University Hospital

Updated 15 August 2025

At this latest assessment of University Hospital in Coventry we reviewed 4 service groups and aggregated the ratings from our previous assessments of 9 service groups. Although some of the services are rated as requires improvement, the overall rating for University Hospital remains good.

Updated 15 August 2025

The medical care service at University Hospital (part of University Hospital Coventry and Warwickshire NHS Trust) provides care and treatment for different specialties. During our assessment we visited 15 wards including: care of the elderly (ward 20), cardiology (ward 21), medical assessment unit (MAU), the respiratory unit (wards 30, and 31),infectious diseases ward (31a),acute frailty unit (AFU), gastroenterology (ward 32), haematology (ward 34), oncology (ward 35), stroke ward (ward 41), neurology (Ward 42), acute medical short stay (AM-SS), the endoscopy suite and the discharge lounge (which is managed by the Community Services clinical group and not solely for medical patients).

We carried out an unannounced visit on 25 and 26 September 2024. The assessment team included 2 CQC inspectors, 2 CQC bank inspectors and a specialist advisor. We also had senior specialists from the CQC people with a learning disability and autistic people team and a member of the medicines team. As part of our assessment, we looked at 16 patient records, spoke with 15 patients, and 41 members of staff. We attended 6 meetings. Our pharmacist specialist spoke with 2 people receiving treatment, 3 nurses and 3 clinical pharmacists. They reviewed clinic rooms, administration records and associated care records for 5 people. We checked 10 pieces of equipment.

This assessment was completed due to an aged rating and intelligence we had received about the service which informed our plan for the assessment.

Updated 15 August 2025

University Hospitals Coventry and Warwickshire NHS Trust provides a range of children and young people’s services which includes inpatients, outpatients, and a separate children’s emergency department. The children’s outpatient department is a separate facility managed by children’s services.

The hospital has 94 inpatient beds for children on several purpose-built wards. Care is available for infants, children, and young people up to the age of 18 years. Care is provided for emergency admissions, medical day case admissions, surgical day cases and inpatient surgical cases. There was a 6-bedded paediatric high dependency unit (HDU).

The service provided care for newborn babies requiring treatment in the level 3 neonatal unit is part of the west midlands perinatal network. Care was provided with 36 cots, 8 of which were intensive care, 8 were high dependency, 14 were special care and 6 transitional care with facilities for parents and carers to stay with their baby in hospital.

We carried out an unannounced assessment of the children and young people’s service on 25 and 26 September 2024. We assessed this service due to the time since the previous inspection and the age of the rating. At the last inspection in 2018, the service was rated good in all key questions. We reviewed all key questions; safe, effective, caring, responsive and well led.

We found 4 breaches while completing the assessment at the service.

We visited the children’s wards, paediatric HDU, the neonatal ward and the children’s outpatient’s department. We looked at 18 patient records. We spoke with 14 patients and their families who represented patients aged from newborn babies to 14 years. During our assessment we spoke with 39 members of staff. These included ward clerks, housekeepers, practice educators, teachers, the safeguarding lead, healthcare assistants, Child and Adolescent Mental Health Services (CAMHS) liaison, service leads, band 4, band 5, band 6, and band 7 nurses. We also spoke with ward managers, consultants, paediatric pharmacists, digital specialists, and children’s nurses.

Updated 15 August 2025

University Hospitals Coventry and Warwickshire NHS Trust provides acute and tertiary hospital services for over 1 million people. A wide range of general surgical services are provided which include but are not restricted to the following specialties: breast, colorectal, ear nose and throat, general surgery, head and neck, hepato pancreato biliary, ophthalmology, oral and maxillofacial, renal transplantation, upper gastrointestinal, urology, trauma and orthopaedics and vascular surgery.

Surgical services included three clinical groups: trauma and neurosciences; surgical services (with 12 surgical subspecialties); and clinical support services (comprising of theatres and anaesthetics). Each clinical group had a leadership team with a group clinical director, supported by a group director of nursing and AHPs and group director of operations. Reporting into the directors for each group were specialty/department teams consisting of a clinical service lead, a senior nurse and a group manager. This model was replicated throughout the three clinical groups.

University Hospital Coventry has 1,064 beds and 26 operating theatres and is a major trauma centre providing care for patients with severe injuries.

We carried out a planned inspection of the surgical services at University Hospital Coventry on the 25 and 26 of September 2024 and 11th March 2025.

