Queen's Medical Centre

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

We looked for evidence that there was an inclusive and positive culture of continuous learning and improvement that was based on meeting the needs of people who used services and wider communities. We checked that leaders proactively supported staff and collaborated with partners to deliver care that was safe, integrated, person-centred and sustainable, and to reduce inequalities.

At our last inspection we rated this key question good. At this assessment the rating has remained as Good. This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care. 

Find out what we look at when we assess this area in our information about our new Single assessment framework.

We scored the service as 3. The evidence showed a good standard. The service had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.

The Trust had a People first strategy from 2026 to 2031 setting out the strategy, values and the plans for the future for the service and how this was going to be achieved.

The strategy was to be outstanding in health outcomes and in patient and staff experience. It set out how the service would focus on what matters the most, improving the quality of care, supporting people, embracing innovation, and becoming a more sustainable organisation for the future.

The strategy was based on a shared vision, and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities. As well as the 4 values of:

What we stand for Our Values:

• Kind
• Inclusive
• Ambitious
• One team 

As part of the development of this strategy, the Trust spoke with patients, staff health partners, and the community. All staff we spoke with were aware of the new strategy and where to find it on the service electronic system.  

Most staff felt supported, respected and valued, with most staff saying they felt positive and proud to work in the organisation.

There was a clear sense of teamwork across all the areas we inspected, and everyone spoke highly of their colleagues. However, staff told us that senior leaders were not always visible on the wards, though managers had a regular presence. 

The service values of safety, integrity, kindness and transparency was encouraged at team meetings to embed the values and encourage ideas for improvement. However, some staff said they felt that any feedback to the service on how services could be improved, was not taken seriously and that they did not feel listened to. 

Staff we spoke with told us that their focus was on providing good care and working as a team to achieve this, they described teamwork as a strong culture applied across the work of the teams. 

We observed as part of our inspection, that staff were passionate about the care they provided for patients.

Information was displayed within departments demonstrating how to staff demonstrating how care was delivered in line with the 5 Care Quality Commission domains of safe, effective, caring, responsive and well-led. The management team advised they performed a monthly cascade to ensure they engage with frontline staff and ensure they uphold the company’s vision and values.

We scored the service as 3. 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.

The service had inclusive leaders at all levels who understood the context in which they delivered care, treatment, 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.

Staff told us they had good working relationships with their ward managers who they described as approachable and visible. However, some staff told us they felt senior leaders were not visible in the service and that decisions were made without taking on board the feedback of the staff teams or that options fed back on developments were ignored.

Leaders were alert to examples of poor culture that had the potential to impact the quality of care and detrimental to staff and tried to address this quickly. Most staff told us any concerns raised to their managers and leaders was managed appropriately and swiftly. 

Leaders were knowledgeable about challenges and priorities for the service and could access appropriate support and development in their roles. They explained challenges such as bed capacity, patient flow and financial sustainability.

Leaders told us they had increased walkarounds recently to increase visibility and had commenced Listening events including winter pressures debrief as winter had been exceptionally busy for staff.  

Leadership development opportunities were available to staff. 

The service had effective recruitment processes and ongoing checks to ensure all leaders were competent in their roles.

The service had a recruitment process that ensured leaders met the Fit and Proper Persons Regulations (FPPR).

We scored the service as 3. The service fostered a positive culture where people felt they could speak up and their voice would be heard. 

Staff had access to the Trust's Freedom to Speak Up policy which provided information on how to speak up and what to expect to happen during the process.

Staff we spoke with felt confident to raise concerns and that they received support and were not afraid of recrimination.

When concerns were raised, staff told us they felt assured that managers investigated sensitively and confidentially, and lessons were always shared with them and acted on. 

The Trust had a Freedom to Speak Up Guardian team with whom staff could raise concerns about any issues. Staff we spoke with, knew who the freedom to speak up guardians and champions were and how to contact them. 

At the time of our inspection, there were 2 FTSU guardians and 39 FTSU champions working across the the Trust. They were in the process of recruiting a Lead FTSU guardian and 7 FTSU up champions. 15 Champions worked in Medicine Care Group across a variety of departments and specialities. All the FTSU champions received initial in person training from the 2 FTSU guardians, which included understanding the role of an FTSU champion, barriers to speaking up and how they can support breaking those down, the history behind FTSU and why it is important along with details of key signposting such as wellbeing offers and services. Some champions had taken additional training such as Psychological First Aid, Sexual Safety Awareness. FTSU Guardians were trained using the National Guardians Office Training which had been taken over by NHSE.

