the other side. When we raised this with the ward staff and this was immediately rectified. Post inspection, the trust provided a robust action plan detailing how this potential risk was being mitigated.

Fire safety training compliance was 91% for nursing staff and 95% for additional clinical services staff.

Leaders and staff considered how the environment could promote both psychological and physical safety. Patients in the CDU were monitored within the main reception area to enable staff to respond quickly if their condition deteriorated. Patients assessed as being at lower risk were offered seating in a quieter area to support comfort and reduce distress. Wards were visibly tidy and clean with functional equipment. Some staff mentioned they felt the equipment was outdated but was still functional. We checked equipment such as crash trolleys, gas bottles and patient monitors. These were all visibly clean and dated from their last maintenance checks. Call bells were readily available and where staff and patients did raise concerns, we saw that staff immediately took action to rectify any issues. We saw that beds were visibly clean and well maintained. Linen looked clean and was stored appropriately. Pressure-relieving mattresses were given to patients that were at risk of developing pressure areas, in accordance with their risk assessments. Some very minor environmental issues were seen on Coronary Care Unit, but the trust took immediate action to rectify these once we had raised it. The trust also reviewed the access to dirty utility rooms to ensure appropriate access for efficient disposal of bodily fluids. Local leaders were fully sighted on the legacy estate issues impacting the CDU.

Equipment seen was fit for use and resuscitation trolleys were checked in accordance with trust policy.

Control of Substances Hazardous to Health (COSHH) products were not consistently stored safely and securely in line with the trust’s own policy. We identified seven examples where disinfectant products were incorrectly stored in unlocked sluice areas, including being left on countertops or in unlocked cupboards. COSHH substances must be stored in a way that prevents access or exposure to patients and others; however, we observed floor cleaning products that were not securely stored. This presented a potential risk to some patients and visitors including visiting children. The trust immediately acknowledged these concerns and confirmed that such products should be stored in locked cupboards or secure rooms. The trust took immediate action to address this during the inspection. Post inspection, the trust provided a robust action plan how this potential risk was being mitigated.

Some staff spoke of the limitations of the estate with some wards not having enough space, this was known by the local leadership who were trying to address these long-term issues.

Whilst being very proud of their services and commitment to patient care, consultants considered the limitations of the estate and IT infrastructure was not conducive to meet future capacity and demand. They had raised this with senior leaders and the trust’s board.

Description: We make sure there are enough qualified, skilled and experienced people, who receive effective support, supervision and development and work together effectively to provide safe care that meets people’s individual needs.

We scored the service as 3. The service made sure there were 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.

The service assessed nursing staffing requirements daily and amended staffing where there was heightened acuity or demand. Whilst a few nursing staff reported feeling pressured, the staffing levels usually matched those planned and were sufficient to ensure the patients received safe care and treatment. There was appropriate skill mix on each ward with the correct amount of clinical and non-clinical staff. There were robust and safe recruitment practices to make sure staff, were suitably experienced, competent and able to carry out their role. Recruitment, disciplinary and capability processes were fair and reviewed to ensure there was no disadvantage based on any specific protected equality characteristic.

The service nurse staffing level was filled to above 90% based on January 2026 data from the trust. However, there were ongoing vacancies for non-clinical staff. Agency staff were very rarely used and staff told us they use staff from other wards if necessary. The hospital operated a daily operations meeting whereby staffing levels were reviewed for all wards and staff were flexed to work in those areas needing cover. We observed this meeting, which was very well organised. Local leaders used additional health care assistants to cover any qualified nursing staff shortfalls on the day. During the inspection, we saw that nurse staffing levels met the needs of patients appropriately. Local leaders were fully sighted on the staffing pressures, particularly in the CDU, with a high turnover noted, and were doing lots of work involving workforce modelling, some changes to the leadership structure and reviewing the ED pathway to alleviate the pressures.

