Improvement but maternity still a concern - report
BBCA hospital trust's rating has improved from "requires improvement" to "good", despite continuing concerns about its maternity care.
The Care Quality Commission (CQC) inspected the medical, urgent and emergency, and maternity care provided by Gloucestershire Hospitals NHS Foundation Trust in late 2025, and its leadership in February 2026.
In the latest report, the CQC said there was increased pressure on maternity staff after the trust failed to fill vacancies, but teams were co-ordinating care effectively via twice-daily meetings to identify if women needed to be induced.
The trust said it has already made changes to its maternity services in line with the findings of the report.
In its report published in October 2022, the CQC rated Gloucestershire Hospitals NHS Foundation Trust as "requires improvement", but this has now been increased to "good".
The CQC rated the following frontline services:
- Medical care at Gloucestershire Royal Hospital - good
- Urgent and emergency care at Gloucestershire Royal Hospital - requires improvement
- Maternity services at Gloucestershire Royal Hospital - requires improvement
- Maternity services at Stroud Maternity Hospital - good
Between 2020 and 2023, there were 44 neonatal deaths in the county's hospitals, and seven maternal deaths between 2017 and 2023.
Gloucestershire Royal Hospital remains the only hospital in the county where women can give birth and receive postnatal care.
Cheltenham's Aveta Birth Centre has been closed since 2023, and there are no postnatal beds at Stroud Maternity Hospital.
'A blame culture'
In 2024, the CQC imposed urgent conditions requiring Gloucestershire Royal Hospital address critical concerns about the safety of care provided to women and service users, as well as how the service is managed and led.
These remain in place and the trust continues to report to the CQC monthly in line with the requirements of those conditions.
Catherine Campbell, CQC deputy director of hospitals, secondary and specialist care for the South West, said change at the top of the organisation stood out "following a period of instability".
While most staff across the trust said the leadership team was now stable and more visible, maternity staff told the CQC they found senior leaders "were less visible and described a blame culture rather than a focus on learning".
"Leaders themselves acknowledged this and know where the gaps remain," Campbell said.
"We saw real signs of progress in maternity services at Gloucestershire Royal Hospital, which have improved from inadequate to requires improvement.
"Women told us the care they received from midwives was often excellent, with staff described as calm, professional and compassionate, even during traumatic births."
At Gloucestershire Royal Hospital, inspectors found maternity leaders were discharging women from the triage unit before their test results were available on some occasions.
Bereavement support praised
However, the CQC noted the "high-quality bereavement support" available for families experiencing baby loss.
Responding to the findings of the report, the trust said it had already taken steps to improve the layout and staffing for the triage area and in the reporting of incidents.
"We acknowledge there is more work to do and we remain absolutely focused on delivering the highest standards of care for women, babies and families," the trust said.
"We have a clear improvement programme in place and will continue working closely with staff, service users and system partners to build on the progress already achieved."
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