Enter and view: Kingston Hospital Emergency Department

Healthwatch Richmond undertook six enter and view visits to Kingston Hospital Emergency Department during the period 19 November to 12 December 2025. They spoke to 124 people.

Overall Experience

Most patients praised the kindness and professionalism of staff, even though the department was under extreme pressure and at times in “business continuity mode.” However, patients consistently felt that ED processes were confusing, inefficient, and lacking in communication. Many experienced long waits, uncertainty about next steps, and poor access to basic amenities such as food, drinks, and clean bathrooms.

Arrival and Initial Processes

Etriage tablets were generally viewed as quick and efficient, but many patients needed help completing them, particularly those in pain, with limited English, or with accessibility needs. At times, no staff were available at the ED entrance, leaving patients confused and creating safety risks. The validation area was often cluttered and short on seating, and some patients struggled to find the yellow chair area due to poor signage and insufficient seating.

Urgent Treatment Centre (UTC)

The UTC was usually calm and felt safe, but it shared a waiting area with validation, making it confusing for patients. Only a small section of the UTC seemed to be in use, raising questions about whether more patients could be redirected there to relieve pressure elsewhere. Some treatment bays had worn equipment and the clocks were incorrect.

Main Waiting Room

Most patients felt safe in the main waiting room, and many described the atmosphere as calm. However, the space was frequently hot and stuffy, and bathrooms were often unclean or had broken fixtures. Vending machines were often out of order, and there were usually no cups for the water fountain. Screens showing waiting times were inconsistent, inaccurate, or not working. Patients often could not hear their names being called and wanted clearer information and entertainment options.

Same Day Emergency Care (SDEC)

The SDEC area was hard to find and lacked proper signposting from the main ED. At times, patients had to walk back to the main reception to check in because the SDEC desk was unstaffed. Security issues were recorded, including unlocked doors, accessible supply cupboards, logged-in computers, and visible patient information. Many patients did not understand why they were required to stay in SDEC, particularly when waiting for results, referrals, or prescriptions that they felt could be communicated remotely. Only one waiting area was used even when the other was empty, leading to overcrowding and frustration. No food was available, and patients were afraid to leave in case their name was called.

Majors

Majors was described as chaotic, cramped, and sometimes dirty. Many patients stayed more than 12 hours, despite the area not being designed for long stays, and some had to sleep in reclining plastic chairs without bedding. Bay 1 in particular presented issues around privacy and comfort, with patients of mixed genders in a small open area. Food provision was inconsistent, with some patients—especially those with health or dietary needs—going long periods without being offered food or drink.

Corridor Care

Corridor care was widely observed and had become “normalised,” which concerned both patients and Healthwatch Richmond. Patients lying in corridors experienced noise, lack of privacy, delays in receiving pain relief, and poor communication. Witnessing corridor care also distressed other patients. Despite this, staff caring for patients in corridors were repeatedly described as kind and respectful.

Clinical Decision Unit (CDU)

The CDU was sometimes left unsupervised despite having patients present. Curtains were left open, and private conversations were overheard. Patient documents were left visible, and the environment was cluttered. While the CDU had better ventilation than other areas, it suffered from similar issues around privacy and organisation.

Communication

Across all areas, patients most frequently requested clearer information about waiting times, next steps, and the severity of their condition. In some cases, poor communication contributed to frustration and anxiety. A follow-up survey showed significant delays in GPs receiving discharge summaries, which in one case delayed cancer treatment.

Cleanliness, Safety, and Food Provision

Litter was seen outside the ED entrance, and bathrooms across the department were often unclean or poorly maintained. Food provision was a major issue across ED areas, especially overnight. Vending machines frequently did not work, and patients with specific dietary needs struggled to access appropriate food. Many patients waited up to 15 hours between meals.

Conclusions

Patients praised staff but were clear that the ED environment, processes, communication, and amenities were inadequate. Key problems included long waits, poor information, difficulties navigating the department, insufficient food and drink access, cleanliness issues, lack of staff presence in key areas, and concerning security lapses in the SDEC.

Recommendations

Healthwatch Richmond made extensive recommendations, including improving cleanliness, ensuring staff presence in the entrance, fixing food provision, enhancing signage, improving overnight comfort, securing the SDEC, reducing corridor care, and improving communication about waits and care pathways.