Queen's Medical Centre

Updated 6 November 2026

Nottingham University Hospitals NHS Trust was formed in 2006. It was formed through the merger of the Queen's Medical Centre NHS Trust and Nottingham City Hospital. The Trust provides acute healthcare services for over 1,000,000 people a year across Nottinghamshire and surrounding areas and is a major specialist centre. The trust provides general and acute hospital care across three hospital sites: Queen’s Medical Centre, Nottingham City Hospital and Ropewalk House. The Trust also provides community services.

This assessment looked at urgent and emergency care and medical care services at the Queen's Medical Centre which we rated as requires improvement and good respectively. The rating of these assessment service groups has been combined with the ratings of the other services from the last inspections. See our previous reports to get a full picture of all the other services at Queen's Medical Centre. The rating of Queen's Medical Centre remains requires improvement. 

Updated 6 November 2026

Nottingham University Hospitals NHS Trust was formed in 2006. It was formed through the merger of the Queen's Medical Centre NHS Trust and Nottingham City Hospital. The Trust provides acute healthcare services for over 1,000,000 people a year across Nottinghamshire and surrounding areas and is a major specialist centre. The trust provides general and acute hospital care across three hospital sites: Queen’s Medical Centre, Nottingham City Hospital and Ropewalk House. The Trust also provides community services.

Some medical services are located at the Queens Medical Centre (QMC). Some of the medical services available at QMC support emergency medical admissions for health care of the elderly and other acute medical specialities via the accident and emergency department; as well as planned patient admissions.

Queens Medical Centre was last inspected in 2019. Medicine was rated as Good overall.  The key questions were rated as Good for safe, effective, and caring with Outstanding for responsive and Good for well led. We carried out an unannounced inspection on the 21 and 22 April 2026. At this inspection the rating has remained good. 

During the inspection we visited the Geriatric Assessment Unit (GAU), the stroke unit, the acute stroke unit, ward C51 ward 51, ward B47, ward C54 ward B47 ward B49, ward B48 ward C53 the Advanced Respiratory Care Unit (ARCU), the discharge lounge, the Same Day Emergency Care (SDEC) unit, the Transfer of Care Unit, (TOCU) the discharge lounge. We attended 3 nursing huddles, one multidisciplinary meeting, 1 nursing handover and 1 board round. We spoke with members of the Integrated Discharge Team (IDT) doctors, nurses, physiotherapists, healthcare assistants and patients. We reviewed 19 cases patient records and 14 Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) forms.

Staff had the skills and knowledge they needed, and there was evidence of effective multi-disciplinary teamwork and communication to promote and support positive patient outcomes. People’s care plans were up to date and reflected their current needs, choices and risks which enabled staff to provide coordinated and personalised support. Ward leaders promoted an open and inclusive culture and maintained oversight of the service through regular checks and audits. Staff felt supported, valued and able to raise issues within the local leadership team, there was a consistent approach towards recognising and celebrating staff success. 

There were processes in place to manage patient safety incidents. When things went wrong, staff apologised and gave people honest information and suitable support. Staff had the required levels of training to safeguard vulnerable adults and children and took action to keep people safe from avoidable harm and abuse. 

The design, maintenance and use of facilities, premises, and equipment kept people safe. The service had enough staff with the right skills, training and experience who received effective support, supervision, and development. 

Leaders ran services well, using reliable information systems and supported staff to develop their skills. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged well with patients and the community to plan and manage services. 

However, although some staff we spoke with were aware of the strategy for the service, not all staff were. Staff told us that senior leaders were not visible on the wards, however managers had a regular presence. Not all Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) forms were completed correctly.

Updated 6 November 2026

The Adult and Paediatric Emergency Department's (ED) at Queen’s Medical Centre provide a 24-hour, seven-day a week service to the local population and surrounding areas and operates as a major trauma centre. The Adult ED consisted of a resuscitation area, ‘majors’ area, primary and secondary assessment area and waiting room with a smaller sub waiting area.  The Paediatric Emergency Department had its own resuscitation area with 2 dedicated bays for children and provides emergency care for children and young persons in the local population. There was a Same Day Emergency Care (SDEC) unit to support short stay adult patients who were in the hospital. There was a co-located Urgent Treatment Centre (UTC) that provides primary care for both children and adults, which is operated by a different provider.

On Tuesday 21, Wednesday 22 and Thursday 30 April 2026 the CQC carried out an inspection at Queen’s Medical Centre. We last inspected Urgent Emergency Care (UEC) services at Nottingham University Hospitals NHS Trust in 2021, when we rated it as requires improvement. 

