An NHS trust in South London has been downgraded by the Care Quality Commission (CQC) following an inspection in September 2025. King's College Hospital NHS Foundation Trust's leadership has received a 'Requires Improvement' rating, down from the 'Good' rating it had received after its previous inspection in February 2023.
Staff Concerns and Inspection Findings
According to a CQC inspection report published on July 15, staff reported bullying, harassment, discrimination, and "inequitable" career progression. Many staff members expressed significant concerns, including a fear of speaking up, poor communication, and limited confidence that problems would be addressed.
Matthew Trainer, who joined the trust as its new chief executive earlier this month, said: "The team at King’s has done a lot of work since the CQC’s inspection, with the trust leaving NHS England’s Recovery Support Programme and making significant improvements in its latest NHS Staff Survey results. But there are findings in the CQC’s report that need to be listened to and acted upon. Staff need to feel safe when they raise concerns, and we need to make sure our leaders live the Trust’s values – to be caring, collaborative, inclusive and innovative – and that we are seen to be doing so by our staff."
Trust Operations and Impact
The trust employs over 14,000 staff and operates from five hospital sites: King’s College Hospital, Princess Royal University Hospital, Orpington Hospital, Queen Mary’s Hospital and Beckenham Beacon. More than 1 million people across the London boroughs of Lambeth, Southwark, Lewisham, and Bromley are served by the trust. The trust is also the designated major trauma centre for South East London, Kent, and parts of Surrey and Sussex.
Inspection Methodology
CQC inspectors visited the trust on the 16, 17 and 18 September, 2025. They also held 24 focus groups with 572 members of staff taking part, and inspectors observed board and committee meetings between May 2025 and October 2025.
During the inspection, staff said there was a disconnect between the trust's values and their own lived experiences. Compassionate and inclusive leadership was not always experienced across the organisation, and staff said senior leaders were not always accessible or responsive to frontline concerns.
Disparities for Staff with Protected Characteristics
Inspectors said staff with protected characteristics, including ethnic minority and Black staff, disabled colleagues and LGBTQ+ staff, reported mixed experiences of development and acting‑up opportunities and progression, with some feeling supported while others described barriers compared to their peers.
The inspection found staff confidence, psychological safety and inclusive leadership were not experienced across the entire organisation, and inspectors said the trust had more to do to ensure its values, behaviours and strategic ambitions were consistently delivered in practice.
Comparative Performance
Inspectors said when compared to similar trusts, the King's College Hospital performed just below average on staff engagement and attitudes towards trust leaders, with high rates of bullying, harassment and discrimination and a "lack of psychological safety".
Positive Findings
However, there were some positive findings from the inspection, which included the trust demonstrating a strong commitment to learning, innovation and research. Inspectors said there were notable strengths in specialist services and maternity, and evidence of "system-focused learning" which led to meaningful improvement in some areas.
Inspectors added: "Staff across frontline services were committed, compassionate and professional, with many examples of kind, respectful and person‑centred care observed in local teams, supported by inclusive and approachable service‑level leadership. Research performance, accreditation, external partnerships and innovation activity were significant, with national recognition and strong participation in clinical research, supported by committed leaders and engaged teams."
Recent Improvements
Since the CQC carried out their well-led inspection last autumn, the trust has exited the NHS Oversight Framework Segment 4, which represents trusts and Integrated Care Boards (ICBs) with the most significant challenges across performance, quality and finance. The trust has also been removed from the NHS's Recovery Support Programme, which provides intensive support and oversight to trusts and ICBs in Segment 4 of the NHS Oversight Framework.
In June this year, the trust published its five-year strategy for 2026-31, and new organisational values, with work underway to embed these across the organisation.