We followed the Care Quality Commission (CQC) Single Assessment Framework and assessed against the safe, effective, caring, responsive and well-led key questions. As part of our assessment, we looked at 15 patient records, spoke with 12 patients, 5 relatives and 50 members of staff including the leadership team for surgery (known as the triumvirate) Surgery, Trauma and Neuro Services and Clinical Support Services, theatre manager, ward managers, scrub nurses, anaesthetists, consultants, healthcare assistants, recovery nurses, advanced care practitioners and staff nurses.

We found:

A strong safety culture was evident, where events were investigated, and learning was embedded to promote good practice. Good care and treatment was delivered in accordance with evidence-based practice, resulting in positive outcomes for patients. Staff were recognised for their kindness, compassion, and caring approach. The service was inclusive, ensuring that patients' individual needs and preferences were considered. Effective governance processes were operated by leaders, who used systems to manage performance efficiently.

The service did not meet NHS treatment standards due to the backlog caused by the COVID-19 pandemic across England. However, managers worked continuously to reduce waiting times and address the backlog, showing steady progress. The service collaborated with other healthcare professionals to ensure timely care, particularly for serious conditions requiring specialist input.

Updated 15 August 2025

The urgent and emergency care directorate at University Hospital compromises of an adult emergency department (AE), a children’s emergency department, a minor injuries unit and urgent treatment centre, a surgical assessment unit, a medical same-day emergency care service, a frailty same-day emergency care service, and a gynaecology emergency unit.

Our inspection focused specifically on the adult’s emergency department and the children’s emergency department.

The adult emergency service at Coventry is a level one major trauma centre. Trauma patients could arrive by road or air ambulance. The service is one of the busiest major trauma centres in the UK.

Within the adult emergency department there was a resuscitation area for adults and 2 separate paediatric resuscitation rooms, a rapid assessment and treatment area for assessment of people arriving by ambulance. There was a majors area for those who were the most unwell, a patient ‘fit to sit’ area, and a waiting room. Within the children’s emergency department were high dependency rooms, a majors area, and a waiting room.

Majors is an area for patients with serious and life-threatening conditions. People with non-life-threatening conditions who were in need or urgent treatment were streamed by a senior nurse to the minor injuries unit or the urgent treatment centre. Fit to sit was a seating area with eight chairs designed to be used at times of overcapacity to prevent patients being held in areas considered inappropriate. The patients in this area were assessed as having lower clinical acuity than other patients within the majors area.

We visited the adult’s emergency department and the children’s emergency department twice. At the first visit which lasted 2 days, a team of 2 inspectors and 2 specialist advisors spoke with 49 members of staff (including managers, doctors, nurses, healthcare assistants, healthcare professionals, receptionists, and administrative staff). We spoke with 24 patients, 3 relatives, we reviewed 19 whole or partial sets of patient notes, and we attended 6 meetings. The second visit took place 4 weeks later and lasted 1 day. The inspection team included a deputy director of operations, a senior specialist, and an inspector. At this visit we spoke with some of the same staff we had previously spoken with, we reviewed 6 partial sets of notes and attended 1 meeting.

We carried out this assessment following information of concern around waiting times and poor performance indicators. We inspected 30 quality statements across the safe, effective, caring, responsive and well-led key questions.

The demand on the service was so high at times and the capacity exceptionally constrained as a result that despite best efforts, staff were not always able to provide satisfactory care, especially for those patients waiting for treatment in the waiting rooms. However, patients who had been admitted to the majors department received good care and treatment that followed evidence-based practice, although because of long waits for treatment outcomes were not always positive. Staff were kind, caring and compassionate but could not consistently provide the best person-centred care or maintain patients’ privacy and dignity due to the demands placed on them. The department and staff were well-led by strong leaders who embodied the cultures and values of their workforce. However, due to constraints across the whole health and care system, leaders could not always make improvements to the service to provide the best safe and effective care that was responsive and met people’s needs.

We found 5 breaches of the legal regulations in relation to safe care and treatment, staffing, premises and equipment, dignity and respect, and person-centred care.

Updated 11 February 2020

• The service had enough staff to care for patients and keep them safe. Staff had training in key skills, understood how to protect patients from abuse, and managed safety well. The service controlled infection risk well. Staff assessed risks to patients, acted on them and kept good care records. They managed medicines well. The service managed safety incidents well and learned lessons from them. Staff collected safety information and used it to improve the service.
• Staff provided good care and treatment, gave patients enough to eat and drink, and gave them pain relief when they needed it. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients, advised them on how to lead healthier lives, supported them to make decisions about their care, and had access to good information. Key services were available seven days a week.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients, families and carers.
• The service planned care to meet the needs of local people, took account of patients’ individual needs, and made it easy for people to give feedback. People could access the service when they needed it and did not have to wait too long for treatment.
• Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff understood the service’s vision and values, and how to apply them in their work. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged well with patients and the community to plan and manage services and all staff were committed to improving services continually.

