It provides "acute healthcare services to a core catchment population of approximately half a million people living in west Hertfordshire and the surrounding area".

[3] The trust is part of the East of England Local Education and Training Board, and has students from UCL Medical School.

[14] The Trust's daily Onion patient safety meeting, "an initiative aimed at improving patient care and empowering hospital staff to raise concerns about the quality of care provided",[15] was also Highly Commended in the 2014 HSJ Awards[16] The Onion's name refers to "the scheme ‘peeling back the layers’ within its hospitals".

[17] The mortality rate subsequently fell by a quarter, an improvement credited to issues raised and dealt with at Onion meetings.

The inspectors found A&E patients at Watford General facing long delays before they were examined by a doctor where unqualified staff assessed A&E arrivals, and there was a dangerous lack of nurses.

[23] Following a Care Quality Commission inspection in April 2015 the Trust decided to suspend the private obstetric service at Watford General Hospital.