Gloucestershire Royal Hospital

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• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

We looked for evidence that the service met people’s needs. At our last assessment we rated this key question as Good. At this assessment the rating has remained Good. This meant people’s needs were met through good organisation and delivery.

We have not awarded this service a score for Responsive.

Find out about when we will not publish a key question score and what we look at when we assess Responsive.

We scored the service as 3. The evidence showed a good standard. The service made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

Care plans reflected service users physical, mental, emotional and social needs, including those related to protected characteristics under the Equality Act. One patient described their care as “organised and co‑ordinated.” We reviewed the pathways of 6 people and found they had been appropriately assessed and reviewed by the relevant specialty teams. An audit of patient notes from September to November 2025 showed that the discharge checklist was consistently completed across the medical division within the required 2‑hour timeframe.

The service had established effective pathways that supported people to receive timely and responsive care. People attending the Same Day Emergency Care centre were assessed promptly and either treated and discharged or admitted for further care where appropriate.

The frailty unit used a structured set of 4 clinical questions to support decision‑making about whether people should be admitted or could be safely managed in the community. This approach helped ensure that decisions were consistent, evidence‑based and aligned with people’s individual needs.

We saw an example of good person‑centred practice where a person was assessed as clinically suitable for the Virtual Ward and the Hospital‑at‑Home team. This decision took account of the patient’s personal circumstances, including their role as the main carer for their partner living with dementia, and allowed them to remain at home while still receiving appropriate clinical oversight. This demonstrated that staff considered people’s wider needs and preferences when planning care and discharge.

We saw staff were consistently responsive in ensuring ReSPECT forms were completed. On 1 occasion, staff identified that a service user had more than 1 ReSPECT form in circulation, and they promptly met with the patient to confirm and record their most up‑to‑date wishes for future care.

We did not look at Care provision, Integration and continuity during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We scored the service as 3. The evidence demonstrated a good standard. The service provided appropriate, accurate and up‑to‑date information in a range of formats tailored to individual needs. The rollout of the patient portal supported people to manage their appointments, complete assessments from home and access digital appointment letters, with automated reminders helping ensure people stayed informed about their care.

Patient discharge summaries were completed, and feedback from people indicated that aftercare arrangements and follow‑up plans were clearly explained prior to discharge. However, there were some instances of care homes reporting that the discharge summaries did not contain all the information required.

The service aligned to the Accessible Information Standard and was working to improve the accessibility of its website, although some areas of regulatory compliance still required further work. Patient information leaflets were available both in print and online, and several wards were developing bespoke leaflets to address common questions raised by patients and visitors.

Most wards demonstrated good adherence to information governance principles. However, we observed isolated lapses in practice. For example, in the Same Day Emergency Care centre, the notes trolley was left unlocked, and two computers were left unattended, which posed a potential information security risk.

We scored the service as 3. The evidence showed a good standard. The service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. They involved people in decisions about their care and told them what had changed as a result.

Service users and their families were aware of how to provide feedback about their care, including how to raise concerns or issues. However, ward teams did not always respond to these concerns in a timely manner. Information we reviewed showed that only 47% of complaints were responded to within the required timescale, indicating delays in the complaints process. The trust told us it was working with ward teams to improve response times, and data showed performance had begun to improve over recent months. Some of the delays were due to multiple teams being involved.

Managers investigated complaints and identified themes. Managers shared feedback from complaints with staff and learning was used to improve the service. Staff knew how to handle complaints appropriately. Learning from complaints was discussed at team meetings and huddles.

The trust carried out patient engagement surveys to obtain feedback about its service. For the respiratory ward in November 2025, 21 people out of 23 rated their experience as very good or good. This feedback was similar on other medical wards. One respondent noted that “The nurses and healthcare assistants were particularly kind and respectful to service users, and informative and supportive to relatives”.

We scored the service as 3. The evidence showed a good standard. The service made sure that people could access the care, support and treatment they needed when they needed it.

People were able to access the service when they needed it. Wards operated 24 hours a day, seven days a week, and provided care for adults with physical health needs and, where required, mental health needs. Our review and tracking of 6 people showed that each was admitted to the appropriate speciality ward for their condition. Specialist teams also attended service users in the Emergency Department and the Same Day Emergency Care centre when requested, ensuring timely specialist input.

Communication between services was generally good, which supported smooth coordination and helped ensure people requiring specialist care received it promptly. Clear eligibility criteria were in place for admission to the Virtual Ward service, and the trust was exploring expanding the service to include people who required oxygen therapy at home.

There were adequate nursing and medical cover day and night. The Acute Medical Unit had consultant cover 7 days a week. Staff on the medical wards told us they would escalate any deteriorating service users for medical review at weekends, and a consultant was available when required.

Staff planned effectively for peoples' discharge, working closely with care managers and co‑ordinators. Wards provided regular updates on peoples' discharge status at site team meetings, which helped ensure bed availability for those who needed admission. The trust was also testing several pilots and initiatives designed to streamline the discharge process and improve safety for people.

We did not look at Equity in experiences and outcomes during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Planning for the future during this assessment. The score for this quality statement is based on the previous rating for Responsive.