By John Wimperis Local Democracy Reporter: The Care Quality Commission (CQC) has rated urgent and emergency care at Royal United Hospital Bath as Requires Improvement. The report published earlier today is based on an inspection visit from the 21 October 2025 to 28 November 2025.
The hospital is run by Royal United Hospitals Bath NHS Foundation Trust and is graded as a medium acute district general hospital.
CQC inspection was carried out after receiving complaints of overcrowding and safety issues in the department. The inspection found three breaches of regulations relating to safe care and treatment, staffing, and management of the service.
As a result CQC: “downgraded the rating for urgent and emergency care for caring: from Good to Requires Improvement, for effective: Good, while safe, responsive and well-led have all been re-rated as Requires Improvement.”
The overall rating for Royal United Hospital is unaffected and remains “Requires Improvement.”
Among other things, the Inspectors found:
Significant shortfalls with safe levels of staff, safe care for patients with mental ill-health, the environment, particularly when crowding and other storage problems resulted in the blocking of fire exits.
Identified concerns around infection prevention and control, specifically relating to inconsistent staff compliance with guidance, and the deteriorating physical condition of the emergency care facilities.
There was a high vacancy and sickness rate for nurses, driven by intense pressures of overcrowding and the resulting higher workload.
The number of senior decision makers fell below the Royal College of Emergency Medicine recommendations, leaving gaps in senior medical cover overnight.
The process of triage for patients was confusing, as was access to the department and information provided for patients.
There was a lack of privacy and dignity for patients waiting for long periods of time in the corridor. This was also a concern for patients who had mental health needs, often waiting many days for a specialist inpatient bed.
Whilst these were the headline findings it is only fair to note that the Inspectors also found some positives too. They noted that staff treated people as individuals and with compassion, including tailoring care to meet the needs of autistic people and those with dementia or a learning disability.
They also noted that the department performed better than both regional and national averages for unplanned reattendance, suggesting people that when people were finally treated, they were discharged at the right time with the right treatment
We approached the hospital for a comment on the Inspection findings. A spokesperson for the Royal United Hospitals Bath told Somerset Confidential®: We acknowledge the CQC’s recent report into urgent and emergency care at the Royal United Hospitals Bath following its unannounced inspection in October 2025.
We cooperated fully with the CQC both during and since the inspection to demonstrate that we are making progress against our improvement plan. We now have more senior decision makers in the Emergency Department overnight and 24/7 security presence. The Emergency Department team has enhanced oversight of emergency access points to ensure they remain unobstructed. We are working with the Avon and Wiltshire Partnership so that patients who are attending ED with mental health presentations are cared for in the right place, at the right time. We have also been working closely with the national Getting it Right First Time team to look at our working practices, which has resulted in a refresh of our Internal Professional Standards.
At the time of the visit and since then, we have been experiencing the highest ever demand levels in our Emergency Department. In addition, the implementation of the ambulance service’s new Rapid Release Protocol coincided with a year-on-year ambulance demand increase of 25 per cent and Emergency Department footfall of 13%. We have been working hard to respond to these new working practices alongside South West Ambulance Service Foundation Trust to make sure that it does not result in overcrowding in the Department and we are committed to putting the right measures in place to avoid corridor care in the hospital during the course of next Winter.”
However, despite the findings the hospital are bullish about their performance and improvement. They told us: “We know from the end of year data that we will be one of the most improved Trusts in the country against the 4 hour Emergency Department target; and we are pleased to have secured access to capital funding to build a new Urgent Treatment Centre this year and to completely rebuild the Emergency Department over the course of the following three years.”
We want to acknowledge our staff’s exceptional efforts and their commitment to making the additional improvements needed for the benefit of our patients and community; and to express our gratitude to our partners in South West Ambulance Service Trust, Avon and Wiltshire Partnership and the Integrated Care Board for their cooperation and support.
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