However:

• Risks around medical staffing being below planned levels, whilst recruitment is taking place, had not been reviewed.
• Although staff had access to trust policies and procedures through the intranet, we identified some policies and procedures which were out of date and in need of renewal at the time of the core service inspection. This had been addressed by the time of the well led reivew.

Updated 31 August 2018

We previously inspected diagnostic imaging jointly with outpatients so we cannot compare our new ratings directly with previous ratings. As this is an additional service, we do not include this service’s ratings in our aggregation of core services ratings at this hospital.

We rated it as good because:

• Changes had been made to strengthen the management and governance structure in this core service, which had led to a culture of continuous assessment of risk and focus of improving performance. There had been progress made to the majority of areas noted for improvement found during our previous inspection.
• The service shared lessons learned from reported incidents and complaints. There was effective use of daily safety huddles meetings to communicate with teams.
• The service monitored its performance including turnaround times. The team were proud that they had been delivering their diagnostic targets since 2015.
• The service developed their staff in order to deliver appropriate care and treatment. They ensured staff attended mandatory training and received an appraisal of their development needs.

However:

• Only medical staff received safeguarding children training to level 3.
• The design of the building did not always lend itself to providing appropriate waiting areas or segregation of male and female patients. The service had made improvements in order to provide facilities to protect patent’s privacy and dignity, although the solutions were not always reliable.
• There was minimal evidence of engagement with patients and the public to ensure services reflected local needs.

Updated 31 August 2018

Our overall rating of this service improved. We rated it as good because:

• There were improvements to safety performance through the identification of and action against safety incidents, risks and patient assessment processes relating to end of life care.
• There was improved recording of ‘Do not attempt cardiopulmonary resuscitation’ (DNACPR) decisions and discussions.
• Care and treatment was delivered in line with evidence based national guidance such as National Institute for Health and Care Excellence (NICE) guidance.
• Patient outcomes were monitored and improved through participation in the national care of the dying audit and subsequent internal audits relating to the individual plan of care for the dying person.
• There were a range of training initiatives available for a variety of staff groups involved in end of life care so that staff had the skills, knowledge and experience to deliver effective care.
• Patients at the end of life and those close to them were treated with kindness, respect and compassion. They were involved in making decisions about their care. Staff went the extra mile to meet patients’ individual needs and were supported by volunteer care of the dying champions.
• There was a clear vision and strategy in place with identified priorities and monitoring of action taken by the end of life care committee. Governance structures around end of life care were in place to ensure continuous improvement.
• There was a strong culture of quality end of life care across the trust, with active engagement, involvement, commitment and representation from a range of staff groups.
• There were opportunities for and examples of innovation in end of life care, including the development of compassionate communities’ projects to improve end of life care for patients within the trust and the community.

However:

• Consent to care and treatment was sought in line with legislation and guidance. However, some patient records of mental capacity assessments relating to decisions regarding ‘Do not attempt cardiopulmonary resuscitation’ (DNACPR) were not always maintained.

• Mandatory training achievement fell below trust targets in a number of areas.
• Facilities for having difficult conversations with relatives were limited, although this had been identified by the trust and was being incorporated into work plans.
• Activity data relating to the responsiveness of the specialist palliative care team was incomplete which meant monitoring of response times to referrals was limited.
• The trust did not provide a seven-day face to face service to support the care of patients at the end of life.

Updated 11 February 2020

Our rating of this service stayed the same. We rated it as requires improvement because:

• Medical staff were not compliant with mandatory training requirements. Medical staff were also not fully compliant with safeguarding training requirements. The service did not consistently control infection risk well. Not all the equipment and the premises were visibly clean. The design, maintenance and use of facilities, premises and equipment was not always in line with national guidance.
• Not all patients had their clinical observations reviewed in line with required timescales.
• The service did not have enough nursing and support staff with the right qualifications, skills, training and experience to keep patients safe from avoidable harm and to provide the right care and treatment. We found not all record keeping followed national guidance.
• Non-medical staff did not apply the Mental Capacity Act effectively prior to undertaking routine care and treatment where applicable to support patients who lacked capacity to make their own decisions. Staff understanding about when to assess capacity was varied.
• Key services were not always available seven days a week to support timely patient care.
• Not all facilities and premises were appropriate for the services being delivered. Not all patients were provided with an interpreter in a timely manner. Patients could not all access the service when they needed it and did not always receive the right care promptly. Waiting times from referral to treatment and arrangements to admit, treat and discharge patients were in not line with national standards; although improvements were noted.
• Staff did not all feel respected, supported and valued. The service did not have an open culture where patients, their families and staff could raise concerns without fear. Leaders did not consistently operate effective governance processes, throughout the service. Whilst governance was clear from the ward; within theatres this was not embedded or clear. Some staff at management levels were not clear about their roles and accountabilities. Although leaders and teams used systems to manage performance, not all responsible individuals were reporting concerns or adverse incidents transparently or openly.

