Leeds Teaching Hospitals NHS Trust: Sites, Pay, CQC Rating & Careers

Leeds Teaching Hospitals NHS Trust (LTHT) is one of the largest acute teaching trusts in the country — seven hospitals, a genuinely significant cancer and transplant service, and close ties to the University of Leeds. It's also, at the time of writing, going through a live and unresolved regulatory episode: the CQC downgraded the trust's leadership rating in September 2025, off the back of serious concerns in maternity and neonatal services. Neither fact cancels the other out, and we'd rather give you both, properly sourced, than a recruitment-page version of either.

What Leeds Teaching Hospitals actually runs

LTHT was formed in April 1998 through the merger of the city's separate hospital trusts into a single citywide organisation, and today runs seven hospitals across five physical sites. We checked this list directly against the trust's own leedsth.nhs.uk site rather than assuming an older or third-party version, since trust footprints and site names do change over time:

As with most large multi-site trusts, each site carries a fairly distinct identity rather than duplicating the same general offer everywhere. Leeds General Infirmary and St James's University Hospital are the two big acute sites and between them carry the bulk of emergency, surgical, cancer and transplant activity; Chapel Allerton, Seacroft and Wharfedale are smaller, more specialised or outpatient-focused sites. If you're applying for a specific specialty rather than "Leeds" in general, which site you'd actually be based at matters more than the trust name — check the vacancy directly rather than assuming.

Scale — staff, budget and patients

LTHT describes itself as a "20,000-strong" workforce with a budget of more than £2.1 billion, treating close to 1.8 million patients a year — a figure it breaks down as roughly 109,000 inpatient admissions, 1.3 million outpatient attendances and 359,000 Emergency Department attendances. We're citing that directly from the trust's own published "about us" material rather than a secondary source, though we'd flag one honest caveat: unlike some trusts that publish a precise, decimal headcount from an audited annual report (Manchester University NHS Foundation Trust's most recent verified figure, for comparison, is 28,479), Leeds's own public-facing figure is a rounded "20,000," so treat it as directionally accurate rather than a precise, audited headcount.

That scale puts LTHT among the largest acute trusts in the country and, per the trust's own and regional NHS material, one of the largest teaching hospital organisations in Europe by activity. As with any trust this size, a single headline number doesn't tell you much about a specific department — the day-to-day experience on a general medical ward at Seacroft and a transplant ward at St James's are very different jobs inside the same employer.

Distinctive specialisms and research

Scale on its own is a weak reason to choose a trust — plenty of NHS recruitment material calls almost any large organisation "one of the biggest," so it's worth being specific about what Leeds is actually known for nationally.

• Cancer. The Bexley Wing at St James's University Hospital — completed in 2007/08 at a cost of around £265 million — houses the Leeds Cancer Centre and St James's Institute of Oncology, and is commonly described as one of Europe's largest cancer centres, with around 1,600 staff and 350 beds. It includes the Leeds Gamma Knife Centre for targeted radiosurgery.
• Transplant services. St James's has run kidney transplants since 1967 — more than 3,000 to date — alongside a liver transplant programme (one of a small number of NHS centres offering this), and LTHT is one of the few UK trusts offering hand and upper limb transplantation. We wouldn't describe the liver programme as the largest in the UK, since more recent reporting we found describes it as the third largest — a genuinely significant service, just not the single biggest one, and worth being precise about rather than reaching for the biggest possible claim.
• Teaching and research. LTHT is a major teaching hospital for the University of Leeds and hosts the NIHR Leeds Biomedical Research Centre, a partnership with the University of Leeds and the University of York, funded at £19.8 million for five years — described by the trust as a threefold increase on its previous funding round. Research themes span antimicrobial resistance, cardiometabolic disease, haematology, musculoskeletal disease, pathology and surgical technologies. That funding is smaller than the £60 million-plus awarded to Manchester's Biomedical Research Centre (see our comparison section below), which is a fair, factual difference in research scale between the two trusts rather than a knock against either.
• Foundation Trust status — a genuine gap, not an oversight. Unusually for a trust of this size and teaching profile, LTHT has never achieved NHS Foundation Trust status. It was placed in the CQC's highest risk category in October 2013 following the Keogh Review into trusts with elevated mortality rates, and sustained financial and governance difficulties around that period are commonly cited as the reason FT status was never subsequently granted. This affects the trust's governance structure and accountability route (to NHS England rather than via an independent Foundation Trust regulator relationship), not your day-to-day pay or terms as staff, which run on the same national Agenda for Change and medical/dental contract frameworks regardless.

