Window to the Womb

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

This means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence. At our last assessment we did not rate effective. At this assessment we rated this key question good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

We looked for evidence that people and communities had the best possible outcomes because their needs were assessed. We checked that people’s care, support and treatment reflected these needs and any protected equality characteristics, ensuring people were at the centre of their care. We also looked for evidence that leaders instilled a culture of improvement, where understanding current outcomes and exploring best practice was part of their everyday work.

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.

The service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing, and communication needs with them.

Staff maintained privacy and dignity of patients during their appointments. They explained to patients the process when undertaking their ultrasound scans, using language that patients could easily understand, and provided reassurances to patients throughout. Staff also checked for patient consent to go ahead with the ultrasound scan.

The service delivered care and treatment in line with national guidance and best practice. Policies were up-to-date and provided assurances on evidence-based good practice and standards, and staff had the skills and training needed to provide safe, effective care.

The service had a foetal ultrasound policy which confirmed compliance with the National Institute for Health and Care (NICE) guidance. The policy was in date and on display at the service. This ensured that patients understood what to expect prior to their appointments. The service had a dedicated chaperone available when patients required this.

Staff ensured that patients were referred to NHS pathways if patients needed to be signposted, including local NHS hospitals and pregnancy and gynaecology units, and the service had a documented escalation process in place when handling abnormal findings. The service would immediately contact NHS emergency services, which was documented in the service’s policy for dealing with emergency situations.

The sonography staff we spoke with said they undertook extensive training, such as phlebotomy training, and kept up-to-date with monthly educational sessions. Staff had annual appraisals and peer reviewed clinical audits with the clinic manager.

The service worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Staff held monthly training sessions for all sonography staff, and monthly team meetings to discuss complaints and learning. There were also separate monthly meetings held between managers. Staff had effective working relationships with other relevant teams, divisions and clinics within the franchise. Staff maintained effective working relationships with local authorities and social services, and shared information from records of patients securely when there were safeguarding incidents. Staff, including sonographers and clinic managers, were able to be flexible and work at different clinics in their respective regions where required, for example due to sickness absence.

The service supported people to manage their health and wellbeing to maximise their independence, choice, and control. The service supported people to live healthier lives and where possible, reduced their future needs for care and support.

The service informed patients that they were required to continue to keep their own NHS maternity appointments. The service promoted the importance of regular health check-ups and had information on display signposting patients to mental health services. The provider’s website also had articles promoting the emotional wellbeing of mothers, such as advice on how best to manage returning to work after maternity leave.

The service routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

The service encouraged all patients to submit a review of their experience of care electronically. The service used patient feedback as a learning opportunity and to improve patient outcomes. Managers discussed patient feedback in meetings to monitor themes and trends and take appropriate action. This ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

The service told people about their rights around consent and respected these when delivering person-centred care and treatment.

The service had an informed consent agreement in place and this was on display at the service. This outlined the scope of conditions that patients were to be assessed against during their scans (for example, heartbeat confirmation of the baby), which also explained the scans did not replace the comprehensive NHS 20-week anomaly scans or similar detailed assessments.

We observed staff obtaining written and verbal consent from patients when performing transvaginal ultrasound and a chaperone was always present and documented. Staff took all practical steps to enable patients to make their own decisions, and we observed sonographers explain the procedures to patients in language that was easy to understand.