The Care Quality Commission
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Princess Royal Hospital

Overall: Requires improvement read more about inspection ratings

Lewes Road, Haywards Heath, West Sussex, RH16 4EX (01444) 441881

Provided and run by:
University Hospitals Sussex NHS Foundation Trust

Important: This service was previously managed by a different provider - see old profile

All Inspections

During an assessment of Maternity

Date of assessment: 19 November 2025 and 15 December 2025

Princess Royal Hospital in Haywards Heath provides a range of NHS hospital services to women living in and surrounding area of Haywards Heath and West Sussex. The assessment looked at maternity services.

The trust has obstetric led maternity units at Princess Royal hospital in East Sussex, Worthing Hospital, St Richards Hospital in West Sussex and the Royal Sussex County hospital in Brighton.

There was also a home birth service provided by community teams across all four sites.

Around 9,000 babies are born in the trust each year. Within Princess Royal Hospital between October 2024 to November 2025 there were 2,174 births at the hospital.

In February 2022, the trust entered the Maternity Safety Support Programme (MSSP). The MSSP is a national support programme provided by NHS England to maternity services where significant concerns have been identified regarding the safety and quality of services.

There was a maternity improvement plan which was monitored via the twice monthly Maternity Improvement Group. The trust was on track to move into the sustainability phase of the MSSP programme mid-2025, and to exit the programme late-2025. However, this was delayed due to the trust being named as one of the trusts within the rapid national investigation into NHS maternity and neonatal services.

Maternity services were rated as requires improvement following the assessment.

At our last assessment the overall rating for maternity services was requires improvement.

The service was previously in breach of legal regulation 18: staffing. Following this inspection the service remains in breach of this regulation. The service did not have enough staff to keep women safe. During this inspection, staff told us they felt tired and burnt-out due to workforce pressures and the demands of the service. Shifts felt increasingly overstretched and sickness rates were high with 8% midwifery sickness, we were told this was mostly due to staff stress.

We also found a breach of regulation 12: safe care and treatment, we found women did not receive a midwifery review within 15 minutes of arrival within the maternity care centre and women did not receive a medical review within a timely manner. The service had 1 obstetric theatre which was frequently reported to be closed due to ongoing equipment failures and issues with the heating and ventilation. There were gaps identified in the medicines record keeping books where the anaesthetic team had not signed to identify drugs which had been administered to women in theatre.

There was a breach of regulation 17: good governance due to the service not having an audit schedule and staff did not routinely complete local audits. Staff did not have access to up-to-date policies and guidance due to several being outside of the review date.

However, policies and guidance did reflect the current National Institute for Health and Care Excellence (NICE) guidance. Staff knew what incidents to report. They raised concerns and reported incidents and near misses in line with the trust policy.

Staff told us they worked well as a team and there was a good culture between midwives and obstetricians. Staff considered patients’ individual needs, circumstances, ongoing care arrangements and expected outcomes during handovers and ward round meetings.

Leaders worked with the Maternity and Neonatal Voices Partnership (MNVP) to contribute to decisions about care in maternity services. Meeting minutes showed current work being undertaken between the trust and the local MNVP.

We refer to women in this report, but we recognise that some transgender men, non-binary women and women with variations in sex characteristics or who are intersex may also use services and experience some of the same issues.

We have requested an action plan, this will be requested upon publication of the final report.

During an assessment of the hospital overall

Date of assessment: 19 November and 15 December 2025. University Hospital Sussex provides a range of NHS hospital services across 4 locations, providing care to the populations of parts of East Sussex, Brighton and Hove and West Sussex.

The maternity assessment took place at Princess Royal Hospital in East Sussex. The rating from maternity has been combined with ratings of the other services from the last assessment at Princess Royal Hospital. See our previous reports to get a full picture of all other services at Princess Royal Hospital. The rating of Princess Royal Hospital is, requires improvement.

The service continued to have poor staffing levels and remained in breach of regulation 18: Staffing.

At this assessment we identified breaches of regulations in relation to regulation 12: Safe Care and Treatment and regulation 17: Good Governance.

1 August 2023

During an inspection looking at part of the service

Princess Royal Hospital is one of the hospitals of University Hospitals Sussex NHS Foundation Trust and provides clinical services to people living in and around Haywards Heath.

At this inspection we inspected the surgery core service at Princess Royal Hospital. We found there was a deterioration in the quality and safety of the surgery service since the last inspection of surgery in 2019, resulting in a drop in their rating. There was no change to the overall rating of Princess Royal Hospital. More detail about the findings and required improvements can be found in the surgery core service section of this report.