We assessed 25 quality statements across the safe, effective, caring, responsive and well-led key questions. We have combined the scores for these areas with scores from the last assessment to give the rating.   

We spoke with patients and relatives/carers. We reviewed patient records. We spoke with staff which included: consultants, resident doctors, nurses, senior leaders within the service, divisional leaders, healthcare assistants, administration staff, pharmacists and security staff.

The rating of Urgent Emergency Care Services at Queen’s Medical Centre:

Safe- The service did not always work well with people to understand and manage risks. The service did not always provide care to meet people’s needs that was safe. The service did not always detect and control potential risks in the care environment. The service did not always assess or manage the risk of infection. The service did not always make sure there were enough qualified, skilled and experienced staff. The service did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. However, the service had a proactive and positive culture of safety, based on openness and honesty. The service worked with people and healthcare partners to establish and maintain safe systems of care. The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that.

Effective- Staff provided care and treatment following evidence-based practice and staff were trained and competent and had the right skills to meet patient’s needs. Staff worked well with each other in the department and across teams to support people. Staff made sure people understood their rights around consent. However, the service did not always routinely monitor people’s care and treatment to continuously improve it.

Caring- The service did not always respect patients’ privacy and dignity, this was difficult due to the care environment. Staff did not always respond to people’s needs in the moment or act to minimise any discomfort, concern or distress. The service did not always care about and promote the wellbeing of their staff.

Responsive - The service did not always make sure people were at the centre of their care and treatment choices. The service did not always supply appropriate, accurate and up-to-date information. The service did not always respond in a timely manner or involve people in decisions about their care or tell them what had changed as a result. The service did not always make sure that people could access the care, support and treatment they needed when they needed it.

Well Led- The service did not always have a clear shared vision, strategy and culture. Staff did not always feel they could speak up and that their voice would be heard and concerns addressed. The service did not always have clear responsibilities, roles, systems of accountability or good governance. However, the service understood their duty to collaborate and work in partnership, so services work for people. Leaders understood the context in which the service delivered care, treatment and support.

Updated 11 March 2026

On 18 February 2026 we inspected the Queens Medical Centre maternity unit, part of Nottingham University Hospitals NHS Trust. We undertook a focused inspection to review progress to enforcement action that we had undertaken following our previous inspection in May 2025. We found that some improvements had been made and whilst concerns had been addressed the underpinning actions were not robust. This included the procedures for reducing the risk of babies being abducted and the support of staff.

Updated 14 March 2019

Our rating of this service stayed the same. We rated it as good because:

• Children’s and neonatal services had appropriate arrangements for investigating incidents and shared the learning from them.
• The services had a well- developed approach to assessing and responding to risk. Staff used a paediatric early warning system to take action on any deterioration in child health. There was a well-established and understood approach to managing and escalating suspected sepsis. Mental health risks were recognised and the service worked well with mental health professionals.
• People’s care and treatment was focused on achieving good outcomes, and this was supported by learning from clinical audit, and initiatives to improve clinical pathways.
• Parents and children told us that nurses and doctors were kind and took time to talk to them and explain care arrangements. The services did as much as possible to ensure that children were comfortable and they responded quickly if a child or young person was in pain. The services helped young children feel settled through play specialists and a variety of volunteers who entertained them, such as Spiderman, a magician, and a therapy dog.
• The services took a holistic approach to childhood and teenage cancer treatment and offered emotional support and arranged relevant social activities for them.
• Children generally had access to timely initial assessment, test results, diagnoses and treatment. Waiting list performance for the service was better than the national target of 92% of patients being definitively treated within 18 weeks (incomplete pathway). The cancer service was responsive and timely.
• Senior leadership capacity for children’s and neonatal services was improving and the leadership team was starting to address significant strategic risks and issues, for example how to ensure staffing and skills levels long term.

However:

• Some beds on wards were not open to children because there were insufficient staff to manage them safely.
• Vacancy rates and turnover figures were high for doctors in neonatal services. The service was advertising for three new neonatologists to give the services some resilience across City and QMC sites in 2019.
• Outpatient appointments did not always run on time and the service did not inform families or display wait times publicly. The outpatient waiting area was very crowded.
• Not all services were available 24/7 and outpatient and day surgery appointments were predominantly during the week between 9am and 5pm.
• Lack of out of hours access to paediatric interventional radiology meant that some babies needed to be transferred to other hospitals, and this had been on the service’s risk register for three years.
• Arrangements for MRI scans 48 hour after tumour removal were not sufficiently formalised for children who needed a general anaesthetic.
• Children and young people’s matters did not have a strong profile at Board level and lacked specific non-executive director representation.
• Processes around monitoring that products were kept at a safe temperature in fridges were not robust.

