Princess Royal Hospital

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

We looked for evidence that women and communities were always at the centre of how care was planned and delivered. We checked that the health and care needs of women and communities were understood, and they were actively involved in planning care that met these needs. We also looked for evidence that women could access care in ways that met their personal circumstances and protected equality characteristics.

At our last assessment this key question was not rated. At this assessment we rated responsive as good. This meant people’s needs were met through good organisation and delivery.

Women were involved in decisions about their care. The service provided information women could understand. Women knew how to give feedback and were confident the service took it seriously and acted on it.

Women were involved in planning their care and understood options around choosing to withdraw or not receive care.

However, the service did not always make sure that people could access the care, support and treatment when they needed it.

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 3. The service made sure people were at the centre of their care and treatment choices and they decided, in partnership with women, how to respond to any relevant changes in women’s needs.

Women had the option of having a home birth or birthing on the labour ward. Women were advised to have counselling to support them in making a choice regarding their birth choice.

Women felt involved in planning and making decisions about their care which was responsive to their needs. They reported staff worked together and supported them to plan their care and the birth of their baby.

The findings of the Maternity survey 2025 showed that when women were asked about being offered a choice on where to have their baby the service scored 9.4, which was above the national average of 8.5 when compared to all other trusts in England.

The service had 2 consultant midwives; part of their role was to support women who chose to birth outside of guidance and provided women with up-to-date guidance and options available to make decisions about their birthing journey. Birth outside of guidance describes women who make decisions that are different from those recommended by the trust or national maternity guidance. For example, women who have health conditions or risk factors, meant they were recommended to have their baby within the obstetric setting.

Women may choose a midwife‑led unit for personalised care in a calm, homely environment that supports normal birth, minimises unnecessary intervention, and maintains safety for low‑risk pregnancies. There was no midwifery led unit (MLU) located at Princess Royal Hospital and the nearest one for women to access was some distance away, which meant travel and accessibility may be difficult for women and their families.

The service provided a patient triage telephone line 24 hours, 7 days a week for patients to speak with a trained midwife about any concerns they may have. Women felt they received the appropriate advice and support when contacting a midwife and the trust scored 9.1 out of 10 for advice given to women at the start of labour in the CQC Maternity survey.

We reviewed women’s electronic records and saw they were comprehensive and there were no concerns regarding documentation. Records showed individualised care was provided, such as for those women who had complex care needs or whose pregnancy was high risk. However, staff told us during the assessment they did not always have sufficient time to complete records during their shift Delays in completing patient records can compromise continuity of care, increase safety risks, and reduce the trust’s ability to provide assurance of safe, effective care.

We scored the service as 3. 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 trust aimed to improve targeted interventions to reduce the risk of health inequalities particularly for women most affected.

The maternity service used statistical process control (SPC) charts to allow early identification of changing rates in maternity data and to action an early response to any concerns or themes or trends identified. For example, the trust monitored the percentage of women most at risk of health inequalities, to understand the needs of service users from diverse groups and co-produce improvements and tailored services to reduce the risk of health inequalities.

Specialist midwives identified and supported women with specific support which included the refugee service, drug and alcohol support and teenage pregnancy. There was a proactive approach to understanding the needs of different groups of people and delivering care that met their needs.

Midwives assessed women’s mood during antenatal visits and were able to signpost women who required further support for anxiety and depression or fear of pregnancy or giving birth. The Maternity survey 2025 showed that when women were asked about their mental health the service scored 8.4, which was just below the national average of 8.6 when compared to all other trusts in England.

The service scored 9, the same as the national average when women were asked if they were given enough support during their pregnancy for their mental health.

Staff could access emergency mental health support 24 hours a day, 7-days a week for women with mental health problems and learning disabilities. The service had systems and specialist staff to help care for women in need of additional support or specialist intervention. For example, the service had fetal wellbeing midwives and midwives designated to supporting women following a difficult birthing experience.

There was a significant increase nationally in women choosing to have a planned caesarean birth. It was reported the increase in caesarean births was due to what birthing experience felt best for the woman or previous birth trauma or medical conditions. The service reported the same at Princess Royal Hospital and to support women in their choice and to support the high demand had introduced weekend caesarean lists. Although this was intended to support the service and mitigate risk of delay, we were told by staff that it had put further strain on the recovery and postnatal ward.

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

The trust website included virtual tours of the maternity units and provided information on maternity services including antenatal education.

Information on birth options and realistic expectations was provided to women and their partners during antenatal appointments, through the trust website and via antenatal education sessions. These sessions, delivered both virtually and face to face, aimed to reduce fear, anxiety and postnatal depression, and to improve birth experiences and overall wellbeing.

Managers communicated changes in national guidance through monthly newsletters, departmental alerts, during huddles and through presentations to staff. There were informative notice boards around the maternity unit displaying best practice guidance for breastfeeding.

The trust scored 7.4 out of 10 for receiving the information and explanations they needed after birth in the CQC Maternity survey 2025.

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

The trust recognised that women were becoming more informed and aware of their options during the pregnancy and birth of their baby and were working to improve birth experiences for women.

