Princess Royal University Hospital Also known as Farnborough Hospital

Updated 4 March 2026

Date of assessment: 8, 9, 14,15 April and 1 May 2025. Princess Royal University Hospital is part of King’s College Hospital NHS Foundation Trust and offers a wide range of hospital services to people living in Bromley and Kent.

This assessment looked at maternity services to assess the quality of the care received by patients using those services. The rating of maternity service has been combined with the ratings of the other services from the last assessments.

See our previous reports to get a full picture of all the other services at Princess Royal University Hospital.

The rating of Princess Royal University Hospital remains requires improvement.

Updated 15 January 2025

King's College Hospital NHS Foundation Trust provides maternity services at both the Princess Royal University Hospital (PRUH) and King’s College Hospital sites. From January to December 2024, there were 3,422 babies born at Princess Royal University hospital.

We last inspected maternity services at Princess Royal University Hospital on 8-9 August 2022. This was a comprehensive inspection of all domains and maternity was rated requires improvement overall.

We conducted this unannounced focused assessment on 8 and 9 April 2025 to follow-up on the 2022 inspection findings. As this was a focused assessment, we only looked at the safe, responsive and well led domains, where there were breaches of regulation. We did not reassess the effective and caring domains, which were rated good at our previous inspection in August 2022.

We visited the following areas as part of the assessment:

Postnatal and antenatal wards, triage and assessment areas, the early pregnancy unit, the theatre and recovery area and labour suite. We also looked at bereavement facilities, and outpatient areas including antenatal consulting areas and pregnancy scanning.

We spoke with members of the maternity team including maternity assistants, junior doctors, registrars, consultant obstetricians and anaesthetists, student midwives, band 6 and 7 midwives, specialist midwives, consultant midwives, safeguarding midwives, matrons and the quadrumvirate.

Safe: We looked at maternity services only and rated Safe as Requires Improvement. Systems, pathways and transitions were not always in line with guidance. Staff did not always manage clinical risks in a timely way. Safeguarding guidance was not in date. The facilities did not always meet the needs of people. Staff did not always follow infection control guidance. However, the service had a good learning culture. Managers investigated incidents thoroughly. There were enough staff with the right skills, qualifications and experience. Staff managed medicines well.

Responsive: We looked at maternity services only and rated Safe as Good. Women were involved in decisions about their care. The service provided information which was accessible and supported people to understand their care. Women knew how to give feedback and were confident the service took it seriously and acted on it. Women received fair and equal care and treatment. The service worked to reduce health and care inequalities through training and feedback. Women were involved in planning their care and understood options around choosing to decline or withdraw from care. However, the service was not always easy to access, and care was not always provided in a timely way.

Well-led: We looked at maternity services only and rated Safe as Requires Improvement. The culture within the service did not always foster collaboration with staff. Leaders were not always visible. Staff did not always feel valued and respected. Risk was not always managed in a timely manner. However, worked collaboratively with partners. There was a culture of continuous improvement with staff given time and resources to try new ideas.

We rated the service as requires improvement. The service had made improvements and is no longer in breach of the regulation for receiving and acting on complaints. However, the service remained in breach of the regulations safe care and treatment and good governance.

We refer to women in this report, but we recognise that some transgender men, non-binary women and women with variations in sex characteristics (VSC) or who are intersex may also use services and experience some of the same issues.

Updated 31 January 2018

• There was a shortage of permanent employed staff throughout the service; nursing and medical.

• Ward staff were not aware of the need for more frequent observations on patients who had been given rapid tranquillisation.

Updated 30 September 2015

There had been significant progress in how the trust delivered services to neonates, children and young people since our last inspection. Some improvements were still required to ensure that nursing levels were aligned to national standards and  that all staff complied with trust-wide policies regarding infection prevention and control practices including the screening of patients for MRSA.

The majority of care and treatment was provided in line with evidence based practice but some improvements were required in areas such as the management of children presenting with asthma. Clinical outcomes for children with diabetes was better than the national average in a number of areas.

