- NHS hospital
The Princess Royal Hospital
Assessment report published 21 August 2026
Contents
Ratings - Medical care (Including older people's care)
Our view of the service
We inspected medical care (including older people’s care), also referred to here as medical care, services on 3 and 4 March 2026 with a team of a CQC inspector and nurse specialist advisor, and 18 March 2026 with a team of a CQC inspector, medical consultant specialist advisor and a pharmacist specialist. The inspection was part of the winter pressures programme of assessment.
We rated the service as Requires Improvement overall because staff did not always complete mandatory training, including safeguarding training. Nursing staffing did not always meet planned levels and there was frailty in some services’ medical staffing. Staff did not always complete risk assessments and patient observations and there was no audit data for the safe and secure handling of medicines since 2023 –2024, therefore we could not be assured that there was adequate oversight of safe medicine storage. There were several ‘very poor’ scores in the latest Sentinel Stroke National Audit Programme. Staff were unsure what was in place for their wellbeing. Inspectors did not see responses to patient feedback on display, for example ‘You Said, We Did’ boards. There were some challenges in referral to treatment pathways.
However, incidents were thoroughly investigated, involving participants from outside of the organisation where appropriate. Staff we spoke with could give examples of safeguarding concerns they had or would raise and felt confident to seek support from trust safeguarding leads. Staff enabled patients to make advance decisions when appropriate, completing and updating Recommended Summary Plan for Emergency Care and Treatment forms. Ward environments were generally tidy and clutter-free, and staff consistently checked emergency equipment. The service scored above average in all areas of the latest National Audit of Dementia Care where sufficient information was returned, and the trust was also above audit average in all elements of the 2026 National Audit of Inpatient Falls. Patients said staff were kind, friendly and generally responsive to their needs. Leaders had the skills, knowledge and experience to perform their roles and staff and patients felt able to speak up.
During our previous inspection of medical care services published in 2024, we identified a breach of regulation relating to completion of risk assessments, with particular attention to venous thromboembolism risk assessments. In this inspection, completion of risk assessment for venous thrombus embolism had improved significantly between January and March 2026, from 69% completion within 14 hours to 82%. However, other risk assessments such as malnutrition universal screening tools and pressure sore assessments were not consistently completed. There was a previous breach around mixed sex breaches. We did not see evidence of mixed sex breaches during this inspection. During the last inspection there was a breach stating that the trust must ensure they continue to work on meeting their referral to treatment targets for all pathways. The trust should continue working on referral to treatment targets for all pathways. Finally, there was a breach around completion of mandatory and legally required training and staff appraisals. There is still a breach of regulation around completion of mandatory training, including safeguarding training, although appraisal rates had improved.
There were 2 new breaches in this inspection around performance of the stroke pathway and staffing. We have requested an action plan, this will be requested upon publication of the final report.
People's experience of this service
We spoke with 11 patients along with relatives and carers as part of the inspection. The patients we spoke with felt safe in hospital, and able to speak up without fear of detriment if they had a problem. Although they recognised staff were busy, most patients said that they responded to their needs quickly and were friendly and kind. Staff maintained patients’ privacy and dignity. Patients spoke positively about the choice of food and drink on offer. On the whole, patients said that staff kept them informed about plans for their treatment and spoke in a way that they could understand. Relatives were updated on their loved ones.