CQC rates leadership at King’s College Hospital NHS Foundation Trust as Requires Improvement

The Care Quality Commission (CQC) has rated the leadership of King’s College Hospital NHS Foundation Trust as Requires Improvement following a well-led inspection carried out in September 2025.

King’s College Hospital NHS Foundation Trust provides secondary and specialist acute services across five hospital sites: King’s College Hospital, Princess Royal University Hospital, Orpington Hospital, Queen Mary’s Hospital and Beckenham Beacon. The trust employs more than 14,000 staff and serves a core population of over one million people across southeast London, with a number of specialist services delivered regionally and nationally.

The inspection focused on leadership and organisational culture following significant changes to the trust’s executive and non-executive board since its previous well-led inspection in 2022, when the trust was rated Good. As part of the assessment, inspectors held 24 staff focus groups involving 572 employees and observed board and committee meetings between May and October 2025.

The CQC found that although leaders had a clear strategic vision, this had not been consistently reflected in staff experience or organisational culture. Staff reported a lack of confidence that concerns would be acted upon and described communication as inconsistent. Inspectors found that many staff felt changes had been introduced without sufficient consultation, while some reported a disconnect between the trust’s stated values and their day-to-day experience.

Inspectors also found that the trust introduced a new three-division clinical model in July 2025. While leaders identified early benefits, some staff said they were unclear about reporting structures and responsibilities as the new model was being implemented.

The report highlighted ongoing challenges relating to equality, diversity and inclusion. Although the trust had initiatives in place, minority ethnic, disabled and LGBTQ+ staff reported mixed experiences of career development and progression. Inspectors also found that minority ethnic and disabled staff were more likely to experience discrimination or enter formal capability processes. In addition, the board did not reflect the ethnic diversity of either the workforce or the communities served by the trust.

The CQC noted that NHS Staff Survey results had remained below national averages for staff engagement, morale and confidence in leadership over the previous five years, although the 2025 survey showed a statistically significant improvement.

The inspection also identified a number of strengths. People using maternity, medical and children’s services, together with their families, reported being treated with dignity and respect, and inspectors observed staff providing compassionate and respectful care.

The report also recognised the trust’s collaborative work with partner organisations across southeast London and its commitment to addressing health inequalities. Inspectors highlighted the trust’s work on environmental sustainability, including initiatives across estates, clinical practice, transport and procurement, as well as its strong research culture and participation in National Institute for Health and Care Research portfolio trials.

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