CQC rating and NHS Staff Survey results

This is the section where we'd most encourage you to read past the headline, because Leeds's CQC picture changed materially and recently, and it's the kind of thing a candidate should know about before applying rather than discovering after starting.

Under the CQC's current framework, trusts receive a specific, trust-level assessment of leadership and governance — "well-led" — separate from individual hospital and service ratings. Following an on-site assessment carried out 17–19 June 2025, published 24 September 2025, the CQC rated LTHT's well-led question as Requires Improvement — down from a Good well-led rating dating to 2019. Rob Assall, CQC's director of operations in the north, was quoted saying the inspection found that "leaders were aware of the challenges they faced, however some weren't as clear on how services could be improved," and that "leaders didn't always listen to concerns, and some staff had negative experiences when they voiced issues."

That well-led downgrade followed a separate, earlier set of findings: the CQC inspected maternity services at both Leeds General Infirmary and St James's University Hospital and rated them Inadequate, with neonatal services rated Requires Improvement, and issued a warning notice requiring immediate improvement. CQC's published findings cited breaches relating to learning from incidents, risk management, a safe environment, infection prevention and control, medicines management and governance processes, alongside concerns about babies being transferred between Leeds General Infirmary and the special care baby unit at St James's when it wasn't safe to do so. Leeds General Infirmary's overall location rating fell to Requires Improvement as a direct result, even though several of its other services — critical care (rated Outstanding in 2019), medical care, surgery and urgent and emergency care — are individually still rated Good or better on ratings that predate the maternity findings. If you're specifically applying to maternity or neonatal services at either main site, we'd read the CQC's own maternity reports directly rather than relying on any secondary summary, including this one.

On the NHS Staff Survey, we were able to verify a specific, current figure directly from the official NHS Staff Survey Coordination Centre benchmark report for Leeds Teaching Hospitals (provider code RR8). In the 2025 survey (fieldwork autumn 2025, results published March 2026), 57.40% of staff said they would recommend the trust as a place to work, against a national average of 57.77% — essentially in line with the sector. That's a genuine decline from 62.34% (above the then-average of 60.90%) in the 2024 survey. The same pattern shows up in the "compassionate culture" and "compassionate leadership" theme scores (both scored out of 10): compassionate culture fell from 7.24 in 2024 to 6.96 in 2025, moving from above the national average (7.05) to essentially level with it (6.97); compassionate leadership fell from 7.07 to 6.94, moving from just above average (6.98) to just below it (6.99). None of these are dramatic single-year swings in isolation, but the direction and timing — a staff sentiment decline landing in the same year as the well-led downgrade and maternity enforcement action — is consistent with a trust genuinely going through a difficult period, not just an unlucky inspection.

Pay and HCAS at Leeds Teaching Hospitals

Pay at LTHT follows the same national Agenda for Change bands and points as any other NHS employer in England. Matching what's in our own trust data: no High Cost Area Supplement applies here. HCAS is defined specifically around London and its immediate fringe by postcode zone, not by a trust's size, teaching status, or the general cost of living in the city it sits in — so a Band 6 role at LTHT is paid at the plain national Band 6 rate, the same figure you'd see at almost any trust outside London and the South East. Run the NHS Pay Calculator to see that figure precisely for your band and point.

