Queen Elizabeth II Hospital

Updated 18 December 2019

Queen Elizabeth II (QEII) hospital is located in Welwyn Garden City. It was opened on the site of the old QEII in June 2015 following a £30 million investment.

It provides outpatient, endoscopy, diagnostic and antenatal services, along with a 24/7 urgent care centre and pre-operative assessments. The diagnostic imaging department offers plain film radiography, computerised tomography (CT), magnetic resonance imaging (MRI), ultrasound, fluoroscopy and breast imaging.

The urgent care centre comprises of a nurse-led service and a co-located GP-led minor illness service. The GP service is from an external provider, commissioned by the local CCG. The UCC is designed to treat adults and children over one year of age with minor illnesses and injuries and does not admit patients.

Updated 18 December 2019

Our rating of services improved. We rated it them as requires improvement because:

Our rating of services improved. We rated it them as requires improvement because:

• There had been significant improvements in the Urgent Care Centre (UCC) and the rating had improved from inadequate to requires improvement. The leaders of the service had made a number of changes to improve the quality of services.
• Whilst there were significant improvements in the UCC we found that there had been a decline in safety practices in outpatient services and patients could not always access care and treatment when they needed it.

Updated 18 December 2019

Our rating of this service improved. We rated it as requires improvement because:

• We rated safe and well-led as requires improvement. Effective, caring and responsive were rated as good.
• Leaders were starting to operate effective governance processes, throughout the service and with partner organisations; however, this was not yet embedded. Staff were not always clear about their roles and accountabilities.
• The service was starting to develop processes and systems to improve the quality of services through audit and triangulation of other quality indicators; however, this was yet to be embedded.
• The service had made some improvements to the assessment processes since our last inspection. However, evidence provided by the trust demonstrated that staff were not always acting appropriately to escalate deteriorating patients.
• Although the service had made improvements in training staff in the recognition of sepsis, there was a lack of clarity around the treatment for patients with suspected sepsis. A lack of formalised processes meant that there was a risk that life-saving treatment would be delayed.
• The design, maintenance and use of facilities and premises mostly met national guidance to keep patients safe. However, the children’s waiting area was still not completely separate from adults in the main waiting area. The service had made some adjustments since our last inspection; however, we were not assured that all reasonable steps had been taken to minimise the potential risks.
• The service had a vision for what it wanted to achieve but the new leadership team had not had time to convert the vision to a strategy.

However,

• The service had enough staff with the right qualifications, skills, training and experience to keep patients safe from avoidable harm and to provide the right care and treatment. Managers had reviewed and adjusted staffing levels and skill mix, and gave bank and agency staff a full induction.
• Staff understood how to protect patients from abuse and the service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.
• The service now made sure staff were competent for their roles. Managers appraised staff’s work performance and held meetings with them to provide support and development.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, and took account of their individual needs.
• The service planned and provided care in a way that generally met the needs of local people and the communities served. It also worked with others in the wider system and local organisations to plan care. People could access the service when they needed it.
• Leaders had the skills and abilities to run the service. They understood the priorities and issues the service faced. They were visible and approachable in the service for patients and staff. They supported staff to develop their skills and take on more senior roles. The service was now having regular opportunities to meet, discuss and learn from the performance of the service.
• Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. The service promoted equality and diversity in daily work, and provided opportunities for career development. The service had an open culture where patients, their families and staff could raise concerns without fear.