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During a routine inspection

Princess Royal Hospital was not inspected during this current inspection. However, we have included it in this inspection report in order to aggregate the ratings from the focused inspection of maternity services carried out in September 2021. The aggregation of ratings from that inspection has resulted in a change of rating for Princess Royal Hospital.

26 May 2022

During an inspection looking at part of the service

We carried out this unannounced focused follow up safety inspection of maternity services provided at the Princess Royal Hospital on 26 April 2022 because at our last inspection in October 2021 we found the following concerns:   

  • The service did not have enough staff to care for women and keep them safe
  • Compliance with skills drills and Cardiotocography CTG training was poor with only 60% and 50% of staff respectively having completed their training.
  • There was not a systematic approach to prioritising women who attended triage, and staffing levels in triage were not robust.
  • Resuscitaire checks were not always recorded.
  • Staff did not complete carbon monoxide screening.
  • Not all incident investigation reports recorded the learning outcomes or whether feedback had been given to the reporter.
  • Not all risks were identified on the risk register.
  • The leadership above matron level was not visible.
  • Staff morale was low and the workforce was exhausted.

As a result, we issued a warning notice to make sure the trust made improvements. We carried out this return inspection to review compliance to the warning notice issued on the maternity services.

This inspection has not changed the ratings of the location overall and our rating of maternity services remains the same. 

28 September 2021

During an inspection looking at part of the service

We carried out this unannounced focused safety inspection of maternity services, provided by the University Hospitals Sussex (UHS), because we received information of concern about the safety and quality of the service.

Information of concern had been received from several sources about the maternity services across the trust. This included staff whistleblowing, patient complaints and information from other regulatory bodies.

University Hospitals Sussex provide maternity services at the Princess Royal Hospital, Royal Sussex County Hospital, St Richards Hospital and Worthing Hospital.  This report focuses on our findings at Princess Royal Hospital.

We also asked the trust to send an anonymous staff survey to give all maternity staff the opportunity to share their experience of working at UHS and raise and share concerns in a safe and confidential manner. The survey was open to staff between 1 September and 15 September 2021 and at the Princess Royal Hospital there were 57 responses. The anonymous results related to the Princess Royal Hospital have been used as evidence to support our inspection.

This inspection has not changed the ratings of the location overall. However, our rating of maternity services went down. We rated them as requires improvement.

Overall, we rated safe as requires improvement and well-led as 'inadequate', we did not have enough evidence to re-rate the effective domain.

University Hospitals Sussex NHS Foundation Trust was formerly called Western Sussex NHS foundation Hospital. It changed its name on 1 April 2021 when it acquired Brighton and Sussex NHS foundation Trust.

The trust has five hospitals – Worthing Hospital, St Richards Hospital, Royal Sussex County Hospital, Princess Royal Hospital and Southlands Hospital – which provide a full range of acute services.

When a trust acquires another trust in order to improve the quality and safety of care we do not aggregate ratings from the previously separate trust at trust level for up to two years. The ratings for the trust in this report are therefore based only on the ratings for Western Sussex NHS Foundation Trust.

Our normal practice following an acquisition would be to inspect all services run by the enlarged trust. However, given we were responding to concerns in the maternity and surgery core services we inspected only those services where we were aware of current risks. We did not rate the hospital overall. In our ratings tables we show all ratings for services run by the trust, including those from earlier inspections and from those hospitals we did not inspect this time.

How we carried out the inspection

Our inspection was unannounced (staff did not know we were coming) to enable us to observe routine activities in maternity services. We carried out a focused inspection related to the concerns raised, this does not include all of our key lines of enquiry (KLOEs). We looked at KLOEs specific to the domains: safe, effective and well-led.

We visited clinical areas in the service including the central delivery suite, the postnatal ward, triage and the day assessment unit. We spoke with members of staff, including service leads, midwives (bands 5-8) obstetric staff (junior-consultant), consultant anaesthetists, maternity care support workers, student midwives and advanced neonatal practitioners.

We conducted a survey of maternity staff prior to the inspection. We observed the morning handover on the delivery suite and the postnatal ward. We observed the multidisciplinary ward round. We reviewed 10 sets of maternity records and 10 medicine charts. We also looked at a wide range of documents including protocols, meeting minutes, risk assessments, grading of recently reported incidents and audit results. Before our inspection, we reviewed performance information about this service.

You can find further information about how we carry out our inspections on our website: https://www.cqc.org.uk/what-we-do/how-we-do-our-job/what-we-do-inspection.