Queen's Medical Centre

On this page

• 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 looked for evidence that the service worked with people to make sure they were at the centre of their care. We checked the service supplied appropriate, accurate and up-to-date information. We checked the service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. We checked the service made sure that people could access the care, support and treatment they needed when they needed it.

At our last inspection we rated this key question requires improvement. At this assessment the rating remained the same and was requires improvement.

This meant 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.

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

Patients we spoke with told us they did not always feel they were at the centre of decisions about their care and treatment. Some patients felt they were not consistently involved in planning and making shared decisions about their care and treatment.

Despite this, patients and their relatives mostly recognised the efforts of staff and told us that staff were clearly trying their best in challenging circumstances. Patients told us that, even during busy periods, staff took time to talk with them and understand their needs.  However, both staff and patients told us that meeting the volume of requests within the department could be difficult. Patients did not have access to call bells, and, in corridor areas, were not always under direct observation, which made it more challenging for them to seek assistance when required.

Staff told us they took account of patients’ individual needs and preferences when planning and delivering care. Patient specific risk assessments were completed to identify specific needs, such as nutrition, hydration, mobility, falls risk and frailty. Staff made reasonable adjustments to support patients in accessing services and meeting their individual requirements. The department had access to translation services, including British Sign Language, to support patients, relatives and carers who required assistance with communication. A multi-faith room was available on-site for patients and staff, and chaplaincy support could be requested for bedside visits when needed.   

We observed positive interactions between staff and patients throughout the emergency departments. In Adult ED, staff mostly made sure patients living with mental health conditions, learning disabilities and dementia, received the necessary care to meet their individual needs. However, the emergency department environment presented challenges in caring for patients living with these conditions. As part of our inspection, we observed patients moving between different areas of the department. However, it was recognised that Adult ED, had a dedicated room designed to support people with mental health needs; however, it was not used routinely by emergency department staff and was primarily used by staff from the mental health trust. This room was in a quieter area of the department, providing a more suitable environment for assessment and support.  In contrast, the Paediatric Emergency Department had designated mental health rooms available for children requiring mental health support.

The children’s emergency department provided a child-friendly environment, with colourful walls and curtains, designed to make the setting more welcoming for children. A sensory play area was available for younger children, and a range of toys and activities helped to keep children occupied whilst waiting for assessment or treatment. There was also a separate waiting area for older children. Staff used distraction and play techniques where appropriate to help minimise stress and anxiety with children if required.

The judgement for Care provision, Integration and continuity is based on the latest evidence we assessed for the Responsive key question.

We scored the service as 2. The evidence showed some shortfalls. The service did not always supply appropriate, accurate and up-to-date information. 

The service provided real time waiting information to patients arriving in the emergency department about expected waiting times. Electronic display boards showed the estimated time to initial triage and the average wait to be seen by a doctor. However, patients and their relatives told us they were not always sure about what was happening next in their care journey. 

Patients could mostly access information and advice that was accurate, up-to-date and provided in a way that they could understand, and which met their communication needs. Staff were accessible to provide information when asked by patients and carers, however there was sometimes delay and confusion for patients, particularly when being moved between different areas of the department. The service made reasonable adjustments and supported patients with accessible information. For example, staff were able to provide information in multiple languages for adult patients. There were multiple private family rooms where staff could take families and carers, when communicating difficult conversations. 

Some patient records were held on a secure electronic patient record system which was accessed by individual staff log in. On several occasions throughout different areas of the department computers were left logged in with no staff member present and patient records and details were accessible. Staff received General Data Protection Regulation training (GDPR).

Patients could use the hospital website to gain information on many conditions. The website had an accessibility bar which allowed patients to make the font size larger and a button to change the contrast to make font appear sharper against the background in accordance with the Accessible Information Standard. The website could also be translated within a web browser. 

If patients had any information or communication needs, this would be highlighted on paper and electronic record systems to alert staff. Staff told us they shared information about patient’s information and communication needs with other providers of NHS and adult social care, when patients had given consent or permission for them to do so. 

