- NHS hospital
Royal Derby Hospital
Assessment report published 4 September 2026
Contents
Ratings - Medical care (Including older people's care)
Our view of the service
We carried out an unannounced, on‑site assessment of medical care (including older patient’s services) at Royal Derby Hospital on 3 and 4 February 2026.
Medical care at Royal Derby Hospital is provided across several wards and departments. These areas deliver both planned and emergency care. They treat patients with acute and long-term medical conditions.
The service incorporates specialist areas such as respiratory, cardiology, gastroenterology and stroke, and admits patients with a wide variety of complex needs. The service also manages areas such as the Medical Assessment Units (MAU) and medical Same Day Emergency Care (mSDEC), all of which were included in this assessment. F[LH1] railty Services are provided through the Frailty Same Day Emergency Care Unit (fSDEC), along with an in-reach model for ED delivered by geriatricians and the multi-disciplinary Frail Elderly Assessment Team (FEAT).
Overall, the inspection identified concerns affecting safety and reliability. These included environmental risks, inconsistent medicines management, gaps in safeguarding training and mandatory training, workforce shortages, and variable discharge processes. Staff were committed, and teamwork within units was positive, but ongoing operational pressures such as overcrowding, delays in assessment, handover challenges, and reliance on temporary spaces limited the service’s ability to consistently deliver safe care.
Leadership was visible and supportive across many areas, and we saw evidence of improvement work and innovation. Nonetheless, cultural issues, low morale, reports of bullying, and limited confidence in Freedom to Speak Up processes highlighted the need for stronger oversight, clearer accountability and more consistent governance to achieve sustainable improvement.
We found 4 breaches of regulations relating to dignity and respect, safe care and treatment, premises and equipment and good governance. An action plan will be requested upon publication of the final report and followed up through engagement and future inspections.
People's experience of this service
We observed there were concerns relating to dignity, respect, cramped conditions within fSEDC, and the area was dirty and untidy. This impacted on patient experience and could be detrimental to the safe care and treatment of patients within this service.
Data showed there were a high number of beds moves which could impact the patients' journey and care and treatment. This meant that patients were frequently moved between different wards.
Overall, patients, families and carers were positive about their experiences within Royal Derby Hospital’s medical care services. They told us staff were kind, approachable and attentive, and that they felt listened to and treated with respect throughout their stay. Patients said communication was clear, their treatment plans were explained in ways they could understand, and they felt reassured by the regular presence of staff on the wards. Patients described staff as compassionate and supportive, and reported that they were given opportunities to ask questions and were involved in decisions about their care.
Patients reported that staff responded promptly when help was required, which contributed to a strong sense of reassurance and trust. Patients said that when things did not go as expected, staff communicated openly and apologised where appropriate. Despite pressures within the service, patients consistently spoke positively about the professionalism and warmth of the staff and said they felt informed, supported and well cared for during their time in hospital.