The Princess Royal Hospital

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

This means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture. At our last assessment we rated this key question Requires Improvement. At this assessment the rating has changed to Good. This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

We have not awarded this service a score for Well-led.

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

The evidence showed a good standard. The service had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.

Staff knew and understood the provider’s vision and values and how they were applied in the work of their team. In the 2025 NHS staff survey, 73% of staff agreed that their team had a set of shared objectives. However fewer respondents, at 46%, felt involved in deciding on changes that affected their area of work. At the time of inspection, the trust was undertaking significant work at both the Princess Royal Hospital and Royal Shrewsbury Hospital as part of the Hospital Transformation Programme (HTP) which leaders aimed to be completed by 2028. Staff reported some uncertainty around the potential impacts of the HTP on their day-to-day work, such as working at a different site, but were hopeful about intended benefits. The service had a ‘zero tolerance’ policy with clear escalation routes for abuse and harassment, and monitored staff experiences of bullying, harassment and discrimination through the staff survey. None of the staff we asked had experienced bullying or harassment at work.

The evidence showed a good standard. The service had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.

Leaders had the skills, knowledge and experience to perform their roles. They had a good understanding of the service they managed and clearly articulated the challenges within them. Leaders were mindful of visibility and made efforts to ensure that they were accessible to all staff. For example, although the Divisional Medical Director spent half of their time working clinically at the trust’s sister site, Royal Shrewsbury Hospital, they ensured they were on site at The Princess Royal Hospital once every week or 2, and aimed to visit new or altered areas of the service, or areas they had not visited for some time. The Divisional Director of Nursing spoke about how they tried to “be there when it really matter(ed)” to staff, such as during a stressful ward move. Most staff we spoke with said that their leaders were approachable and supportive. Leadership development opportunities were available for staff, although they were mainly internal. Leaders explained that cohorts of Matrons and band 7 staff had recently completed internal leadership programmes which had been good opportunities for staff to network and share good practice. The Divisional Medical Director also spoke about providing mentorship. Leaders spoke with compassion about the processes in place to manage poor staff behaviour, with a focus on the wellbeing of people involved and seeking to understand triggers such as workload or training needs.

The evidence showed a good standard. The service fostered a positive culture where people felt they could speak up and their voice would be heard.

Patients and their loved ones had opportunities to give feedback on the service they received. However, inspectors did not see evidence of responses to feedback on display, for example ‘You Said, We Did’ boards. This was also noted during the 15 steps walkarounds undertaken on wards 9 and 11 on 2 March 2026.

Staff we spoke with felt able to speak up without fear of detriment. A staff member told us that members of the Freedom to Speak Up team were visible to staff, but they chose not engage with them as they could not escalate concerns further than they had already been able to.

The evidence showed a good standard. The service valued diversity in their workforce. They work towards an inclusive and fair culture by improving equality and equity for people who work for them.

Staff were able to apply to work flexibly. One staff member we spoke with had recently had a baby and were able to adjust their working pattern. The service undertook equality monitoring of staff; reports on equality, diversity and inclusion and gender pay gap were available on the provider’s public website, and an ethnicity and disability pay gap report was also planned for the 2025/2026 reporting period. There was a race equality network, PRIDE network for LGBTQIA+ staff, DAWN, the Disability, Ability, and Wellness Network and a multi-faith and belief network.

The evidence showed some shortfalls. The service had clear responsibilities, roles, systems of accountability and good governance. However, performance and outcomes did not always reach expected levels.

Staff undertook or participated in local clinical audits, and we saw examples of action plans produced when local audits results did not meet target levels. However in some areas, such as patient observation and sepsis pathway compliance, performance was below expected levels. Performance in some national audits, such as the Sentinel Stroke National Audit Programme was significantly below expected levels, although we saw an action plan was in place for improvement.

Staff we spoke with did not raise any concerns about access to equipment and information technology needed to do their work. At the time of inspection, patient records were paper-based and generally secured in locked trolleys to maintain patient confidentiality. Plans were in place for electronic records to be rolled out shortly after the inspection. There were electronic ‘flow’ boards on each ward, generally positioned behind or in front of the main nursing base in view of the public. The boards displayed patients’ full names and ages which could breach patients’ confidentiality. This was fed back to senior leaders.

There were clear frameworks for discussion in meetings to ensure that essential information was shared and discussed. We viewed minutes of weekly medicines safety huddles and saw that a standard proforma was used to include discussion of incidents, compassionate engagement/duty of candour, and quality audits. Staff maintained and had access to the directorate risk register at ward or directorate level, and staff and leaders’ concerns matched those on the risk register. The service had business continuity plans for emergencies for example, adverse weather or a flu outbreak.

The evidence showed a good standard. The service understood their duty to collaborate and work in partnership, so services work seamlessly for people. They share information and learning with partners and collaborate for improvement.

The service had close working relationships with several partners. Virtual ward services were provided by a community trust who the trust were formally partnering with under a group model on 1 April 2026. We saw collaboration with partners for learning in the sample of after action reports viewed. Staff spoke about the “excellent” relationship between the service and partners at the trust who provide thrombectomy services.

We spoke with a member of staff who was employed in association with a national charity to provide additional support on acute assessment unit as part of the winter resilience programme. Tasks included taking patient meal orders, running errands, and providing patients who needed additional support with help to free up clinical staff.

Staff collaborated with patient volunteers in annual Patient Led Assessment of the Care Environment assessments, with patient assessors making up a minimum of 50% of the assessment team.

The evidence showed a good standard. The service focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contribute to safe, effective practice and research.

Staff were given the time and support to develop opportunities for improvement and innovation which led to changes in care delivery. A leader in frailty spoke about how advanced clinical practitioners in the service had made an electronic version of the comprehensive geriatric assessment form to allow for continuity of care and were also leading on silver trauma training in the service.

Staff had opportunities to participate in research and spoke with us about projects relating to Parkinson’s disease they had been involved with, as well as the Frail Elderly in the Emergency Department study.

Staff participated in national audits relevant to the service and learned from them.