We scored the service as 2. The evidence showed some shortfalls. The service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. However, they 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 sought feedback from patients and those close to them on the care and treatment they received. Patients and relatives were able to provide compliments and raise complaints, which were reviewed by the department’s clinical governance team. Where there was a cross-service complaint the patient experience team coordinated the responses from the individual services. Complaints were discussed as part of the emergency department specialty governance meeting monthly meeting. Between 1 May 2025 and 30 April 2026, the service received 107 complaints relating to the adult emergency department and 7 relating to the children’s emergency department. Common themes of complaints in the adult emergency department centred around time spent within the assessment area, poor communication between staff and patients, length of bed waits and delayed or inadequate pain relief for patients. 

Patients we spoke with felt confident to raise a complaint should they need to. Patients accepted that services were under strain and that waiting was inevitable. Patients in the adult’s department and those close to them did not always feel involved in the decisions made whilst in the department and were not always able to talk to staff if they wanted to. Patients in the children’s department and those close to them felt involved in the decisions made whilst in the department and were always able to talk to staff if they wanted to.

We scored the service as 2. 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.

Staff worked hard to provide equity in access to care and treatment. This included making reasonable adjustments for people with disabilities, those with communication difficulties or cognitive impairment. Patients felt they were not always listened to when they wanted to share their experience or talk about their care and treatment. 

The department was open 24 hours a day all year round. Adults and children were cared for including those seeking treatment for mental ill health. The service worked with other healthcare professionals to provide a service for different healthcare needs and serious conditions needing specialist input. The service had policies, escalation areas and care of patients in non-designated areas (temporary escalation areas), to mitigate the main risks from crowding. Staff told us these areas were in use every day, often also being full. One of these areas was within the main major’s area, these were not assigned bed spaces. The corridor was also an escalation area, on the first visit of our inspection, mainly for ambulance patients and on the second visit mainly for patients waiting for beds. These areas were very congested and reduced patients’ privacy. 

Patients were mostly assessed and triaged timely and escalated as appropriate to their clinical needs. Between 1 October 2025 and 30 April 2026, in the adults ED 86% of patients received an initial assessment within 15 minutes of arrival in line with national standards. The average time to initial assessment during this period was 8 minutes for walk-in patients and 19 minutes for patients arriving by ambulance.

In the Children’s ED 96% of patients received an initial assessment within 15 minutes of arrival in line with national standards. The average time to initial assessment during this period was 4 minutes.

People did not always have timely access to test results and diagnosis. We saw that electrocardiogram’s (ECGs) were performed by triage staff and reviewed in a timely way by doctors and clinicians where an issue was highlighted, however this was not always happening on the corridor, alongside other tests. ECGs are a test to record the electrical signals in the heart. 

There was a Trust joint site meeting at regular intervals throughout the day to discuss bed capacity across the entire organisation. We observed a meeting, and the focus of the call was to increase capacity and flow in the hospitals, to improve ED capacity and focus on facilitating safe transfers or discharges for patients. The call provided updates across directorates on staffing, bed capacity and site team updates around discharges. There were monthly ED speciality governance meetings. These meetings enabled service leaders and other key personnel to understand, monitor and assess the quality and performance. 

In the 2024 National Urgent Emergency Care survey the trust ranked about the same as other trusts overall. The trust was performing about the same for all of the questions as most other trusts that took part in the survey.

The most recent data provided by the trust showed in between 1 October 2025 and 30 April 2026, a total of 2,199 adult mental health referrals were made from the adults ED. The trust were not able to determine what percentage of patients with urgent mental health needs were seen by an appropriate mental health clinician and ED clinician. The trust stated this ‘highlights a limitation in the available data, as the absence of a recorded external clinician response makes it difficult to accurately assess timeliness of mental health reviews and overall pathway performance.’ In the children’s, 94.6% of patients presenting with urgent mental health needs were seen by both an ED clinician and an appropriate mental health clinician (CAMHS).

As part of the digitalisation process across the Trust, the service had improved the ‘ED Mental Health Triage Tool’ used in Adult ED. The tool now provides additional guidance on what area of the ED the patient should be cared for, level of supervision and checks and whether the patient should be allowed to leave ED. These improvements were made in response to safety events and incidents, as well as patient and staff feedback.

The judgement for Equity in experiences and outcomes is based on the latest evidence we assessed for the Responsive key question.

The judgement for Planning for the future is based on the latest evidence we assessed for the Responsive key question.