A man has been remanded in custody accused of the murder of a healthcare assistant who died after being stabbed while at work in a psychiatric hospital.
Ryan Matthews, 61, of Wotton Lawn hospital, Horton Road, Gloucester, faced magistrates in Cheltenham charged with Sharon Wall's murder.
He spoke only to confirm his name, address, date of birth and that he understood the charge he faces during the three minute hearing.
Matthews is accused of the murder of Ms Wall on July 9 at the hospital, which is run by the 2gether NHS Foundation Trust.
Emma Davies, representing Matthews, did not make any representations on her client's behalf.
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Marjorie and Michael Cawdery, both 83, are understood to have been stabbed to death in a killing their family called "incomprehensible".
Detectives have launched a murder investigation following the shooting in Brent, north west London on Friday night.
Hot and humid throughout the Bank Holiday Weekend.