Window to the Womb

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• 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.

This is the first assessment for this service as a diagnostic and screening service. This key question has been rated good.

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

We have not awarded this service a score for Effective.

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

We scored the service as 3. The evidence showed a good standard. 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 ensured that each patient had completed an online risk assessment upon admission. This included information on allergies, health conditions, previous infections, estimated gestation and additional health needs. Staff had demonstrated an understanding of and responded promptly to any immediate risks to women’s health.

The provider had implemented a robust process for identifying risks both prior to bookings and during scans, including the identification of previous pregnancy loss. Women were encouraged to bring their NHS records to appointments to ensure sonographers had access to a complete medical history. The service had issued clear guidance for sonographers to follow when unexpected results were identified during scans.

Staff provided examples of women referred into local NHS services and knew how to act swiftly in emergency situations. The provider conducted emergency scenario drills, including procedures for contacting emergency services. Individuals requiring referrals had been given their scan reports to share with NHS GPs, midwives or clinicians to ensure continuity and clarity of care.

The provider informed women of pregnancy-related risks via its website and had advised all women to continue attending their NHS appointments as usual.

People told us that staff had acknowledged their worries or anxiety and had been proactive in offering support throughout the process.

The service had developed pathways to support staff with referrals and next steps when unusual findings were identified during ultrasound scans. Staff had understood their roles and responsibilities in ensuring timely referrals.

Patients attending scans had been asked about latex allergies. Although pain levels had not been formally monitored due to the pain-free nature of the procedure, staff had asked individuals if they were comfortable during their scans.

We scored the service as 3. The service planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

None of the individuals we spoke with raised concerns about the service’s ability to deliver evidence-based care and treatment. The service offered appropriate hydration and nutrition options.

Local policies and protocols were up to date and aligned with national guidance. This included standards from the Royal College and Society of Radiographers, the foetal abnormality screening programme, and the British Medical Ultrasound Society.

We saw evidence that managers routinely monitored staff compliance with these standards.

The provider maintained responsibility for reviewing and updating policies in line with evolving best practice and national guidance. All staff confirmed they could access policies both online and in paper format.

Policy updates relevant to the service were cascaded simultaneously across all clinic locations to ensure consistent care delivery. Governance systems tracked policy changes and included reminders for scheduled reviews. Staff regularly reviewed guidance and alerts from authoritative bodies including the National Institute for Health and Care Excellence (NICE), the British Medical Ultrasound Society (BMUS), and the Society and College of Radiographers (SCoR), ensuring care remained aligned with current best practice.

The provider ensured adherence to ALARA (As Low As Reasonably Achievable) protocols, with clear guidance provided to women before and during scanning. Information about ALARA was prominently displayed in clinics.

Staff demonstrated familiarity with accessing relevant policies and procedures via the service’s online system. Updates to policies were discussed during team meetings and reinforced during daily huddles. All staff had appraisals completed when due.

All policies reviewed were current and in date. The registered manager performed a monthly clinic visit, and the clinic manager produced a monthly performance report. Performance against key indicators was shared with staff during monthly team meetings.

We scored the service as 3. The evidence showed a good standard. 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.

We observed that all staff involved in care delivery worked cohesively to provide person-centred support throughout the patient journey. Team collaboration was evident across the service, with positive communication between managers and staff.

People using the service felt the team worked well together, highlighting good communication between the sonographer, chaperone, and the individuals and families. Service leads had access to all relevant online systems, ensuring timely access to information and scans when a second opinion was needed.

Staff from different roles worked together effectively to support women and their families. Scan assistants greeted people on arrival and worked alongside sonographers in the scanning room, each clearly understanding their role in the process. We observed them supporting each other and building a good rapport with the women and their relatives. After the scan, women were guided back to the waiting area where they could collect their photographs.

The service maintained a positive working relationship with the local NHS maternity service, referring women when abnormalities were detected during ultrasound scans. In instances where the woman would be attending a different NHS Trust, a copy of her report and referral was made available for her to take along.

We scored the service as 3. The evidence showed a good standard. 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 demonstrated a consistent and proactive approach to supporting individuals to lead healthier lives.

Women using the service told us that they received a wellbeing check at every appointment, which included discussions about both physical and mental health.

We observed that the service promoted health awareness through visible and accessible information. Leaflets providing information on home human papillomavirus (HPV) testing were available. The service also provided details about a telephone application designed to support women with pregnancy-related queries and access to a parenting coach. Leaflets promoting mental health and addressing anxiety were readily available. Scan reports included information on healthy eating and information about important vaccinations during pregnancy.

We scored the service as 3. The evidence showed a good standard. 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.

Despite operating as a business with performance targets, women using the service consistently reported feeling valued and respected.

The clinic demonstrated a strong culture of continuous improvement. Monthly team meetings included discussions of audit results, and staff actively monitored the effectiveness of care. Findings were used to drive improvements and consistently achieve positive outcomes for women.

The registered manager conducted regular clinical and environmental audits, focusing on key performance indicators (KPIs) such as incidents, inaccuracies, complaints, and scan times. These KPIs were set by the franchiser and used to benchmark performance against other clinics.

The service monitored attendance. In the past 12 months, it recorded a total of 2,434 scans. More than half, 55%, of these were window to the womb scans. 37% were first scan, 4% were gynaecological scan and 4% general health scans. The service also monitored rescan rates as part of the monthly audit. A rescan rate is a percentage of booked scans which must be repeated to get the desired ultrasound images. This is used as an indicator of quality. In April 2026, this was 17.24% which was an increase from 4.2% in the previous year. This was being addressed by management with clinical support for the sonographer. A future review was scheduled to monitor improvements in these measures.

We scored the service as 3. The evidence showed a good standard. The service told people about their rights around consent and respected these when delivering person-centred care and treatment.

The service ensured that all women received comprehensive information prior to their scan. This included a technology and safety briefing, terms and conditions, scan limitations, a crib sheet outlining what was and wasn’t included in the scan package, and details regarding medical records, consent, and data usage. A pre-scan questionnaire and declaration form required women to confirm they were receiving appropriate pregnancy care and consented to information sharing with the NHS.

At booking, women were informed if a male sonographer was going to be performing their scan, including transvaginal scans. These gave women, including those with religious reasons, the opportunity to be booked in an alternate clinic if they preferred.

Upon arrival, women signed a wellbeing report confirming their consent to the scan, which was then verified by the sonographer in the scan room. Staff demonstrated awareness of Gillick competence. All staff had completed training on the Mental Capacity Act (MCA) and consistently applied its principles, including seeking consent and offering choices in line with MCA requirements.

The booking consent materials were available in multiple languages to support understanding, and staff clearly documented consent in patient records. Staff had access to detailed consent guidelines, including instructions for recording consent and identifying exceptions. Mandatory training included modules on learning disability awareness, ensuring staff were equipped to support diverse needs.

The service only provided procedures for individuals aged 16 and over and maintained an up-to-date consent policy.

We saw that staff followed best practice in requesting and documenting consent. Women were required to specify the type of scan they were attending, with this information included in confirmation letters and verified onsite. If a woman was unsure, the consent process was repeated to ensure full understanding.