Gloucestershire Hospitals NHS Foundation Trust

Ratings - Well-led

• Well-led Our assessments of NHS trusts now focus on leadership. We no longer rate trusts overall for their safety, effectiveness and responsiveness or how caring they are. We do still publish those ratings for the services they provide.

  Good

Our view of the service

Date of assessment: 10 to 12 February 2026

Gloucestershire Hospitals NHS Foundation Trust was established in 2004 through the merger of Gloucestershire Royal and East Gloucestershire NHS Trusts.

The trust provides acute hospital services from two large district general hospitals, Cheltenham General Hospital (CGH) and Gloucestershire Royal Hospital (GRH) as well as maternity services at Stroud Maternity Hospital.

Outpatient clinics and some surgical services are provided by trust staff from community hospitals throughout Gloucestershire. The trust also provides services at the satellite oncology centre in Hereford County Hospital.

Gloucestershire Hospitals NHS Foundation Trust is registered for the following regulated activities:

• Assessment or medical treatment for persons detained under the Mental Health Act 1983.
• Diagnostic and screening procedures.
• Management of supply of blood and blood derived products.
• Maternity and midwifery services.
• Surgical procedures.
• Termination of pregnancies.
• Treatment of disease, disorder or injury.

We carried out a well led assessment of the provider which commenced with a 3-day site visit on 10, 11 and 12 February 2026.

Before carrying out this assessment, we assessed maternity, urgent and emergency care, and medical care. We used those findings to assess how well the overall trust strategy and risk management aligned with local services.

Our comprehensive well led inspections of NHS trusts have shown a strong link between the quality of overall management of a trust and the quality of its services. For that reason, we look at the quality of leadership at every level. We also look at how well a trust manages the governance of its services – in other words, how well leaders continually improve the quality of services and safeguard high standards of care by creating an environment for excellence in clinical care to flourish.

Our rating of well-led at the trust improved. We rated well-led as good because:

• The trust had an experienced leadership team with the skills, abilities, and commitment to provide high-quality services. They recognised the training needs of managers at all levels, including themselves, and worked to provide development opportunities for the future of the organisation.
• The board and senior leadership team had set a clear vision and values that were at the heart of all the work within the organisation. They worked hard to make sure staff at all levels understood how the vision and values related to their daily roles.
• Staff at all levels reported an improved culture across the trust, with leaders actively listening to, and responding to concerns raised. Senior leaders made sure they visited specialties across the organisation and fed back to the board to discuss challenges staff and the services faced.
• The trust had a clear structure for overseeing performance, quality and risk, with board members represented across the divisions. This gave them greater oversight of issues facing the service and they responded when services needed more support.
• The leadership team worked well with the clinical leads and encouraged divisions to share learning across the trust. The leaders were knowledgeable about the issues and priorities for the quality and safety of services being provided.
• Staff had made good links with some charities and local organisations to improve services for local populations, whilst recognising there was work to do to engage with the hardest to reach communities.
• Leaders provided examples of learning, improvement and innovation which encouraged staff to identify creative ways of delivering equality of experience, outcome and quality of life for people.
• The leadership team was committed to improving services by learning from when things went well and when they went wrong, promoting training, research and innovation.

However:

• At the time of the inspection, the trust's subsidiary organisation had a vacancy in its Freedom to Speak Up Champion role. Staff working within the subsidiary continued to have access to the trust's Freedom to Speak Up arrangements, including the Freedom to Speak Up Guardian.
• Whilst we saw significant improvements in governance processes, including clearer responsibilities, roles and systems of accountability, these arrangements were at varying stages of maturity across the organisation, with ongoing work to strengthen consistency of implementation across all areas and specialties.
• Board members recognised that further work was required to improve equality, diversity and inclusion across the trust and at Board level. The Workforce Race Equality Standard (WRES) report 2024/2025 and the Workforce Disability Equality Standard (WDES) report 2024 identified differences in experience and outcomes between white and ethnic minority staff, and between disabled and non-disabled staff.
• The trust’s strategy was aligned with a number of local integrated care system priorities, although leaders recognised further work was required to strengthen alignment in practice.

People's experience of this service

Most staff told us leaders listened to their views and there was an improved culture within the organisation. Most staff felt that consultation on changes within the organisation had improved, and that processes to enable staff to speak up had improved. They were able to do so without recrimination, and actions would be taken. Staff told us the culture had substantially improved over the last two years.

Partners and stakeholders told us the executive team were engaged at various strategic and quality improvement meetings within the integrated care system (ICS). They told us there was good representation from senior managers in all system and regional improvement groups.