Harrogate District 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

This means we looked for evidence that the service met people’s needs.

At the 2016 assessment we rated this key question good. At this assessment the rating has remained good.

Good: This meant people’s needs were met through good organisation and delivery.

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

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.

We make sure people are at the centre of their care and treatment choices and we decide, in partnership with them, how to respond to any relevant changes in their needs.

We scored the service as 3. The evidence showed a good standard. The service made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

Women had named midwives which ensured continuity of care throughout their pregnancy.

Women were supported to decide on the care and birth choices suitable for them. For example, a home birth, use of the birthing pool.

The service had implemented the perinatal mental health model of care which focused on the relationship between the baby and care givers, which recognised early interventions shaped a child’s emotional and social development.

The service did not have a dedicated epilepsy midwife; support in this area was provided by another local trust in West Yorkshire.

We understand the diverse health and care needs of people and our local communities, so care is joined-up, flexible and supports choice and continuity.

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.

Good multi-disciplinary team (MDT) working was observed in the diabetes clinic. The specialist midwife, consultant and specialist nurses communicated and worked well together.

Harrogate Maternity and Neonatal Voices Partnership attended the Belonging and Inclusion conference in Hull. A mix of professionals, organisations and service users gave talks whose experiences would help to shape future maternity services.

Leaders encouraged engagement and learning with external stakeholders and forums either in person or via attendance at webinars. For example, we saw that attendance at the Humber and North Yorkshire Local Maternity and Neonatal System Perinatal Safety Learning Forum encouraged learning and made recommendations to improve clinical practice among the multi-disciplinary teams.

Ad-hoc supportive debriefing sessions were attended by the MDT where they focused on what went well and identified areas for learning.

Community and outpatient services were provided in Ripon Hospital for local populations, which included a large asylum seeker population. Staff said a vulnerabilities midwife was to be employed to support women and families who were hard to engage. A risk assessment to identify the level and understanding of the English language was not in place for women whose first language was not English. Staff said family interpreters were sometimes preferred although an external interpreter could be provided. However, staff did not distinguish between the woman’s understanding of social conversations and the more complex understanding of medical discussion and agreement to treatment plans. The trust had translation videos which had a human avatar reading the booklet to make it accessible, this included the different prenatal tests, induction of labour and all other aspects of care pathway.

Consultant staff held clinics on Tuesdays and women could also access scanning services at Ripon. In addition, 0-19 years support was provided for breast feeding. Staff said a breast-feeding support group was to be established in Ripon.

Support for high-risk pregnancy was provided and identified. Women and their babies were often cared for in a larger maternity service at a local NHS Trust. The electronic information system Badger net was updated so that women’s care plans were current. Staff said the bereavement midwife was aware of potential palliative care babies and their families to ensure support was provided when needed.

We provide appropriate, accurate and up-to-date information in formats that we tailor to individual needs.

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.

The trust systems, processes and guidance which ensured compliance against data protection requirements.

The trust complied with the Accessible Information Standard (AIS) as of June 2025. The AIS was supported through clear processes and guidance. Leaders said the trust had an AIS communication guide that was used across the organisation. The trust website had recently undergone an accessibility audit by the Government Digital Service; the outcome was to be communicated. The trust had a tool on its website located at the top of each web page which allowed the user to change web page text to over 100 different languages.

Staff ensured that patients could obtain information on treatments, local services, patients’ rights, how to complain and so on. The information provided was in a form accessible to the patient groups (for example, in easy-read form, different languages). Staff made information leaflets available in languages spoken by women. When necessary, arrangements for a translator or interpreter were made to support the woman whose first language was not English.

Staff made notifications to external bodies as needed.

Following a woman’s attendance at the early pregnancy assessment unit a notification was sent to the antenatal clinic informing them of the pregnancy. When women did not speak English or understand how to navigate the service staff escorted them to the antenatal clinic.

The electronic system Badger net and the baby buddy app provided information for families. The baby buddy app was designed to help parents and parents to be through pregnancy and the first year of a baby’s life. Badgernet information could be provided in different languages, however, staff were unsure as to whether this information was available in different languages and whether the information provided by the baby buddy app was consistent with that provided on Badger net.

Staff ensured carers and families were regularly updated about women’s progress.

