CQC rates Gloucestershire Hospitals leadership good as inspections highlight progress and ongoing concerns

The Care Quality Commission (CQC) has rated the leadership of Gloucestershire Hospitals NHS Foundation Trust as good following an inspection carried out in February.

The assessment comes as CQC publishes findings from its trust-wide well-led inspection alongside reports from inspections of medical care, urgent and emergency care and maternity services. Under CQC’s current approach, NHS trusts receive a single trust-level rating focused on leadership and culture.

Inspectors found signs of greater stability within the trust’s leadership following several changes in executive roles over the previous three years. Staff reported that leaders were increasingly visible across wards and services and that they felt listened to when raising concerns.

The trust has significantly reduced registered nursing vacancies from 15% to 4.5% and introduced daily executive-led safety huddles to give senior leaders a better understanding of issues affecting frontline services. A new process has also been introduced to tackle bullying, harassment and discrimination, alongside an initiative aimed at creating a more consistent and compassionate leadership culture.

However, CQC found that improvements in culture were not yet consistent across the organisation. Disabled applicants were appointed less frequently than non-disabled applicants, while disabled staff reported higher levels of discrimination. Inspectors also found gaps in ethnicity data, with records available for 89% of staff.

Urgent and emergency care at Gloucestershire Royal Hospital was rated requires improvement following an inspection in December 2025, with eight breaches of regulation identified. Concerns included delays in patient flow, low mandatory training rates, delays in nursing risk assessments, sepsis care and the safety of the hospital environment.

Inspectors found sustained overcrowding within the emergency department and said the trust had one of the highest rates of delay-related harm in the region. Some patients experiencing extended waits were unable to sleep comfortably or meet their hygiene needs, while overcrowding could also make it difficult for staff to protect confidentiality.

Despite these pressures, inspectors found staff treated people with kindness, discretion and respect. The department had also introduced a checklist to identify the needs of homeless people, while leaders had set out a five-year strategy which prioritises returning to the four-hour waiting standard.

Maternity services at Gloucestershire Royal Hospital were rated requires improvement following an inspection in September 2025, with safety and leadership also rated requires improvement and caring, effective and responsive rated good.

CQC identified concerns around staffing and the safety of the triage pathway, including occasions when women were discharged before test results were available and asked to wait at home for the results. Inspectors also highlighted positive practice, including twice-daily induction of labour meetings and specialist bereavement support delivered by dedicated bereavement midwives.

Conditions imposed by CQC on Gloucestershire Royal Hospital’s maternity department in 2024 remain in place, with the trust continuing to report monthly to the regulator.

At Stroud Maternity Hospital, the picture was more positive, with CQC upgrading maternity services from requires improvement to good overall and across all five key questions. Inspectors highlighted work with the Stroud Hospitals League of Friends to improve facilities and provide additional support for new mothers, as well as the service’s participation in a national pilot supporting bereaved families following serious incidents.

Medical care at Gloucestershire Royal Hospital was also rated good following its December 2025 inspection. Inspectors found staff treated patients with kindness, empathy and compassion and worked collaboratively to manage patient flow. However, concerns included bathrooms on elderly care wards being unavailable for patient use, inconsistent checks of emergency medicine trolleys and difficulties securing an appropriate specialist placement for a patient with an eating disorder.

Catherine Campbell, CQC deputy director of hospitals, secondary and specialist care for the South-West, said inspectors were encouraged by the trust’s direction of travel and the willingness of leaders to acknowledge areas where further improvement was needed.

CQC said it will continue to monitor the trust’s progress and ensure people remain safe while further improvements are made.

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