- NHS hospital
Salford Royal Hospital
Assessment report published 30 September 2026
Ratings - Surgery
Our view of the service
The surgical services at Salford Royal Hospital have been restructured into 3 clinical service groups following the implementation of the clinical leadership model in April 2026. This includes the neurosciences and major trauma clinical group, the surgery clinical group (which includes ear, nose and throat (ENT) and oral surgery, urology, ophthalmology, trauma and orthopaedics, intestinal failure and upper gastrointestinal surgery). The theatres and gynaecology services form part of the families, anaesthetics, critical care and theatres clinical group.
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 carried out 10,555 procedures between September 2025 and May 2026.
We commenced a responsive assessment of the surgical services at Salford Royal Hospital to check improvements after we issued a warning notice under section 29A of the Health and Social Care Act 2008 in October 2025. The assessment was also undertaken 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 September 2025.
We carried out an unannounced inspection visit between 19 and 21 May 2026. During the inspection, we spoke with 32 patients and 5 relatives and carers. We looked at 29 care records. We also spoke with over 80 staff, leaders and service partners and looked at policies and other documents relating to the service.
Our overall rating for surgery remained the same. We rated it as requires improvement.
We identified 12 regulatory breaches relating to safe care and treatment, governance and staffing.
We issued a warning notice under section 29A of the Health and Social Care Act 2008 in October 2025 because we identified significant concerns relating to staffing and the systems and processes to identify and manage risks to the safety and quality of care received by patients. During this inspection we found the service had made sufficient changes to reduce the likelihood and impact of poor care for patients and therefore comply with the warning notice. However, we identified an ongoing need for the surgical services to ensure that improvements made to improve staffing levels and reduce risks to patient safety were sustained and fully embedded. We also found wider governance concerns continued to impact on the surgical services.
The services had implemented a new clinical leadership structure, which meant leaders did not yet fully understand the context in which the service delivered care, treatment and support. A positive work culture and morale had not been embedded across all staff groups. Staff did not always feel they could speak up and that their voice would be heard. The surgical services did not always effectively assess patient needs within the surgical wards. The services did not have sufficient numbers of trained staff in the theatres department.
The services did not have effective governance and quality monitoring processes. Incident investigations and complaint responses were not always completed in the timelines specified by trust policies. Compliance in quality assurance audit standards had improved but was still below trust targets for some audit indicators.
Training compliance in life support training, autism awareness and dementia awareness were below expected trust standards. The service did not always make sure that medicines and treatments were safe and met people’s needs. The service did not effectively assess patient’s needs in the surgical wards.
However, staff understood how to protect patients from abuse. Premises and equipment were clean and well-maintained. Staff treated patients with compassion and kindness, respected their privacy and dignity and took account of their individual needs and choices. The service provided relevant information and made it easy for patients to give feedback about their experiences.
People's experience of this service
Most of the patients and relatives we spoke with were positive about the way staff treated them. They told us they felt there were enough staff on the wards and that staff responded promptly when called and supported them with their medical and personal care needs. Most patients we spoke with told us staff gave them pain relief medicines when needed and their pain symptoms had been managed appropriately.
Patients 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 felt the premises and equipment were safe, clean and well maintained and they knew how to raise a complaint or concern.