CQC rates leadership at Gloucestershire Hospitals NHS Foundation Trust as good

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

Under CQC’s updated approach, NHS trusts now receive one trust-level rating focused on leadership and organisational culture, replacing the previous collection of ratings at that level.

Inspectors found greater stability within the executive team following several leadership changes over the past three years. Staff said senior leaders were more visible, listened to concerns and had developed a better understanding of pressures affecting frontline services.

The trust has reduced its registered nursing vacancy rate from 15% to 4.5%, introduced a new process for addressing bullying, harassment and discrimination, and established daily executive-led safety meetings. A further initiative has been launched to develop a more consistent and compassionate leadership culture.

However, inspectors found this improvement had not reached every part of the organisation. Some maternity staff described limited visibility from senior leaders and a culture focused more on blame than learning.

CQC also found disabled applicants were appointed less frequently than non-disabled candidates, while disabled employees reported higher levels of discrimination. The trust’s staff ethnicity records also remained incomplete.

Several hospital services were inspected separately before the trust-wide leadership assessment.

Medical care at Gloucestershire Royal Hospital was rated good. Inspectors found staff treated people with kindness and compassion, worked effectively across teams and held three daily meetings to manage beds and patient flow. A respiratory ward pilot was also helping suitable patients leave hospital earlier.

Concerns included two bathrooms on elderly care wards being unavailable and used for equipment storage, with one having been out of use since May 2025. Emergency medicine trolleys were not consistently checked, while one person with an eating disorder remained on an acute medical ward for four months because a suitable specialist placement had not been secured.

Urgent and emergency care was rated requires improvement after inspectors identified eight breaches of regulation. These related to delays moving patients through the hospital, low mandatory training compliance, late nursing risk assessments, poor sepsis care and environmental safety.

The emergency department experienced persistent overcrowding and had one of the region’s highest rates of harm linked to delays. Some patients waited in noisy and draughty corridors where privacy, sleep and personal hygiene could not always be properly maintained.

Despite the pressure, inspectors saw staff treating people with kindness and respect. Improvements included arranging British Sign Language support for a patient with hearing loss and introducing mandatory documentation to identify the needs of people experiencing homelessness.

Maternity services at Gloucestershire Royal Hospital improved from inadequate to requires improvement. Safety and leadership were rated requires improvement, while caring, effectiveness and responsiveness were rated good.

Inspectors found the maternity triage pathway was not always managed safely, with some women discharged before test results were available. Unfilled vacancies also increased pressure on midwives and contributed to overcrowding.

Positive findings included twice-daily meetings to review every woman awaiting induction and specialist bereavement support delivered by dedicated midwives within a purpose-designed suite.

Conditions imposed on the trust in 2024 to protect the safety of maternity care at Gloucestershire Royal Hospital remain in place, with the trust continuing to report its progress to CQC every month.

At Stroud Maternity Hospital, the overall rating improved from requires improvement to good, with all five assessment areas rated good.

Inspectors highlighted improvements to maternity facilities, community-funded yoga and singing sessions for new mothers, and participation in a national pilot providing independent support to bereaved families following serious incidents.

CQC said the trust was moving in a positive direction but further work was needed to embed improvements consistently and address the remaining safety concerns.

Stay informed with the stories shaping health and social care.