Updated 14 March 2019

• The service had innovative and leading practices that improved the experience and outcomes for patients and their families.
• The service was a national lead in critical care practice and guidance.
• The service had enough staff, who had completed required training. Staff were supported by managers and had annual appraisals.
• On both units the environment was clean, tidy and equipment was readily available, clean and well maintained.
• The service stored and administered medicines well.
• Staff worked well in multidisciplinary teams and provided compassionate, appropriate and individualised care to ensure good outcomes for patients.
• Staff provided emotional support to patients and relatives to help them to manage through a traumatic experience.
• The service responded where there was a need for improvement. For example, staff carried out many local audits, compared results to national target and set actions to improve the service.
• Managers supported staff, promoted learning from incidents, concerns and complaints and used available information to improve to the service.

However:

• The service had become accredited to deliver the post registration critical care module and 37% of staff were due to complete the course by March 2019. However, there was a risk that the course would not be funded after March 2019 and the service would not be able to ensure that 50% of staff had completed the course.
• Follow up clinics were not available for patients discharged from critical care. Managers planned to create follow up clinics and had created a new coordinating specialist nurse for continuing care role. Follow up clinics for critical care patients had not received support from commissioners.
• Discharge summaries did not include personalised rehabilitation goals and were not consistently sent to patient’s GPs at the time of discharge.
• The lack of a critical outreach team service overnight had put a strain on the capacity in the adult intensive care unit and higher demand on the critical care consultant.
• Training completion rates for medical staff were lower than expected.
• The service had higher than expected numbers for patients transferred out of the unit for non-clinical reasons and out of hours discharge to the ward from the adult intensive care unit due to activity and continual high number of admissions to the unit.

Updated 14 March 2019

Our rating of this service improved. We rated it as good overall because:

• The trust had taken steps to improve consistency in completion of patient’s nutritional screening and the completion of nutrition and fluid charts.
• Improvements had been made to the availability of patient information leaflets, including those in other languages and accessible formats.
• Staff followed policies and procedures to ensure medicines were administered appropriately to make sure people are safe.
• The trust had implemented care plan documentation specific to end of life care.
• The Trust had increased their number of palliative care consultants to improve availability of a senior end of life care clinician.

However:

• Do Not Attempt Cardio-Respiratory Resuscitation (DNACPR) forms were not always completed correctly.
• Conversations with patients and relatives regarding DNACPR decisions were not always documented in patients’ medical record.
• Mental Capacity Act assessments were not always completed for relevant patients when making DNACPR decisions.
• Care plans, although personalised and improved since last inspection, did not always document conversations about patient’s mental health needs, spiritual and pastoral needs.
• There was a lack of audit processes to monitor the effectiveness of end of life care.
• The service did not monitor or audit if end of life care patients died in their preferred place of death (PPD).
• The trust was not providing a HPCT seven days a week. However, this would commence in April 2019.

• The service did not record palliative or end of life care patients as delayed transfers of care

Updated 8 March 2016

Overall, we judged the outpatients and diagnostic imaging services to be good.

There were reliable processes to protect patients from avoidable harm. Departments were mostly clean and hygienic, and risks to patients attending appointments were monitored and well managed. Staffing levels were appropriate to the needs of each outpatient clinic, but there were unfilled vacancies in radiology which had an impact on the service. Patient records were not always well managed; paper files were overdue for collection and secure storage and patient letters were sometimes misfiled.

The care and treatment of patients was delivered in line with current evidence based practice and recognised national guidance. Staff had good opportunities for personal and professional development. There was effective multidisciplinary working in many departments. There were few seven day services. Staff supported patients in a caring, kind and compassionate way. They respected patients privacy and dignity, and made sure that people's individual needs were met.

Services were largely planned to meet people's needs. While the trust was able to provide timely assessments for people with non-urgent conditions, the trust did not meet national standards for urgent referrals. There were higher than average rates of cancelled appointments, both by hospital staff and patients. The hospital had put in place some innovative methods aimed at reducing cancellation and unattended appointments. There were largely effective governance structures, but not all risks were recorded and addressed. There was work in progress to re-design the outpatient pathway and improve the trust-wide outpatient service. Staff were committed to their roles and in most departments there was a positive, supportive working culture. There was good staff and public engagement, and a focus on continued improvement.

Updated 15 September 2021