The Care Quality Commission has published its findings following inspections of Royal Derby Hospital and Queen’s Hospital Burton, both run by University Hospitals of Derby and Burton NHS Foundation Trust.
The inspections took place in February 2026, and the reports were published on 4 September 2026.
In summary, the findings have resulted in both hospitals being downgraded from good to requires improvement overall. Urgent and emergency care was downgraded at Royal Derby and re-rated as requires improvement at Queen’s Hospital Burton. Medical care at Royal Derby was also downgraded, though medical care at Queen’s Hospital retained its good rating.
The full CQC reports for Royal Derby Hospital and Queen’s Hospital Burton can be found on the CQC website.
What did the CQC find?
Inspectors identified multiple breaches of regulation across both sites. The areas of concern included dignity and respect, safe care and treatment, staffing, premises and equipment, and overall management.
Royal Derby Hospital
In the emergency department, the CQC found serious overcrowding, with patients on trolleys placed in front of other patients’ cubicles and insufficient room for staff to reach someone quickly in an emergency. Emergency equipment was not within easy reach in these improvised treatment areas, and patients did not have curtains to protect their privacy. One elderly patient spent 21 hours on a stretcher before being moved to a bed, placing them at real risk of developing pressure injuries.
The department had 12 nursing vacancies, a sickness rate of 10%, and was using a staffing tool that did not reflect the actual number of patients being treated. Only 27.24% of patients received an initial assessment within 60 minutes, and some patients arriving overnight waited around nine hours to see a doctor.
There were also concerns around medicines management, with staff not always storing, labelling or disposing of medicines correctly and fridge temperatures not being routinely checked.
On the medical wards, inspectors found that sepsis screening rates remained at around 50 to 60% against a 90% target, despite repeated audits and plans to improve. Staff were regularly pulled from training and education roles to cover clinical gaps on wards, reducing the support available to develop and upskill nursing staff.
Queen’s Hospital Burton
The picture at Queen’s Hospital was similar in a number of respects. The emergency department was frequently too crowded for the number of patients using it, and on busy evenings people were sitting or lying on the floor because there was not enough space. Families and visitors were asked to leave busy areas, meaning some patients were left without support at difficult times.
Staff did not always ensure that patients received antibiotics for sepsis within the target time of one hour. The single mental health room could only accommodate one person at a time, so patients in mental health crisis were sometimes cared for in ordinary cubicles that were not appropriate for their needs.
On the medical wards, a medicines fridge repeatedly recorded temperatures above safe limits and used an access method that did not follow trust policy.
Staff reporting and culture
One of the more troubling findings concerned staff confidence in reporting concerns. At Royal Derby, some staff had stopped reporting certain incidents, including being short-staffed or administering medicines late, because they felt nothing would change and that leaders would not provide feedback. Only 59.3% of staff felt safe to speak up about concerns, and just over half of those who experienced bullying or harassment had reported it.
These findings suggest a culture in which frontline staff did not feel confident that raising concerns would lead to meaningful action. That is significant, because a reluctance to report incidents can mask the true scale of problems within a department and delay steps that might otherwise prevent harm to patients.
The CQC’s response
Sarah Ivory-Donnelly, CQC’s Deputy Director of Hospitals, Secondary and Specialist Healthcare in its central region (east), said:
“During our visit to Royal Derby Hospital, we found staff who were clearly committed to people’s care. Despite long waits in urgent and emergency care, people told us staff were warm, kind and polite. There were also real strengths in how the hospital worked with partners to reduce unnecessary emergency attendances and support people to be cared for closer to home.
However, we had serious concerns about the safety of the environment in the emergency department. It was very overcrowded, with people on trolleys placed in front of other people’s cubicles, leaving little room for staff to reach someone quickly in an emergency.”
She added:
“Leaders at the trust need to take urgent action to address the safety concerns we’ve identified, and we’ll continue to monitor services closely.”
The CQC has requested an action plan from the Trust setting out what steps it is taking to address the concerns identified.
Positive findings
It is worth noting that the reports were not entirely negative. Patients at both hospitals generally spoke positively about the kindness and commitment of individual staff. At Royal Derby, security staff had completed a four-day training course in trauma-informed care and positive behaviour support, and the paediatric emergency department was found to have a strong learning culture with effective partnership working with community services. At Queen’s Hospital, leaders on the medical wards had implemented a strong culture of learning and improvement, and staff used a colour-coded system to monitor patients’ fluid intake which helped identify problems more quickly.
These are encouraging areas of good practice, but they do not alter the overall picture. The systemic issues with overcrowding, staffing and safety that the CQC has identified are the kinds of conditions in which patients are most at risk of receiving substandard care.
Why this matters
CQC findings of this nature are significant for anyone who received care at either hospital, particularly around the time of the inspections. Overcrowding, inadequate staffing, delays in treatment and failures in medicines management are all factors that can contribute to patients suffering avoidable harm. Where care falls below an acceptable standard and a patient is harmed as a result, there may be grounds for a clinical negligence claim.
These reports also sit within a broader pattern of regulatory concern about the pressures facing emergency departments and medical wards across the NHS. Staffing shortages, overcrowding and under-reporting of incidents are themes that arise repeatedly in CQC inspections, and they create an environment in which errors are more likely to occur and less likely to be identified.
How we can help
If you or a family member received care at Royal Derby Hospital or Queen’s Hospital Burton and you have concerns about the standard of treatment provided, our clinical negligence team can help you understand your options. Even where the issues are complex, there may be a route to obtaining answers and, where appropriate, fair recognition for what happened. Please get in touch with our specialist team to discuss your situation.
How we can help
Mohammad Abdullah is a Senior Associate in our Medical Negligence team, which has been ranked in tier one by the independently researched publication, The Legal 500. He has represented clients in a wide range of medical negligence matters, including injuries arising from hospital falls, failures in orthopaedic and maxillofacial treatment, and serious spinal conditions such as cauda equina syndrome. He is also experienced in claims involving delayed or misdiagnosis cancer diagnoses, dental and vascular negligence, pressure sores, and ophthalmology.
If you would like to discuss a potential bowel perforation claim, please contact Mohammad or another member of our team in Derby, Leicester, or Nottingham on 0800 024 1976 or via our online form. We’re here to listen, advise, and support you through every step of the claims process.