Salford Royal surgery services issued warning notice after safety inspection

Surgical services at Salford Royal Hospital have been issued with an urgent warning notice after inspectors found patients were left in pain, exposed to safeguarding risks and reluctant to ask for help due to staffing shortages.

The warning was issued by the Care Quality Commission following an inspection of gynaecology, spinal and neurosurgery services between 23 and 25 September 2025.

Inspectors found that some aspects of care were not always safe and that there was an increased risk people could be harmed.

Surgical services at Salford Royal Hospital have now been rated as requires improvement. The overall rating for the hospital and the Northern Care Alliance NHS Foundation Trust remains requires improvement.

The CQC said patients were not always protected from abuse or improper treatment. Risk assessments were not consistently completed and deteriorating health was not always managed appropriately.

Inspectors were told some patients experienced delays in receiving pain relief after surgery. Four people on one ward reported extended pain symptoms and delays in being given medication.

Staff also said individually labelled bed pans and bottles were sometimes left in ward bathrooms until staff had time to collect them. Inspectors warned this created infection control risks and could lead to inaccurate recording of fluids.

Patients told inspectors that staffing shortages had affected their emotional wellbeing and that they sometimes felt uncomfortable asking for help, particularly at night, after previously experiencing delays.

The CQC identified 11 regulatory breaches, including failures relating to safeguarding, person centred care, safe care and treatment, staffing levels and management oversight. Many of these issues had also been raised at a previous inspection in December 2022.

The report found that compliance with hand hygiene standards and admission screening processes was below trust targets. Only 18.3 per cent of eligible staff had completed dementia awareness training over the past three years. Life support training rates were also below expected levels.

Inspectors said formal duty of candour procedures were not always carried out in line with trust policy. In one surgical division, families were informed within 10 days of an incident in 68 per cent of cases, below internal expectations.

The warning notice requires rapid and significant improvements, particularly around staffing levels and systems used to identify and manage risks. The CQC has the power to take further action if sufficient progress is not made.

In response, Juliette Cosgrove, chief nursing officer for the Northern Care Alliance, said the trust recognised it had not always got things right and that further improvements were needed.

She said nine additional registered nurses had been recruited between September and January, and that senior nursing presence had been strengthened during late, weekend and twilight shifts. The trust said it had been working closely with the CQC, NHS England and partner organisations since the inspection.

The Northern Care Alliance runs Salford Royal Hospital, The Royal Oldham Hospital, Fairfield General Hospital in Bury and Rochdale Infirmary, serving around one million people. Surgical services recorded more than 15,000 attendances between October 2024 and September 2025.