- NHS hospital
Salford Royal Hospital
Assessment report published 13 February 2026
Ratings - Surgery
Our view of the service
The surgical services at Salford Royal Hospital are incorporated into 2 divisions across the hospital. The division of surgery and perioperative care includes the general surgery, gynaecology, urology, plastics, trauma and orthopaedics, theatres, anaesthetics and perioperative care specialties. The major trauma, spinal, neurosurgery, head and neck and ear, nose and throat (ENT) specialties form part of the Manchester Centre of Clinical Neurosciences (MCCN) division. The hospital is also the regional centre for major trauma and neurosurgery and the tertiary referral centre for complex spinal surgery. The hospital is the regional centre for major trauma, upper gastrointestinal and bariatric care and the tertiary centre for neurosurgery, neurology and complex spinal care. It is also the quaternary centre for intestinal failure. The surgical services had 15,400 attendances between October 2024 and September 2025.
We commenced a responsive assessment of the surgical services at Salford Royal Hospital because we had concerns about governance and safety processes in the gynaecology, spinal and neurosurgery services, and to re-rate the surgical services following a rating of requires improvement from our previous inspection in December 2022. We looked at 33 quality statements as part of the assessment.
We carried out an unannounced inspection visit between 23 and 25 September 2025. During the inspection, we spoke with 24 people who used the service and 5 relatives and carers. We looked at 29 care records. We also spoke with over 100 staff, leaders and service partners and looked at policies and other documents relating to the service.
Following the inspection, we issued a warning notice to the trust on 21 October 2025 under section 29A of the Health and Social Care Act 2008. We took this action as we believed significant improvement was required to reduce the risk of harm to people who used the service. The warning notice related to staffing levels across the surgical wards and concerns about the systems and processes used to identify and manage risks affecting quality and safety on the surgical wards.
We also identified a further 11 regulatory breaches relating to person-centred care, safe care and treatment, safeguarding service users from abuse and improper treatment, good governance, staffing and duty of candour in addition to the concerns identified within the warning notice.
Our overall rating for surgery remained the same. We rated it as requires improvement.
The services did not have effective governance and quality monitoring processes. We found significant shortfalls around the safety, effectiveness and responsiveness of the surgical services. Actions taken to address key issues or reduce their impact had not resulted in effective and timely improvements in the management of risks, issues and performance across the services. The services had also failed to make any significant improvements to address most regulatory breaches identified during our previous inspection in December 2022.
However, most staff had completed mandatory training and received regular appraisals. Services had enough medical staff, and teams worked collaboratively to follow national guidelines, manage sepsis effectively, and promote healthier lifestyles. Staff considered inequalities, encouraged feedback, and demonstrated a commitment to learning and innovation. Leaders engaged with partners and the wider community to plan and improve services.
We will return to assess the service to check the trust has made significant improvements in the quality of healthcare provided.
People's experience of this service
Feedback from people using the service was mixed.
Most people told us the surgical wards did not have enough nursing and support staff. Some people told us staffing shortfalls on the surgical wards had impacted their emotional well-being and they did not always feel comfortable asking for help when they needed it, because they had experienced delays in support from staff, especially during the night. We spoke with people on some surgical wards who experienced delays in receiving pain relief and support with their personal care needs.
However, some people we spoke with were positive about the way staff treated them. They told us staff were kind, respectful, asked for their consent and worked well as a team. They told us the staff kept them informed and planned and delivered their care and treatment in a way that met their needs. They also told us they knew how to raise a complaint or concern.