- NHS hospital
Gloucestershire Royal Hospital
Assessment report published 27 August 2026
Contents
Ratings - Urgent and emergency services
Our view of the service
Gloucestershire Royal Hospital emergency department is operated by Gloucestershire Hospitals NHS Foundation Trust. The trust operates two emergency departments, the other being at Cheltenham General Hospital. The two hospitals share a divisional management team. Cheltenham General Hospital Emergency Department was inspected and reported on separately.
The emergency department is located on the main hospital site in Gloucester and serves the local population of Gloucestershire and the Cotswolds. The emergency department accepts patients conveyed by ambulance or those who self-present. It is open 24 hours a day, seven days a week. For adults, the emergency department will see patients with urgent and emergency healthcare needs 24 hours a day. Specialist children’s services are based here, and ambulances arrive with children any time of day or night. There is a dedicated paediatric department with its own entrance.
From December 2024 until November 2025, Gloucester emergency department saw 37,032 adults and children combined, and the average time from referral to specialty was 133 minutes. Of these, 55.4% of patients were discharged, admitted or transferred within 4 hours, 86.7% were discharged or transferred within 12 hours with 21.8% admitted to hospital.
We carried out this assessment of the emergency department on 8 and 9 December 2025. We assessed 25 quality statements across the safe, effective, caring, responsive and well-led key questions. We have combined the scores for these areas with scores from the last assessment to give the overall rating. We spoke to patients, family, carers and all grades of staff within the department. We reviewed both paper and electronic patient records.
We found 8 breaches of regulation where care and treatment were not always provided in a safe and timely way in line with clinical guidance. The environment was not always safe and suited to patient needs due to the volume of patients and relatives in the department. Patients were not always admitted from the emergency department to a ward bed in a timely manner. Patients were being cared for in corridors and spaces inappropriate for clinical care. There were no private areas for staff handovers to protect patient confidentiality. Mandatory and specialist training compliance was below the trust target. Patients were not always reviewed by pharmacy staff in a timely manner. Nursing risk assessments were not completed in a timely manner, sepsis care did not meet national standards, and the environment did not meet the needs of the patients. We have asked the provider for an action plan in response to these breaches.
People's experience of this service
We found some elements of patient’s care did not meet the expected standards. There were long waits for triage (time to initial assessment), treatment, referral to other services, admission to hospital or discharge. During this assessment we spoke with patients who experienced long waits in all areas of the emergency department but especially the minor’s section.
Patients, family or carers we spoke with were positive about staff treating them. They told us staff treated them with kindness and provided good care and treatment. Some patients told us staff communicated with them well, they felt listened to and described staff as “caring and met their needs” and their treatment as “excellent”. However, some patients said waiting for long periods was tiring and they were not always kept informed about what was happening. While the people we spoke with expressed they were happy with their care, our assessment found not all elements of care met the expected standards.