However,

• Nursing staff had training in key skills, understood how to protect patients from abuse, and managed safety well. Staff assessed risks to patients and acted on them. They managed medicines well. The service managed safety incidents well and learned lessons from them. Staff collected safety information and used it to improve the service.
• Staff mostly provided good care and treatment, gave patients enough to eat and drink, and gave them pain relief when they needed it. Managers made sure staff were competent. Staff worked well together for the benefit of patients, advised them on how to lead healthier lives, supported them to make decisions about their care, and had access to good information.
• Staff treated patients with compassion and kindness, mostly respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients, families and carers.
• The service planned care to meet the needs of local people, took account of patients’ individual needs, and made it easy for people to give feedback.
• Leaders mostly ran services well using reliable information systems and supported staff to develop their skills. Staff understood the service’s vision and values, and how to apply them in their work. Staff were focused on the needs of patients receiving care. The service engaged well with patients and the community to plan and manage services.

Updated 10 March 2023

Updated 31 August 2018

We cannot compare ratings to previous inspections as we inspected outpatients with diagnostic imaging previously. We rated it as good because:

• The service provided mandatory training in key skills to staff. Most staff had completed mandatory training in line with trust policy
• The service controlled infection risk well. Staff kept themselves, equipment and the premises clean. They used control measures to prevent the spread of infection.
• The service had enough staff with the right qualifications, skills, training, and experience to keep people safe from avoidable harm and abuse and to provide the right care and treatment.
• The service managed patient safety incidents well. Staff recognised incidents and reported them appropriately. Managers investigated incidents and shared lessons learned with the whole team and the wider service.
• The service provided care and treatment based on national guidance and evidence of its effectiveness. Managers checked to make sure staff followed guidance.
• Staff gave patients enough food and drink to meet their needs and improve their health. The service adjusted for patients’ religious, cultural, and other preferences.
• The service monitored the effectiveness of care and treatment and used the findings to improve them.
• Generally, the service made sure staff were competent for their roles. Managers appraised staff’s work performance and held supervision meetings with them to provide support and monitor the effectiveness of the service.
• Staff in different teams worked together as a team to benefit patients. Doctors, nurses and other healthcare professionals supported each other to provide good care.
• Staff cared for patients with compassion. Feedback from patients confirmed that staff treated them well and with kindness.
• Staff involved patients and those close to them in decisions about their care and treatment.
• The service took account of patients’ individual needs.
• The service had managers at all levels with the right skills and abilities to run a service working to provide high-quality sustainable care.
• The service used a systematic approach to continually improve the quality of its services and safeguarding high standards of care by aiming to create an environment in which excellence in clinical care would flourish.
• The service had effective systems for identifying risks, planning to eliminate or reduce them, and coping with both the expected and unexpected.
• The trust was committed to improving services by learning from when things go well and when they go wrong, promoting training, research and innovation.

However, we also found:

• Staff understood how to protect patients from abuse and the service worked well with other agencies to do so. Staff had basic training on how to recognise and report abuse and they knew how to apply it. Some medical staff had not completed the appropriate level of safeguarding training required by the trust and some nursing staff had not received the required level of safeguarding recommended by national guidance.
• Staff understood their roles and responsibilities under the Mental Health Act 1983 and the Mental Capacity Act (MCA) 2005. They knew how to support patients experiencing mental ill health and those who lacked the capacity to make decisions about their care. However, not all staff received specific training in MCA or Deprivation of Liberty Standards (DoLS).
• People could not always access the service when they needed it. Waiting times for treatment were not in line with good practice. There were still large numbers of patients waiting to be seen in the outpatient department.
• The service sometimes collected, analysed, managed and used information to support its activities, using secure electronic systems with security safeguards. However, some patient notes and referrals had gone missing or not been available for clinic appointments.