Window To The Womb

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s needs were met through good organisation and delivery.

We have not awarded this service a score for Responsive.

Find out about when we will not publish a key question score and what we look at when we assess Responsive.

We scored the service as 2. The evidence showed some shortfalls. The service did not always make sure people were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

A pre-scan questionnaire was given to women on arrival to the clinic, this questionnaire did not ask women about additional support needs ensuring their experience was planned and managed uniquely for them. The service’s policy guidance stated that women who were deaf or with a hearing impairment could be supported through British Sign Language (BSL) Interpretation by prior arrangement. Without disclosure of these needs before the appointment, the service could not reasonably ensure all required support was set up in a timely manner. This limited the services ability to plan appropriate adjustments in advance. This also meant the service was unable to anticipate certain individual needs prior to attendance for women with mental health needs, autistic people and people with a learning disability. Staff explained that patients with additional needs were often accompanied by carers or chaperones, which reduced the immediate need for internal adjustments. However, this placed the burden of additional support on the women.

Leaflets promoting mental health and addressing anxiety were readily available. Staff demonstrated an understanding of the importance of reviewing not only the progress of pregnancies but also identifying and referring any potential gynaecological concerns.

The service did not provide leaflets in the clinic in other languages, but translated leaflets were available on the services website, this relied on women accessing information independently before attending.

We scored the service as 3. The evidence showed a good standard. The service understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

The service had established effective working relationships with local NHS emergency care and midwifery services. This represented a significant improvement in service provision, as it enabled sonographers to refer women directly to the NHS trust whet they identified concerns, such as ectopic pregnancy. Through this agreement, the service received follow up information from NHS services regarding patients care and outcome, which staff used to support learning.

Staff coordinated appointment schedules to ensure scans did not take place too close together.

The clinic provided a spacious waiting area that offered a comfortable and suitable environment for women. The service supplied free feminine hygiene products and nappies, and accessible toilets and baby-changing facilities were available onsite. The clinic was located close to public transport links, supporting ease of access. In addition, the electronic booking system was monitored daily, offering people the flexibility to book appointments online via a 24/7 platform or by contacting the clinic directly during opening hours.

We scored the service as 3. The evidence showed a good standard. The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Staff engaged with women and their families in an open and supportive manner. They provided available information clearly and responded to questions honestly. Staff made use of other accessible methods of communication wherever possible. For example, they used a pad and paper to facilitate communication when needed for people with communication difficulties and they use online translate for people who do not speak English.

The service did not ensure that key information was publicly available. At the time of assessment, the website did not include up to date details about the service opening times and dates. We discussed this with the managers and confirmed that it was an external agency responsible for maintaining and updating this content, and that the opening times and dates were only applicable to the customer service telephone line. This meant the service did not always keep the public updated information.

We scored the service a 3. The evidence showed a good standard. The service generally made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

The service provided clear information on how women and their family could raise concerns or make complaints. Feedback forms were available throughout the clinic that explained how to escalate concerns. The clinic also displayed information in patient areas explaining how to raise a concern. People were encouraged to raise any issued initially with staff or the clinic manager.

Staff demonstrated a good understanding of the complaints policy and knew how to manage concerns appropriately. They could access the policy easily via the intranet or from a folder held within the clinic. The complaints policy clearly outlined the process for handling complaints, including escalation arrangement and how complaints would be investigated.

Managers investigated complaints and actively identified themes and trends. The clinic Where issues were identifies, managers acknowledged the feedback and contacted people to seek resolution.

We reviewed the services complaints monitoring report in the past 12 months, which recorded the number of complaints received, response times, and time taken to close complaints.

In the past 12 months, the service had received a total of 10 complaints. All were handled appropriately as according to the services policy. They all contained clear actions taken and resolutions achieved withing one week. We found that the most common theme was related to the quality of the scan images. In response the service offered those women a rescan appointment.

The services complaints policy also included contact details for an independent third-party organisation, allowing patients to escalate concerns if they remained dissatisfied with the services response. This aligned with best practice for complaints escalation within independent healthcare services. Managers confirmed, and we saw evidence, that the service used the Centre for Effective Dispute Resolution (CEDR) as its Alternative Dispute Resolution provider with complaints submitted through the CEDR portal where required.

We scored the service as 3. The evidence showed a good standard. The service made sure that people could access the care, support and treatment they needed when they needed it.

The clinic environment supported accessibility as all areas were step-free. Staff completed training in autism, learning disabilities and supporting women with mental health needs. This training included communication techniques and helped staff understand how these conditions could affect a person’s pregnancy experience. We saw that staff and managers also took steps to ensure women were not left waiting unnecessarily and always explained any delays to appointments this, supported a positive and inclusive patient experience

We scored the service as 3. The evidence showed a good standard. Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

All staff completed mandatory training in equality, diversity, inclusion, and human rights. Staff were able to explain how they embedded equity into their day-to-day practice and ensured care and treatment decisions were made without discrimination, including in relation to protected characteristics.

The service also offered specific training to raise staff awareness of LGBTQ+ people and how to best support this patient group.

We scored the service a 3. The evidence showed a good standard. People were usually supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

The service focused on providing reassurance and emotional support to people at key stages of their pregnancy journey. Although the service did not offer ongoing or long-term support following pregnancy, sonographers took the time to signpost people to appropriate external services that could meet their individual needs.

The service demonstrated a compassionate and personalised approach to care. Many people chose to remain in contact with the clinic after their appointments and shared photographs of their babies with staff. This reflected strong rapport with staff and women using the service.

The service also showed sensitive and respect when supporting those who had experienced pregnancy loss. A designated quiet room was available which included dedicated “butterfly boxes.”