Window to the Womb Reading

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We found a service where staff assessed the needs of women in attendance. There were systems to effectively communicate with third party health providers, for example GP’s and NHS trusts. The service supported women to live healthy lives and ensured women were consented to treatment in accordance with guidelines.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People’s experience

Score: 3

People felt staff acknowledged any worries or anxiety and were proactive in supporting them through the process. For example, one woman had a history of miscarriage and therefore wanted further scanning throughout her pregnancy. Staff discussed a timetable for future scans in conjunction with the woman and her partner to ensure that they had the frequency of assurances, but also to prevent any adverse effects from overexposure to ultrasound. This information was relayed to the woman’s GP to ensure if they went to another scanning company, they would have the details of the scanning plan.

Feedback from staff and leaders

Score: 3

Staff described and we observed a daily huddle, which was a discussion about the women in attendance on that day and the next day’s listing. Staff used this as an opportunity to discuss the type of scans, any extra support they may require as well as any additional needs of the women and families in attendance. As the service saw some women frequently, this enabled staff to build a rapport. One member of staff had supported a woman through two previous pregnancies and ensured they were in attendance during appointments.

Processes

Score: 3

The service developed pathways to support staff regarding referral and next steps if they found unusual findings on the ultrasound scan. Staff understood their role and responsibilities in ensuring a quick referral. Staff completed dedicated referral forms which the registered manager reviewed to ensure accuracy.

People’s experience

Score: 3

None of the people we spoke with had any concerns regarding the services ability to deliver evidence-based care and treatment.

Feedback from staff and leaders

Score: 3

Staff we spoke with knew how to access relevant policies and procedures on the services online system. Staff stated that when a policy was changed or updated, this was discussed at team meetings and managers reminded them at daily huddles. Staff were given sufficient time to read and understand policies and confirmed they signed off to state they understood the changes.

Processes

Score: 3

The manager reviewed all policies annually in conjunction with the area manager. These were planned to allow sufficient time to review new legislation and guidance, and these were signed off by the franchiser to ensure all Window to the Womb clinics were working cohesively against the same guidance. There was a full and detailed catalogue of policies and procedures that covered all areas of the service. We checked 20 policies and noted that all were in date.

People’s experience

Score: 3

People using the service felt the team worked well together and there was good communication between the sonographer, chaperone and the women and families.

Feedback from staff and leaders

Score: 3

During the booking process, staff requested women bring their NHS pregnancy records with them. This meant the sonographers had access to women’s full medical history including details of any previous fertility treatments and pregnancies.

Feedback from partners

Score: 3

Local providers we spoke with did not have any issues or concerns regarding this service.

Processes

Score: 3

The team worked well together, and we observed positive communication between managers and staff. The service had a clinical lead who was available 24 hours a day, 7 days a week. The leads had access to all online systems, ensuring sufficient access to information and scans when a second opinion was required.

People’s experience

Score: 3

Women using the service advised us that at every appointment they received a wellbeing check which included discussions of both their physical and mental health.

Feedback from staff and leaders

Score: 3

Staff understood the importance of reviewing not only the women’s pregnancies but also assessing and referring any potential signs of gynaecological concerns. The service provided hormone testing to help women understand their fertility and likelihood of becoming pregnant.

Processes

Score: 3

We observed the service displayed posters for domestic abuse support on toilet doors, as well as signs and leaflets detailing the signs and symptoms of breast and ovarian cancer.

People’s experience

Score: 3

Women we spoke with were happy with their pregnancy outcomes. Although the service was a business and was required to reach targets. Women advised us they did not feel like a number, one person said “We’re not pushed through the doors as soon as”.

Feedback from staff and leaders

Score: 3

Monthly team meeting agendas included a discussion of audit results. We reviewed 20 audits and saw that all achieved scores of 90% or more. Where there was room for improvement, a detailed action plan was created. These included a responsible person, mitigations, completion sign off and re-audit to assess effectiveness.

Processes

Score: 3

The service monitored outcomes and women’s experiences via their monthly clinic audits and patient satisfaction feedback cards. The franchiser carried out an annual compliance audit and we saw the service was compliant with all aspects of the audit. The service used key performance indicators to monitor performance, which was set by the franchiser. The service benchmarked themselves against other clinics within the franchise. Measures included; number of reviews received, number of rescans and number of completed scans. The target was 70 scans a week, which the service consistently met.

People's experience

Score: 3

Women advised us they consented to care and treatment numerous times throughout the process, both verbal and written, and they understood what procedure they were consenting to.

Feedback from staff and leaders

Score: 3

Staff had a good understanding of Gillick and Fraser guidelines and knew when to apply the principles as well as how to document understanding. `Gillick guidelines' are used to decide whether a young person is able to consent to their own medical treatment, without the need for parental permission or knowledge. The `Fraser guidelines' specifically relate only to contraception and sexual health and medical staff giving contraceptive advice and treatment to young people without parental consent.

Processes

Score: 3

Women's consent was both verbal and written. We saw staff requesting and documenting consent in line with best practice. We noted that women now had to state which type of scan they were attending for and could not just state they were having a scan, this was to ensure understanding. The service included information regarding scan type, on the confirmation letter and stated women would be asked this when onsite. If a woman did not remember this information, the consent process was repeated.