Mediviewer will be rolled out gradually from October 2025; Obstetrics & Gynaecology have been identified as early adopters and will be the first services to go live. Mediviewer will empower clinicians with easy access to past patient encounters in a clearly structured and easily searchable format.

We make it easy for people to share feedback and ideas or raise complaints about their care, treatment and support. We involve them in decisions about their care and tell them what’s changed as a result.

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

Throughout the service we observed patient feedback displayed in the form of thank-you and feedback cards. Information pertaining to the 2024 patient survey was displayed in different languages.

We received mixed responses from women in relation to the services complaints process on how to raise a complaint. Some women said they did not know how to raise a complaint but had recognised their stay had been short and they had been happy with their birthing experience.

Not all women knew about the patient survey.

Leaders said on Tuesday afternoons a maternity huddle included information and updates on complaints status. We saw a copy of the oversight complaints summary document which identified key messages.

Minutes of the maternity and neonatal safety champions group (dated 9 June 2025) confirmed some issues raised by the maternity and neonatal voices partnership included concerns about language use and how news was broken. There was a perception that some consultants were not always empathetic. It was noted that patients thought they were being seen by a consultant when they were not. We saw 2 actions identified to ensure information was clearer which included greater clarity in appointment letters so patients knew they would not necessarily be seen by a consultant and the introduction of posters in clinics which confirmed who was in clinic that day and explanations of roles.

Complaints guidance was in place and could be accessed through the complaints policy and / or by contacting the Patient Experience Team. We saw information displayed through the clinical areas asking for feedback. When patients complained or raised concerns, they received feedback. Staff protected patients who raised concerns or complaints from discrimination and harassment.

Eighteen complaints were received by the service from 1 July 2024 – 2 July 2025. Of these 11 complaints were upheld and had been closed; 2 complaints were under investigation. We observed 11 complaints related to Pannal ward and the main themes related to the care received, followed by birth experiences.

Staff knew how to handle complaints and had received feedback on the outcome of investigation of complaints and acted on the findings. Learning from complaints was also shared through committees, staff meetings and via the padlet system.

We make sure that everyone can access the care, support and treatment they need when they need it.

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 4 - bedded maternity assessment centre (MAC) operated 7 days per week from 7.30 am – 8 pm. Referrals to the MAC were through the antenatal clinic, community midwives, GP, accident and emergency, the ambulance service or via a self-referral. There was adequate medical cover day and night, a doctor could attend the ward quickly in an emergency. In the last 12 -months an average of 4291 women had attended the MAC; staff confirmed a monthly average of attendance as 357 women.

The service received referrals from several sources and had a total of 3362 referrals from July 2024 – June 2025; of these 2448 (72.8%) were self-referrals and 434 (12.9%) were GP referrals.

In the last 12 months 13053 women had attended the antenatal clinic.

From July 2024–June 2025 there were 1,651 births at the hospital. Women’s average length of stay was 2.15 days.

There had been no emergency theatre transfers from April 2024 – April 2025.

Bed occupancy on Pannal ward from 31 January 2024 – 30 June 2025 ranged from 42.13% to 62.24%.

From July 2024 – June 2025 there had been 32 emergency readmission's following discharge.

From July 2024 – June 2025 18 women were transferred out to other hospitals.

Trust stratified data confirmed the service had 35 closures from March 2024 – March 2025 which had resulted in 30 diversions to other trusts. There were 20 occasions during this period when staffing levels had meant diversions had taken place. One change now implemented meant consultant staff were now present on the Delivery suite to provide additional support to ensure women received 1-1 care. A business case resulted from the divert concerns which resulted in the agreement the service could recruit 5.7 wte. band 7 midwives. This meant an extra band 7 midwife was present at night and weekends. This would improve staffing and skill mix in the Delivery suite. When diversions and / or closures were anticipated the service communicated daily with the local maternity and neonatal networks to ensure safety of the women using the service. Staff could also contact the on-call midwife (overnight only) or director on call for support. The consultant obstetrician discussed potential transfers and admissions with the site coordinator. During the assessment the service closed on the evenings of the 22 and 23 July 2025 due to acuity.

In the last 12 months the home birth service was suspended twice.

Over the last 11-months staff said an average of 67% of women were booked into antenatal clinics for their first appointment by 10 completed weeks. Bookings were lower in August, September 2024 and January 2025 and ranged from 58.8% to just below 60%.