We reviewed training compliance data for staff and found that overall mandatory training completion rates were above 90% across all staff groups, demonstrating a strong level of compliance. Training in Basic Life Support (BLS) or equivalent for nursing and additional clinical staff was lower, with an average compliance rate of 79.8%. While this indicates that most staff had completed the required training, there remained some gaps. The provider had oversight of training compliance and was able to identify areas requiring improvement to help ensure all staff are suitably trained to respond effectively in emergency situations. However, staff received the support they needed to deliver safe care. This included supervision, appraisal and support to develop, and improve services where needed and professional revalidation. Staff at all levels had opportunities to learn, and poor performance was managed appropriately. For example, staff were involved and engaged in quality improvement projects such as the Leicestershire Excellence Accreditation Framework (LEAF). LEAF is an evidence-based, continuous improvement program which combines real-time data and shared governance to assess ward performance, improve patient care, and empower multidisciplinary teams to lead meaningful change.

The service had appropriate support from allied health care professionals, including speech and language therapists (SALT), dietitians, physiotherapists and occupational therapists. For example, the service was funded for 6.7 whole time equivalent SALT staff and had a vacancy factor of 7%. The service was funded for 62.8 WTE therapy staff and 5.9 WTE vacancies and minimal sickness. Ward staff reported no concerns about accessing this support when required. Each ward had support from clerical and administrative staff, as well as domestic staff.

We noted the well organised and efficient site meeting on the second day of the inspection with a clear focus on safety. Staffing pressures were seen on Wards 15, 28 and 30 but leaders took actions to ensure this was not impacting on the safety and quality of patients’ care. The trust was actively monitoring this position every shift and flexed staff across wards to ensure patients’ needs were being met.

Medical cover across the wards met patient needs. Consultants were very proud of their teams and the relationships across specialities. Appropriate out-of-hours cover was provided. Medical staffing data showed 84 doctors working in the respiratory service (average head count) with a turnover of 13%. Medical staffing data showed 56 doctors working in the cardiology service (average head count) with a turnover of 14%. Medical staffing data showed 20 doctors working in the nephrology service (average head count) with a turnover of 26%. The trust target for turnover was below 10% and the Renal, Respiratory, Cardiology and Vascular (RRCV) service overall was showing 6% turnover at the time of the inspection.

Description: We assess and manage the risk of infection, detect and control the risk of it spreading and share any concerns with appropriate agencies promptly.

We scored the service as 3. The service assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

Staff maintained equipment well and kept it visibly clean. Cleaning records were up to date and demonstrated that the ward areas were cleaned regularly. Staff adhered to infection control principles, including handwashing. Trust hand hygiene audits stated that staff were 88% compliant trust-wide which is slightly below trust target of 90%. We did see one staff member using the same gloves on attending to two different patients which potentially risked cross infection, which we raised at the time. Leaders took immediate actions during the inspection to reinforce correct IPC processes were followed and sent a robust action plan post inspection.

There was an effective approach to assessing and managing the risk of infection, which was in line with current relevant national guidance. For example, there were hand washing guides around the sinks, there were adequate equipment and products to keep hands clean and all staff observed were seen to be bare below the elbow in clinical areas. Hand gel dispensers were readily available and well stocked. Staff were seen to comply with trust dress code.

There were clear roles and responsibilities around infection prevention and control (IPC). Information about the risk of infection was shared appropriately with relevant partners, including agencies, people using the service and visitors. Staff knew who to contact in the trust’s IPC team, who also visited the wards routinely. Leaders told us that they had worked closely with the Local Authority and Integrated Care Board (ICB) due to the elevated risk of Tuberculosis (TB) in the Leicestershire area. Working with the board they were granted extra funds to improve staffing and facilities to limit the spread of TB and other infections.

Training for Infection, prevention and control was at 91% compliance for all staff. Compliance rates for the 14 clinical areas and wards were on average 88% for nursing staff, 86% for additional clinical services, 100% for administrative and clerical staff and 87% for estates and ancillary staff. Local leaders monitored this and had plans in place to ensure improvements, combined with regular audits.

