Salford Royal surgery remains below standard despite progress on safety warning

Surgical services at Salford Royal Hospital continue to require improvement after inspectors identified 12 regulatory breaches involving patient safety, staffing and management.

The Care Quality Commission inspected the service between 19 and 21 May to assess its response to a warning notice issued in October 2025. That notice followed serious concerns about staffing and the systems used to identify and manage risks to patients.

Although the hospital had made sufficient progress to comply with the warning notice, inspectors concluded that further work was still necessary to provide consistently safe care.

The inspection also examined concerns involving gynaecology, spinal and neurosurgery services. Safety, effectiveness, responsiveness and leadership were all rated requires improvement, while the caring rating increased from requires improvement to good.

Salford Royal Hospital, which is operated by Northern Care Alliance NHS Foundation Trust, remains rated requires improvement overall.

Inspectors found that patients could not always access treatment and support when they needed it. Leaders were also told to reduce prolonged hospital stays and readmissions after surgery, as well as improve discharge arrangements so people were not kept in hospital unnecessarily.

Incidents were not always investigated promptly or in accordance with trust policies, limiting opportunities to identify lessons and prevent similar events. Some employees had not completed the level of life-support training required for their roles.

Infection prevention also remained an area of concern. Inspectors found that staff did not always assess or manage infection risks appropriately, while compliance with hand hygiene and the correct use of personal protective equipment remained below the trust’s own standards.

Gill Hodgson-Reilly, CQC deputy director of operations in the North West, said leaders and staff had made improvements since the previous inspection but had more work to do before safe and consistent care could be assured.

The trust had taken action to reduce vacancies and sickness absence, although inspectors said those changes were not yet fully embedded. Further measures were required to reduce risks arising from workforce pressures.

Patient experiences offered a more positive picture of frontline care. People described staff as compassionate and kind, said their individual needs were considered and generally felt there were enough employees on wards to respond promptly. Patients and relatives also said they felt safe and raised no safeguarding concerns.

The CQC will continue monitoring the service to determine whether the trust can embed and sustain the required improvements.

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