Staff had fully embraced the concept of family centred care. All members of the family played pivotal roles in the care and treatment of neonates and children. Children and parents spoke positively about the care they received.

Access into children’s services was generally good. There had been a reduction in the number of surgical cases being cancelled and children and young people who presented to the hospital requiring surgical intervention were appropriately managed in a safe and effective way.

Local leadership at ward level was considered to be good. Staff were complimentary about their direct ward leaders who were seen to be working at ward level, supporting staff.

The service had a specific child health strategy that was aligned with the trust-wide strategy. The strategy was driven by quality and safety, and took into account the requirement for the service to be fiscally responsible.

Governance arrangements were in place for which a range of healthcare professionals assumed ownership. There was evidence that risks were managed and escalated accordingly. However, there were a small number of examples where risks that might have an impact on the clinical effectiveness of the service were not recorded on the divisional risk register.

Since our previous inspection in December 2013, the service had introduced a quality measurement scorecard; however, there was a lack of information for some metrics, which meant that the scorecard was not being used to its optimum.

Updated 31 January 2018

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

• Following our inspection in 2015, there had been improvements to the critical care unit. The trust had approved a business plan to expand the unit. Patient records were now comprehensive, with all appropriate risk assessments completed. Medicines were generally stored safely and securely. The unit had purchased new equipment and mitigating plans were in place to alleviate the lack of technical support on site. A larger visitor’s room had been created in the CCU following feedback from patients. The room was spacious and relatives had access to a toilet close to the visitor’s room.

• There were effective systems in place to protect patients from harm and a good incident reporting culture. The iMobile (critical care outreach) team provided rapid response and stabilisation to patients who needed immediate attention and transfer.

• Patients received effective, evidence-based care and patient mortality outcomes were within the expected range.

• Appropriately qualified staff cared for patients. The percentage of nursing staff with post registration qualification was higher than recommended guidelines.

• Patient feedback for the services inspected were mostly positive. Staff respected confidentiality, dignity and privacy of patients. Patients were engaged through surveys and feedback forms and the response showed high satisfaction with the service.

• Services were developed to meet the needs of patients. Feedback from patients were taken into consideration in creating a more spacious visitor’s room.

• There was good local leadership on the CCU. Staff felt valued, were supported in their roles and had opportunities for learning and development. Staff were positive about working on the critical care unit.

However:

• The unit was very busy and occupancy on the critical care unit consistently ran above 100%.

• Out of hours, medical staffing was stretched and did not comply with recommended guidelines.

• Therapy staffing levels were below the recommended guidelines.

Updated 12 June 2019

Our rating of this service stayed the same. We rated it as requires improvement because:

• The service did not always provide care and treatment based on national guidance or evidence its effectiveness.
• Staff did not always complete and update risk assessments for each patient or have an action plan to address any identified risk. We found little evidence of individualised planning or regular review of the dying patient in place.
• The end of life care plan was not integrated into the electronic patient record and we were not assured there was an identified date by which this would be available.
• There was incomplete documentation of discussions with relatives when recoding ‘do not attempt cardio pulmonary resuscitation’ status on patient treatment escalation plans (TEP).
• There was no on-site consultant presence at weekends.
• It was not always clear whether all patients were offered the opportunity to meet with a member of the chaplaincy.

However:

• There was an improved palliative care clinical nurse specialist seven-day service introduced in April 2018. Referrals to the SPCT were responded to in a timely manner with 91% of referrals seen within one day of referral and 98% within three days.
• The specialist palliative care team (SPCT) now included a palliative care social worker who provided emotional support for patients and their families.
• There was improved weekday on-site provision of palliative care medical staff with the right mix of qualification and skills, to keep patients safe and provide the right care and treatment.
• Patients and their family members told us staff treated them with dignity, respect and compassion. They said staff explained what was happening and were caring. There were no visiting time restrictions for family and friends in the last days or hours of a person’s life.
• End of life care had a clear governance framework. This ensured responsibilities for end of life care went right up to trust board level. End of life priorities had been identified and there was an action plan for the service based on these priorities.