The Infection Prevention (IP) Team conducted biannual hand hygiene audits based on the WHO 5 Moments for Hand Hygiene and the 7-step hand hygiene technique. Audit data was recorded securely, and the collated data was shared with all Clinical Management Groups (CMGs) in a formal report. Compliance for RRCV for February 2026 for ‘arms bare below the elbows’ was 96% and the combined ward total for RRCV was 80%.

The Aseptic Non-Touch Technique (ANTT) audit was undertaken biannually by the IP Team to assess compliance among all staff performing ANTT procedures. Senior Band 5 nurses, Band 6 Deputy Sisters, ward leaders, and members of the education team had been trained by the Infection Prevention Nurse Specialist to become ANTT assessors. Competencies for successful assessors had been updated on the trust’s e-learning platform.

An RRCV Action Tracker had been developed from the submitted data and corresponding action plans, providing a consolidated overview of themes, risks, and progress across the service. Leaders were monitoring this closely to ensure improvements were on track.

The service also monitored all hospital acquired infections and comprehensive governance processes were in place to ensure prompt actions could be taken where required. For example, the renal speciality had reported no clostridium difficile infections in the three months of December 2025 to February 2026. The respiratory and cardiac service had reported 2 clostridium difficile infections in the three months of December 2025 to February 2026. MRSA infections reported in 2025/26 (hospital acquired bacteraemia) were none for the renal service, and 3 in 12 months for the cardiac and respiratory service.

Description: We make sure that medicines and treatments are safe and meet people’s needs, capacities and preferences by enabling them to be involved in planning, including when changes happen.

We scored the service as 3. The service made sure that medicines and treatments were safe and met people’s needs, capacities, and preferences. They involved people in planning, including when changes happen.

Staff followed good practice in medicines management (that is, transport, storage, dispensing, administration, medicines reconciliation, recording, disposal, use of covert medication) and did it in line with national guidance.

People were involved with assessments, decisions and reviews about the level of support they needed to manage their medicines safely and to make sure their preferences were included. This was clearly documented in their care plan.

The approach to medicines mostly reflected current and relevant best practice and professional guidance. We found some examples of denaturing kits containing broken glass vials. The denaturing kits should only contain liquids and therefore risking the incorrect disposal of sharp objects and pharmaceutical waste.

People’s medicines were appropriately prescribed, supplied and administered in line with the relevant legislation, current national guidance or best available evidence, and in line with the Mental Capacity Act 2005.

Accurate, up-to-date information about people’s medicines was available, particularly when they moved between health and care settings, in line with current national guidance, when transferring between locations or changing levels of care. Staff followed good practice in medicines management (that is, transport, storage, dispensing, administration, medicines reconciliation, recording, disposal, use of covert medication) and did it in line with national guidance.

Staff said Pharmacy teams were visible within clinical areas and provided timely support, contributing to the safe and effective management of medicines. Systems were in place for the reporting, review and learning from medicines-related incidents and errors, with evidence of appropriate oversight and governance. Arrangements for the management and monitoring of controlled drugs were robust, and records reviewed demonstrated appropriate storage, documentation and monitoring processes. Medicines reconciliation was completed in a timely manner and supported continuity of care during admission, transfer and discharge.

The service undertook a range of medicines-related audits, including antimicrobial stewardship activity, which helped to monitor compliance with best practice and identify opportunities for improvement. Staff demonstrated appropriate knowledge and competence in the calculation, preparation and administration of medicines, including intravenous medicines where relevant, and there was evidence of ongoing training and competency assessment. Overall, medicines’ management arrangements were well embedded, and no significant concerns were identified during the inspection. Based on the evidence reviewed, the service was managing medicines safely and in line with national guidance.

Regarding disposal of controlled drugs in denaturing pots, leaders took action to confirm the correct disposal method was being followed in all wards.

We reviewed medication storage facilities in a number of wards and saw that all medicines, including controlled drugs, were securely stored and that the trust’s required documents had been completed. Controlled drugs registers were completed appropriately. Ward staff said that support from pharmacy technicians was effective and that medication reconciliations were carried out as and when required, in accordance with trust policy. We also saw how the service used a ‘heatmap’ for medication management audits and generally the service performed very well in these audits.