The Care Quality Commission (CQC) has today (Friday 28 November) published a report following its inspection of the urgent and emergency care service at Medway Maritime Hospital in April.
The overall rating remains requires improvement. Of the five areas rated, well-led remains good, with safe upgraded from inadequate to requires improvement. Ratings for caring, effective and responsive remain requires improvement.
Inspectors found improvements to patient care and staff culture in the Emergency Department (ED) since the previous inspection in February 2024, and the requirements of a warning notice, issued in April 2024, have since been met.
The department routinely sees between 380 to 450 patients a day, of whom more than three in four are treated, discharged or a decision is made to admit them, within four hours of arrival. The hospital is ranked 31 out of 118 hospital trusts in England on performance against the four-hour standard.
The report recognises a number of improvements and areas of good practice:
- Ambulance turnaround times are regularly among the best in the country, quickly releasing ambulances to help others in need.
- Effective daily safety huddles have been established to escalate and address capacity and staffing issues.
- Improved culture and team working in ED, with staff feeling able to raise concerns, incidents thoroughly investigated, and a focus on improving staff wellbeing.
- Effective multi-disciplinary team working, and strong partnerships with specialist in-house teams, and community, mental health and ambulance partners.
However, the report also expresses concerns about the service’s ability to consistently provide safe care for all patients, and in ways that always maintain their privacy and dignity, particularly when the department is very busy.

Jonathan Wade, Interim Chief Executive of Medway NHS Foundation Trust, which runs the hospital, said: “Our hard-working staff are determined to further improve services so that people attending our Emergency Department are treated sooner, and consistently cared for in a compassionate and dignified way.
“We strive to ensure that everyone feels safe in our care and has a positive experience in their time of need. However, we acknowledge that despite the improvements recognised by the CQC, too often this is still not the case.
“We are very sorry to patients who wait much longer than they should for a bed to become available on a ward, and who do not receive the high standard of care or experience that they are right to expect from us.”
Improvements have continued since the April inspection, including:
- more ED nurses and doctors recruited
- improved procedures to ensure patients receive specialist assessments, tests and treatments sooner, and
- additional senior checks to ensure risk assessments are completed, and medications given in a timely manner.
To help reduce delays, the hospital has recently expanded its virtual ward service from 80 to 120 beds, and made them available 24/7, so that more people who would otherwise be in hospital can be safely cared for in the comfort of their own home.
This is the first step in an exciting journey from a well-established virtual ward to a fully-fledged 200-bed virtual hospital.
Enabled by technology, patients’ vital signs (such as pulse, blood pressure and oxygen levels) are remotely monitored, and treatments given (such as intravenous antibiotics, and breathing support), with close oversight, and regular contact, from the hospital’s Surgical, Medical and Acute Recovery Team (SMART).
Should a patient’s condition deteriorate, the team can quickly undertake further assessment on screen. At any time of day or night, a member of the team can visit the patient at home, and if needed, bring them into hospital for further tests or treatment.
Jonathan Wade added: “Expanding our virtual ward is already helping people leave hospital sooner, and means that some do not need to come into hospital at all, with care provided at home instead.
“This is already helping to relieve pressure on our Emergency Department, by freeing up ward beds for those who need them most, and reducing delays and overcrowding in the department.
“This is a great example of how we are making more care available locally for our patients, supported by technology, and helping to deliver the NHS 10 Year Health Plan for England.”
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