Updated 12 June 2019

We previously inspected outpatients jointly with diagnostic imaging so we cannot compare our new ratings directly with previous ratings. We rated outpatients as requires improvement because:

• The service did not take steps to ensure all staff completed the required mandatory training. Compliance rates for required safety related training amongst medical staff was poor.

• The service did not always have suitable premises or equipment and did not always look after them well.

• Patient’s privacy and dignity was not always maintained due to the environments staff were working in, although staff tried their best to maintain standards where possible.

• Outpatient services showed generally poor performance in referral to treatment (RTT) and cancer waiting times. The trust was performing worse than the England average and national standard for both the RTT incomplete pathway, where patients should be seen within 18 weeks, and for urgent cancer referrals, where patients should be seen within two weeks. This meant the service was not always responsive and could not always meet patient urgent clinical needs in a timely manner.

• Services did not always provide the right information to service users prior to their appointments. Incorrect telephone numbers were often printed on appointment letters.

• Morale amongst administrative staff across most services was low.

• Not all risks on the risk register for OPD had not been reviewed recently, and it was not clear if all risks were being addressed.

• There were some additional plans for the long-term future of the OPD, but these were not an immediate priority due to the current challenges faced by the department. Plans did not always have clear timescales, and staff could not give examples of being involved in such plans.

However:

• The service managed patient safety incidents well. Staff recognised incidents and reported them appropriately. Managers investigated incidents and shared lessons learned with the whole team and the wider service.

• The service provided care and treatment based on national guidance and evidence of its effectiveness. Managers checked to make sure staff followed guidance.

• Staff cared for patients with compassion. Feedback from patients confirmed that staff treated them well and with kindness.

• Services were delivered and co-ordinated to take account of the needs of different people, including those with protected characteristics under the Equality Act and those in vulnerable circumstances.

• The trust used a mostly systematic approach to continually improving the quality of its service, with clear escalation and reporting structures.

Updated 12 June 2019

Our rating of this service stayed the same. We rated it as requires improvement because:

• There had been no improvements in mandatory training completion rates for medical staff since our last inspection. The 80% target was not met for any of the 22 mandatory training modules for which medical staff were eligible.

• Safeguarding training completion rates for medical staff were below the trust target with completion rates as low as 12% for level 3 safeguarding children training.

• The endoscopy unit was not suitable and there were insufficient procedure rooms to meet the demands for the service. Endoscopy decontamination took place in theatres due to space constraints. Decontamination of endoscopes was carried out in a room used for both clean and dirty equipment.

• Plans to improve endoscopy services had not been implemented since our last inspection.

• Medicine audit results showed the service performed below trust standards for a number of indicators.

• Vacancy rates for medical staff were worse than the trust’s target.

• Staff felt there was a disparity in the way resources were allocated across trust sites.

• The trust did not always provide services in a way that met the needs of local people. There was a significant number of medical outliers in surgical wards. Mixed specialities were admitted on surgical wards due to bed pressures.

• Waiting times from referral to treatment were not always in line with good practice.

However:

• Nurse staffing had improved since our last inspection. The service had enough nursing staff with the right mix of qualifications and skills, to keep patients safe and provide the right care and treatment.

• Staff kept records of patients’ care and treatment. Staff completed risk assessments and followed escalation protocols for deteriorating patients.

• There were effective systems to protect people from avoidable harm. Learning from incidents were discussed in departmental and governance meetings and action was taken to follow up on the results of investigations.

• Staff provided evidence-based care and treatment in line with national guidelines and local policies. There was a program of local audits to improve patient care.

• The service made sure staff were competent for their roles. Managers appraised staff’s work performance.

• Staff were aware of their responsibilities under the mental capacity act.

• There was effective multidisciplinary working, including liaison with community teams, to facilitate timely discharge planning.

• Feedback for the services inspected were positive. Staff respected confidentiality, dignity and privacy of patients.

• There was good local leadership on surgical units. Staff felt valued and they were supported in their role. There was a good governance structure, both within surgical care and within the directorate.

Updated 11 August 2021