- NHS hospital
Royal United Hospital Bath
Assessment report published 13 May 2026
Contents
Ratings - Urgent and emergency services
Our view of the service
Date of assessment: 21 October 2025 to 28 November 2025. We conducted a responsive assessment of Urgent and Emergency Services at the Royal United Hospital Bath, following multiple sources of information received about overcrowding and concerns regarding patient safety.
At the time of the inspection, we identified significant shortfalls with safe levels of staff, safe care for patients with mental ill-health, the environment, particularly when crowding and other storage problems resulted in the blocking of fire exits. We had concerns around infection prevention and control, specifically relating to inconsistent staff compliance with guidance, and the deteriorating physical condition of the emergency care facilities. There was a high vacancy and sickness rate for nurses, driven by intense pressures of overcrowding and the resulting higher workload. The number of senior decision makers fell below the Royal College of Emergency Medicine recommendations, leaving gaps in senior medical cover overnight. The process of triage for patients was confusing, as was access to the department and information provided for patients.
The department experienced significant pressure as high patient demand coincided with reduced bed capacity. These factors, compounded by delayed discharges, led to long waiting times for many patients. There was a lack of privacy and dignity for patients waiting for long periods of time in the corridor. This was also a concern for patients who had mental health needs, often waiting many days for a specialist inpatient bed. Governance processes were carried out well in some areas, but there were significant gaps in audit and local risk management. However, most staff had no concerns about speaking up and worked well with others to give a multidisciplinary approach to patient care. Staff followed evidence-based care and treatment protocols. Staff talked to patients about their care and got their permission before starting treatment. Despite the challenges of a crowded environment, we observed staff treating patients with kindness and compassion. The culture of teamwork and wellbeing was evident. There were opportunities for learning, change and innovation whenever possible, but the high workload meant this did not always have the focus of attention it needed.
We rated the service as requires improvement. We found 3 breaches of the regulations in relation to safe care and treatment, staffing and governance.
People's experience of this service
Patients and any family or carers with them we met were mostly positive about the staff treating them with kindness and providing good care and treatment. However, not all said they were seen quickly on arrival and were anxious about waiting times and a lack of information or communication. Some said they were concerned they had waited over an hour for triage or been waiting for many hours in a corridor. Other patients we spoke with told us how compassionate staff were. They stated that although staff looked very busy, they were always helpful and kind.