Gloucestershire Royal Hospital

On this page

• 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

At our last assessment we rated responsive as requires improvement. At this assessment the rating has istayed the same at requires improvement.

We looked for evidence people and communities were always at the centre of how care was planned and delivered. We checked the health and care needs of people and communities were understood, and they were actively involved in planning care met these needs. We also looked for evidence people could access care in ways to meet their personal circumstances and protected equality characteristics.

While staff identified individual communication needs and ensured people could access information in appropriate formats, the department did not always provide person‑centred care. Crowding meant some patients were cared for in inappropriate areas with limited oversight, and incomplete nursing risk assessments affected safe and timely care. Patients often waited long periods for specialty review, and escalation pressures across the hospital meant people were not always transferred to the right setting when needed. Although patients knew how to give feedback and the service acted on complaints, persistent flow challenges, high demand and limited space meant people could not always access care in a way that met their needs.

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.

The service did not always make sure people were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

Staff’s ability to provide person centred care was impacted by the persistent pressure and demand on the department.

We observed staff attending to patients’ individual needs, such as ensuring they positioned themselves so patients with communication difficulties could lip read.

Rising demand and limited space availability impacted on where patients were placed when arriving by ambulance which often, was not suitable to their needs. For example, patients who may be confused were placed in busy areas. At the time of assessment, this corridor had 3-4 patients waiting at any one time, with limited clinical oversight.

Essential risks assessments, such as those to enable pressure care were not always completed.

Collaboration from other specialties was limited and further impacted the department’s ability to provide person centred care. For example, surgery or orthopaedics, did not always see patients in the ED in a timely way. Patients waited longer than expected to be cared for in the most appropriate area of the hospital. This did not follow the Patient Pact agreement.

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.

The service supplied appropriate, accurate and up-to-date information in formats tailored to individual needs.

The service identified people’s individual communication needs to make sure information was provided in an accessible way. This included making reasonable adjustments for disabled people, interpreting and translation for people for whom English was not their first language and for deaf people who used British Sign Language. Information about what to expect in the emergency department was available through written leaflets and posters within the department. Staff made information leaflets available in languages spoken by patients.

Staff ensured patients could obtain information on treatments, local services, patients’ rights and how to complain. Signage and information were sufficient to enable navigation to, through, and from the emergency department. However, there was no display to inform patients of waiting times within the department.

Carers and families told us they were updated about the patient’s progress. Patients and carers were informed about the use of non-designated clinical spaces, including why they had been placed in a non-designated clinical space.

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.

Patients knew how to complain or raise concerns. When patients complained or raised concerns, they received feedback. The department accepted feedback, concerns or complaints as an opportunity to improve the service and the quality-of-care people received.

There were 246 complaints about the emergency departments from 1 January 2025 to 19 December 2026 of which, 223 (91%) were about Gloucestershire Royal Hospital. The highest themes for complaints were clinical treatment (48%), communications (17%) and values and behaviours from staff (11%). A trust wide quality improvement project was underway to review the whole complaints process and to trial early resolution within emergency department specifically.

Staff knew how to handle complaints appropriately. Staff received feedback on the outcome of investigation of complaints and acted on the findings.

The service made sure that people could access the care, support and treatment they needed when they needed it.

A key area of focus for emergency care was supporting the vulnerable and homeless patients when they presented in emergency department. The trusts emergency departments saw significant numbers of patients who were experiencing homelessness, approximately 400–600 attendances annually. Established practice within emergency departments often resulted in homeless patients being discharged without appropriate referral, follow‑up, or support, leading to unmet need and increased risk of harm. The project produced a checklist for staff to ask about home situation and was successful and the checklist is now part of the mandatory documentation. This represents equity in access for vulnerable people with complex health and social care needs.

Managers tried to plan and organise services to meet the needs of the local population. Due to pressures in the wider health and social system, the department, along with the wider hospital, was gridlocked. This meant facilities and premises were not always appropriate for the services being delivered with patients cared for in parts of the department not always clinically appropriate.

Staff assessed people’s needs to identify the most appropriate specialty or area of care. However, space was not always available within the specialty areas and patients often waited many hours within the emergency department.

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.