The trust had a ‘voice of the user’ section on their maternity dashboard, where maternity leaders monitored themes from women and their families. The dashboard showed friends and family test results, formal complaints, duty of candour compliance, number of obstetric claims and maternity and neonatal voice partnership meetings (MNVP).

The service displayed information about how to raise a concern and give feedback on care or experience of the service on notice boards around the unit. Leaders told us they shared feedback from women with staff and the trust board.

In August 2025 the service received 93.88% friends and family positive feedback on care.

Complaints were shared within the monthly safety champions report and presented at the maternity and neonatal clinical leaders meeting and maternity and neonatal patient safety meeting.

From May 2025 to the end October 2025 the service had received 10 complaints. Out of the 10 complaints there were 4 still open to an investigation, 3 of those complaints had exceeded their 60 working day closure target.

The most common theme of complaints was due to clinical incidents. These were broken down into failure to diagnose, inappropriate procedure, awareness under anaesthetic and delay or failure to undertake scans.

Complaints were shared in the monthly safety champions report and presented at the maternity and neonatal clinical leaders meeting and maternity and neonatal patient safety meeting.

Staff knew how to handle complaints effectively and the head of midwifery reviewed all complaints and responses.

We scored the service as 2. The evidence showed some shortfalls. The service did not always make sure that people could access the care, support and treatment they needed when they needed it.

The trust’s maternity dashboard showed between June 2025 to November 2025 there were 71.9% of women who saw a midwife for their 10-week booking appointment.

The NHS guidance for a first midwife appointment (also called the booking appointment) is to be before the woman is 10 weeks pregnant. This is because some tests may need to be done before 10 weeks. It was unclear whether the service was in the process of improving access for women.

There was inequitable access to antenatal information across the 4 locations, at Princess Royal Hospital, antenatal education sessions were only available in person every other weekend and there were limited places available for women and their partners.

Infant feeding sessions were offered virtually and face to face, which was the preferred method for sessions. Women were given information and advice about their health, prenatal and postnatal care.

From September 2024 to August 2025 there were 58 incidences where the maternity service had identified capacity issues and the trust escalation procedure had been activated. This meant there were a higher number of women using the service and a higher number of operational pressures on the service. The service reported the demand was managed within the trust and there were no incidences of pregnant women diverted to other trusts.

Women attending the service for an induction of labour (IOL) were given an initial date for admission to start the induction process. Women were advised that this date may change based on acuity and the prioritisation according to clinical risk.

Information received from staff identified that there were regular delays in women receiving the IOL. We requested the number of IOL delays and times of waits between May 2025 to November 2025 for the hospital. However, we were told the service did not collect data regarding the waiting times and to identify the information would mean a review of women’s case notes. This meant the service could not clearly identify reasons, themes or trends for delays in induction of labour to improve women’s experiences and alleviate risk.

The service had recently updated their guidelines and formed an IOL discussion group to listen to concerns and to explain emerging plans. However, this did not lessen the potential risk for women experiencing long delays with IOLs.

The service worked with local maternity and neonatal systems (LMNS) and maternity and neonatal voice partnership (MNVP) to identify barriers to women accessing maternity care and discuss improvements. The MNVP did this by providing a survey to women using maternity services, talking to women at baby groups and through accessing social media.

Mental health midwives and specialist bereavement midwives supported women who required additional support.

Women were given a discharge date when they booked for a planned caesarean section to allow women to plan discharge arrangements and family support if needed.

We scored the service as 3. 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.

The service developed online and face-to-face birth education classes to enhance women’s experiences of birth. These classes aimed to support women by reducing fear, anxiety and postnatal depression, and lowering the risk of birth-related trauma while improving overall wellbeing.

Staff and leaders actively listened to information about women who were most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this. For example, the service had a continuity of care team established for women from the Gypsy, Roma and Traveller community, women with a history of substance misuse as well as other vulnerable women.

Leaders monitored outcomes and investigated demographic data to identify when treatment and outcomes differed for different groups of women. Equity in experiences formed part of divisional quality meetings and was part of the work that the Maternal and Neonatal Voices Partnership (MNVP) were involved in.

The trust was focused on improving interventions to reduce the risk of health inequalities. Through the perinatal quality surveillance model, the trust monitored health inequalities using electronic data charts. These showed the number of women accessing services through the continuity of carer model and asylum seeker specialist services, helping to identify where further support was needed. The trust worked with system partners and service user groups to better understand the needs of service users from diverse groups and co-produce improvements and tailored services.

We scored the service as 3. Women were 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.

Women could get information and advice that was accurate, up to date, and provided in a way they could understand to plan for their birth. The service supported women to make informed choices about their care. This was achieved through health promotion information, antenatal classes, appointments with midwives, birth plan documents, information leaflets, and resources available on the maternity page of the trust’s website.

Women were supported to make decisions to improve their overall health. This included stopping smoking and making healthy eating choices.

Women were clear about discharge plans and who to contact with any concerns. Discharge summaries were shared electronically with health visitors and GPs and follow up arrangements were made prior to discharge.