Spotlight on local innovation – how investment in people is driving innovation, training and retention in Romford

Queen’s Hospital in Romford is a large and busy district general hospital, serving a diverse population across northeast London and Essex. The trust sees around 1,000 patients a day through its emergency department, delivers more than 7,000 babies a year and operates with a budget of around £1bn. Patient demand continues to rise, primary care access locally is limited, and, like many NHS organisations, the trust is managing financial constraint alongside increasing clinical complexity.

Innovation here has focused less on stand out pilots and more on strengthening the fundamentals – unlocking workforce potential, creating the conditions for learning and leadership, and building systems that support education, research and care under pressure.

The trust now hosts around 1,000 undergraduate medical students each year. As placement numbers have increased, the organisation has invested in roles and structures to maintain quality, including undergraduate fellows already in post and plans for embedded educators within clinical teams. A redesigned elective programme aligns the trust with other London providers, while a well-established work experience scheme offers local young people (many from backgrounds where medicine may not feel accessible) an opportunity to engage with clinical environments. The trust also delivers large scale Objective Structured Clinical Examinations (OSCEs) on site, with consistently positive student feedback.

At postgraduate level, induction has been strengthened significantly. Foundation doctors, doctors in internal medicine training and international medical graduates (IMGs) receive structured shadowing and orientation, including a 4-week programme for IMGs focused on NHS systems and expectations. Feedback is consistently positive, particularly in relation to psychological safety and early confidence.

Education quality has improved over time, reflected in a reduction in GMC-related quality actions. The introduction of an Education Charter, developed jointly with resident doctors and clinical leaders, sets out clear expectations for training and supervision.

The trust’s human factors and simulation centre is a central driver of innovation. Designed to replicate clinical environments, it delivers immersive, multi-professional training across a range of specialties. The focus extends beyond technical skills to communication, situational awareness and team decision-making, recognising their importance for patient safety. Programmes run from foundation level through to higher specialty training, alongside curriculum-aligned procedural training. In situ simulations delivered in clinical areas have been particularly well received. Over a single year, hundreds of staff participated, with strong feedback from both doctors and nurses.

A distinctive area of focus has been the development of locally employed and specialist, associate specialist and specialty (SAS) doctors. With over 500 doctors in these roles, the trust has adopted a clear principle that all doctors are in training. This underpins a comprehensive development offer, including named clinical and educational supervisors from the outset. Induction covers grades, job planning and career pathways, with structured support for portfolio pathway (formerly known as CESR) routes. More than 20 doctors have already made significant progress.

Leadership and development opportunities are actively promoted. Locally employed doctors are contributing as medical examiners, associate medical directors, clinical informatics leads and panel members. Many are undertaking EDI training, quality improvement work and supervisor accreditation, with a positive impact on retention and organisational stability.

Research activity has also expanded. An in-house principal investigator training programme, alongside participation in the NIHR Associate PI scheme, has supported both consultants and resident doctors to lead studies. Since 2023, dozens of doctors have completed PI or Associate PI training. The trust has secured a £6m innovation grant for a brain–computer interface project and is participating in commercial phase III trials, supported by external partnerships. As part of a national Commercial Research Delivery Centre, it is developing the infrastructure to widen access to research.

The trust has also developed sustained global health partnerships in East Africa, including Tanzania and Zanzibar, focused on diabetes care, ultrasound training, telemedicine and multidisciplinary support. These long-term collaborations are based on mutual learning, with ongoing virtual education and shared programmes.

Across all this work, the emphasis is consistent: improvement starts with people. Investment has prioritised clinical and educational roles, alongside leadership that enables staff to lead change. This demonstrates that, even under sustained pressure, district general hospitals can deliver innovation, education and professional development when the workforce is supported effectively.