It's worth separating two things that are easy to conflate: the Agenda for Change rate for your band, identical everywhere in England regardless of HCAS, and the actual cost of living in Leeds and West Yorkshire, which is generally well below London and the South East, particularly on housing. Doctors and dentists are paid under their own separate national contract regardless of trust or location, so LTHT's lack of HCAS doesn't change that comparison either.

Leeds Teaching Hospitals NHS Trust is your legal employer for anyone joining, which is what continuous service and redundancy pay calculations are tied to — not "the NHS" as a single body, and not affected by the trust's non-Foundation status covered above. See our explainer on how NHS trusts fit together for the wider picture. As a broad acute trust, LTHT covers the usual full range of roles — nursing, medicine, midwifery, allied health professions, pharmacy, healthcare science, and the healthcare assistant, admin and estates staff needed to run acute services day to day. Our nursing and allied health professionals guides walk through how pay progresses at each band.

How Leeds compares to Manchester University NHS Foundation Trust

Leeds and Manchester are both genuinely large acute teaching trusts serving major Northern English cities, both sit outside HCAS zones, and both are fair, like-for-like comparisons rather than arbitrary ones. On the figures we could verify, MFT is the larger organisation: roughly 28,479 staff and £2.2 billion in annual income (2021/22, the most recent figures we could independently confirm for MFT) across ten hospitals, against LTHT's roughly 20,000 staff and £2.1 billion-plus budget across seven hospitals on five sites. Both host significant NIHR Biomedical Research Centres, though MFT's — funded at more than £60 million for 2022–2027 — is considerably larger than Leeds's £19.8 million, five-year award. MFT also holds NHS Foundation Trust status; Leeds does not.

The regulatory picture is where the comparison gets more interesting, and less one-sided than the scale figures suggest. MFT's overall CQC rating is still Good, but it rests on a comprehensive inspection from autumn 2018, published in 2019 — a rating that hasn't been refreshed trust-wide since, even though narrower, service-specific inspections (including of MFT's own maternity services) have since found Requires Improvement in places. Leeds's well-led rating, by contrast, was actively downgraded to Requires Improvement in September 2025 — a more current, still-unfolding finding, following its own maternity and neonatal enforcement action. Put simply: MFT's "Good" badge is real but ageing, while Leeds's "Requires Improvement" badge is recent and reflects a live improvement process still underway. Neither picture is straightforwardly better than the other — they're different kinds of caution to apply when reading a trust-wide rating.

Neither comparison point should be read as one trust being straightforwardly "better" than the other — both are large, credible teaching trusts with genuine specialty depth, and the right choice depends far more on specialty, department and personal circumstances than on headcount, income or a single CQC badge. If a live regulatory improvement programme is something you'd want to ask about directly at interview, Leeds is the trust on this page currently going through one — which some candidates will see as a reason for caution and others as an opportunity to join an organisation with real leadership attention on fixing known problems. Use the tool below for a more structured side-by-side.

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The bottom line

Leeds Teaching Hospitals NHS Trust is, on the figures we could verify, one of the largest and most academically significant acute trusts in the country — seven hospitals, a genuinely major cancer and transplant service, and a real research partnership with the University of Leeds and University of York. It's also, right now, a trust in the middle of a serious and current regulatory improvement process: a CQC well-led downgrade to Requires Improvement in September 2025, maternity and neonatal enforcement action at its two main hospitals, and a staff survey trend that moved from above-average to roughly-average in the space of a year. None of that is a reason to rule Leeds out — plenty of good trusts go through difficult regulatory periods and come out the other side, as UHB's own recovery from an Inadequate well-led rating shows — but it is current, verifiable, and worth asking about directly at interview rather than assuming the trust's genuine scale and teaching reputation tell the whole current story. Pay is standard national Agenda for Change with no HCAS, a genuine trade-off against Yorkshire's lower cost of living rather than a discount.

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