- NHS hospital
The Princess Alexandra Hospital
Assessment report published 30 July 2026
Contents
Ratings - Surgery
Our view of the service
On the 11 and 12 November 2025 we carried out an assessment of surgical care. This was a responsive assessment due to emerging safety risk for people receiving care at the Princess Alexandra Hospital. We inspected all quality statements across safe, effective, caring, responsive and well-led key questions.
During our inspection we spoke to staff, patients and families using the service. We observed how patients were being cared for and reviewed treatment records of patients.
The service fostered a positive learning culture, with staff encouraged to report incidents and operating theatre teams showing good adherence to safety procedures. However, staff did not consistently complete patient risk assessments. Environmental and equipment risks, such as obstructed fire exits, incorrect oxygen storage, cluttered or dusty storage areas, and the use of corridors for patient care contributed to concerns, as did staffing shortages and delayed call‑bell responses.
Staff delivered treatment aligned with legislation, evidence-based standards, and patients’ individual needs. However, effectiveness was hampered by shortcomings in assessments and documentation. Staff commented that the electronic patient record (EPR) system was difficult to use, affecting handovers and continuity of care. We observed multidisciplinary team (MDT) communication was inconsistent, and daily MDT meetings were not routine, leading to delays in patient care and missed information between professionals. The service promoted healthier living through preoperative optimisation and education. However, clinical audits showed mixed performance, staff did not consistently embed learning from mortality reviews, and compliance with Venous Thromboembolism (VTE) risk assessment remained low. Compliance to World Health Organisation (WHO) standards was observed in theatres.
Staff consistently showed kindness, compassion, and respect. Patients generally felt informed and supported. Staff provided emotional support, used private spaces for sensitive conversations, and made effective adjustments for people with learning disabilities. Frontline teams aimed to respond promptly to immediate needs, high acuity pressures sometimes caused delays, and auditing of nurse rounding was weak. Nurse rounding is a system whereby staff interact with patients to ensure any immediate needs are met. Staff wellbeing was strongly prioritised, contributing to a positive caring culture.
The service had a clear vision, positive culture, and the workforce felt respected and valued. Leaders were visible, knowledgeable, and supportive, though organisational restructuring created uncertainty and some staff questioned senior leadership accessibility. Leaders actively supported equality, diversity and inclusion, with flexible working, development programmes, and secondment opportunities available to staff. The service engaged with partners, implemented improvement initiatives, participated in research, and utilised an accreditation framework to drive continuous improvement, though the impact of some innovations was not yet measurable.
During our assessment, we found concerns which resulted in a breach of regulation.
We found breaches in safe care and treatment, dignity and respect and good governance.
Patients’ care and treatment was not always delivered in a way that met their needs because of incomplete assessments.
We were told patients’ dignity was not always maintained when cared for overnight in the Post Anaesthetic Care Unit (PACU). The unit was mixed sex, had no toilet or bathroom facilities or kitchen.
The trust did not audit the escalation of deteriorating patients to ensure policy was followed.
Staff on the wards we visited told us that they did not always receive a comprehensive patient handover from the Emergency Department (ED). When patients were admitted staff could not access the clinical records for the patient that were recorded in the ED. We were not assured there was a plan in place to rectify this.
In instances where CQC has begun a process of regulatory action, we may publish this information on our website after any representations and/or appeals have been concluded, if the action has been taken forward.
Or, if we have requested an action plan, this will be requested upon publication of the final report.
People's experience of this service
People did not always receive care and treatment in a timely manner. They told us staff were doing their best in busy environments and treated them with respect.
Patients told us they felt safe and knew how to raise concerns and make complaints. We observed apologies being offered when care and treatment did not meet hospital policy.
Most patients told us they knew the plan for their ongoing treatment and staff spoke with them in a way they could understand.