All the freedom to speak up champions had received initial in person training from the 2 freedom to speak up guardians, the subjects included training on psychological first aid, understanding mediation, and a meeting the freedom to speak up non-executive lead  session.

We scored the service as 3. The evidence showed a good standard. The service valued diversity in their workforce. They work towards an inclusive and fair culture by improving equality and equity for people who work for them.

Staff were able to apply to work flexibly, for example flexible working agreements to account for personal circumstances such as caring responsibilities and health issues.

The service valued diversity in their workforce. Staff and leaders told us there was a diverse workforce with a positive sense of inclusion. Managers told us they made workplace adjustments where necessary. For example, if staff wanted to change their working arrangements either temporarily or on a permanent basis.

There was a multi-faith room on site for everyone in the hospital to use, for those of all faiths and none.

The Trust carried out staff surveys annually and create actions to address any areas of concern based on staff feedback. 

The Trust had a policy on equality and diversity which meant recruitment decisions were based on the candidate’s ability to undertake the job and eliminated discrimination on any grounds.

The NHS Workforce Race Equality Standard (WRES) is an essential tool in supporting the NHS to be an inclusive and fair workplace. It helps evaluate progress and identify areas where further improvement is needed. WRES data showed that for 2025 that 33.6 % of Clinical staff where from a Black, Asian, and Minority Ethnic (BAME) with 20.9% Non-Clinical Staff -being from BAME. With an overall total of 31.9%. This was an overall of 5.6% increase from 2024 when the BAME total was 26.3%. 

The 2025 staff survey for medicine showed that 74% of staff said the service made reasonable adjustment(s) to enable them to carry out their work, with 91% of staff stating they were trusted to do their job, however 59% of staff stated as soon as they could find another job, they will leave the service.

Data was received from the service. However, a site-level breakdown was not available, and the data could only be provided at service level.

Recruitment packs included an equal opportunity monitoring form.

We scored the service as 3. 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.

The service had a clear governance structure with defined roles and responsibilities. Staff understood what their roles and responsibilities were, and they were able to access the information they needed about patients’ care and treatment. This clearly defined governance structure also supported the flow of information from frontline staff to senior managers, the service leadership team and the Trust board.

Regular governance meetings were held to review information about the service, including performance, risks, incidents, and complaints.

There were arrangements for the availability and confidentiality of data, records and data management systems. Information was used effectively to monitor and improve the quality of care. Patient records were stored securely on all the wards we assessed.

At service level, daily site conference calls were held to monitor capacity and patient flow. This enabled staff to have an up‑to‑date understanding of the pressures within the service and they supported timely decisions and escalation.

Information was shared with staff through daily handover meetings and emails. This kept staff up to date with what was happening in the service, social events and updates on training and policies.

Senior leaders used a risk register to manage risk across the service. There were several different risk registers for specific areas within the service. For example, a health and safety risk register, an operational risk register and a service wide operational risk register. We reviewed the risk registers and saw the documented risks reflected the work of the service.

Patient information, such as medical records, were stored in line with data protection and audit outcomes were displayed on notice boards and used by leaders to drive improvement in the service. Managers met with staff and provided feedback on local audits to recognise success and share feedback on areas for improvement.  

During our inspection we observed that all professional clinical staff were registered with the appropriate professional body, and the service had systems in place to ensure that revalidation took place as required. 

Various policies and procedures were in place to cope with unexpected events. Business continuity plans were in place across the service which detailed strategic arrangements and activities undertaken within the service to support emergency preparedness.

The service implemented the Accredited Care Excellence (ACE) framework. This is a clinical program designed to ensure that the services facilities, hygiene, and patient care meet nationally recognised, quality standards and provide a quality rating. Staff on wards we visited knew their ACE accreditation rating and the actions they were following to make improvements. We also noted celebrations of success where teams or individual staff had contributed to achieving an ACE accreditation rating. The ACE programme team could carry out priority visits alongside ward teams to specifically look at areas of concern shown within any audit data.

The ACE accreditation at ward level allows staff to establish where they are in terms of performance against the audits and where they're doing really well or whether changes need to be made. The ACE programme team can carry out also priority visits if they want to specifically look at areas of concern shown within the data.

Staff implemented recommendations from reviews of deaths, incidents and complaints. The service held mortality and morbidity meetings (MM). These are recurring, peer-reviewed medical meetings where healthcare professionals analyse adverse patient outcomes, complications, or unexpected deaths. Its primary goal is to identify medical errors, modify clinical judgment, and drive systemic quality and patient safety. We reviewed MM meetings that showed how the staff looked at improvements and considered if incidents had contributed adversely towards patient safety to prevent future events.

Staff we spoke with understood the arrangements for working with other teams, both within the service and external, to meet the needs of the patients. MDT working was effective and contributed towards positive patient outcomes. 

The service had plans for emergencies, for example, adverse weather, or infection outbreak. Staff we spoke with knew the local escalation processes for an emergency, including ward lock down, action cards and processes to follow to ensure peoples safety. 

At the time of our inspection, leaders told us a comprehensive review of governance arrangements across the wider organisation was being undertaken by the Trust, which included a review of governance arrangements at all levels within the service. The review was focused on strengthening the service’s “Ward to Board” and “Board to Ward” approach, to ensure clear, consistent, and reliable communication, reporting, and assurance processes across the organisation's leadership structures, including leadership structures within the service.

We scored the service as 3. 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.

The service understood their duty to collaborate and work in partnership, so services worked well for patients. The service shared information and learning with partners and collaborated for improvement.

The service at all levels including leaders engaged with external partners and external stakeholders to support patient care, transfer and discharge. They worked with commissioners, GP practices, other local acute hospitals and community teams to care for patients. The service had access to 106 beds in the virtual ward in the community to support keeping patients at home receiving the care they required. A virtual ward (often called "hospital at home") allows patients to receive acute hospital-level medical care and treatment in their own homes or usual place of residence instead of being in a physical hospital bed.

We saw collaborative working at the MDT meetings we attended between the local authority’s social care teams and the service.

Staff told us they could provide feedback to their immediate leaders as well as more senior leaders.

The service had governance processes in relation to aggressive and violent behaviour toward staff, all incidents were evaluated and the information used to determine what actions to implement to mitigate against any forthcoming incidents. Leaders told us that staff and patient psychological and physical safety was a top priority and working in partnership with the police provided a framework to reduce harm.  

Patients and members of the public could become a volunteer, attend open Board meetings and annual public meetings to feedback and engage on how the service is managed and being developed. 

The Trust had an Our People First Recognition Awards, which provided an opportunity for all members of staff, teams and volunteers at the service to be recognised and rewarded across 12 award categories, 1 of the categories was for a volunteer award.

We scored the service as 3. 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.

All staff we spoke with were committed to continually learning and improving services. Staff described a culture of learning and of opportunities to develop their knowledge and skills. Staff were encouraged to attend multidisciplinary team meetings to develop their knowledge and understanding about end-of-life care, including to gain an understanding of different treatment options. 

At the time of our inspection, work was being undertaken by the Acute Deterioration Improvement Team (ADIT) Team and the organisations 'Acute Deterioration Improvement Programme'. The programme aimed to reduce avoidable harm from patient deterioration by improving how deterioration was recognised, escalated, and managed across the Trust. It focused system wide, rather than individual blame, restoring reliability in core acute care practices, and supporting staff through clearer processes and improved training.

The service was working towards reducing the length of stay in hospital for patients using the Getting It Right First Time (GIRFT). This is a national NHS England programme designed to improve patient care by reducing unwarranted clinical inconsistency. It is led by senior clinicians, uses in-depth data analysis and benchmarking to help services share best practices, improve outcomes, and achieve efficiencies like shorter hospital stays. 

We observed during our inspection, that work was underway on the same day emergency department (SDEC) to increase the number of patients who could be seen and increase patient throughput. The service anticipated the expanded unit to open March 2027.

Staff on the wards inspected were aware of their ACE accreditation rating and demonstrated clear understanding of the actions being undertaken to drive continuous improvement.