The maternity and neonatal voices 15 steps audit was completed earlier in 2025 and one recommendation was to review antenatal clinic on site waiting times as this was seen in the comments made by friends and family. However, we noted that despite this finding no action was taken as waiting times data in clinics was not collected or audits identified to collect this data.

During the antenatal period electronic referrals were reviewed by a consultant anaesthetist who planned what intervention the woman required. In high-risk cases women were reviewed face to face and a plan made with their involvement. The anaesthetist undertook debriefing sessions with women who had traumatic experiences.

If the maternity anaesthetist was busy the consultant of the day would be called. They were onsite until midnight. After midnight the anaesthetist attended emergencies as soon as possible.

The service had one dedicated obstetric theatre next to the Delivery suite area. Some emergency theatre activity took place in the hospital’s main theatres if the obstetric theatre was in use. Staff said the main hospital theatres were located close by along the main corridor that the maternity unit was based on. The main theatres did not have a dedicated maternity theatre the first available theatre was used. If a second theatre was required, the Delivery suite coordinator, midwife, contacted the on-call consultant to come into the hospital. Staff said consultant staff had mostly responded quickly to these calls. A designated midwife always accompanied the women to and from theatre.

A separate team of anaesthetists performed elective caesarean sections; two anaesthetists were present at each procedure. Elective caesarean activity had increased as the service now accessed two theatres. The service operated 3 half-day caesarean lists weekly in the main theatres. The Harrogate Maternity Services Overview (January 2024 – December 2024) confirmed 329 (19.0%) of women had an elective caesarean, whilst 398 women (23.2%) had an emergency caesarean section.

From July 2024 – June 2025 there were 6 cancelled procedures due to the theatre list having over run.

The service booked 2 induction of labour (IOL) women daily, although, this could increase to 4 if there was sufficient capacity. Some women experienced a delayed induction of labour. The service induction of labour statistics from September 2024 – June 2025 confirmed there had been between 1 – 13 IOL delays, The highest IOL delays were in January 2025 and June 2025; these were 13 and 11 respectively. The June 2025 strengthening maternity and neonatal report confirmed during June 2025 there were 11 delays in induction of labour of over 24 hours. The birthrate plus staffing and acuity data from January to June 2025 identified 11 red flags, of which 8 were for delayed or cancelled inductions of labour.

Staff said paediatricians were newborn and infant physical examination (NIPE) trained, and they ensured all babies were reviewed.

Staff planned for patients’ discharge, including good liaison with care managers/coordinators. Discharge was never delayed for other than clinical reasons. We asked whether the service had experienced delayed discharges in the last 12 months and were told that delayed discharges were not monitored within maternity services.

We actively seek out and listen to information about people who are most likely to experience inequality in experience or outcomes. We tailor the care, support and treatment in response to this.

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.

The maternity service strategy’s health and well being priority recognised the importance of reducing inequalities in perinatal outcomes for women of minority ethnic groups. The work included the implementation of individualised care programmes to improve outcomes and to tackle the findings of recent Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries (MBRRACE) reports. Please refer to the monitoring and improving outcomes section of the report for further information with regards to the trusts MBRRACE reports.

The service monitored protected characteristics such as ethnicity and deprivation when women attended the maternity inpatient services. Statistics from July 2024 – June 2025 defined women by ethnicity and deprivation. For deprivation decile 1 represented the most deprived 10% of local areas, the statistics confirmed 1% of women within this range. Most women were identified within decile 5 to 10 (11,818).

We saw examples of clinical guidelines and guidance in place, for example, learning disabilities and supporting transgender patients, service users and staff. The guidance helped staff ensure that all people’s needs and potential risks were identified and met. One example related to the outcome from a safety incident meeting on the 27 February 2025 where the documentation confirmed an awareness of possible ethnic bias and the addition of an alert for the awareness of cultural needs and birth planning.

Day surgery selection criterion referenced exclusion criteria when considering a women’s discharge post-surgery. We saw examples of anonymized cases where the midwives supported, cared for and explained what was happening. The examples showed good interactions with the mothers and in one case a personalised risk assessment.

The trust recognised the importance of equality of perinatal care for childbearing persons who identified as transgender or non-binary, as well as those with learning disabilities, disabilities or those who had complex social risk factors. A vulnerabilities midwife was due to start in post from September 2025 who we were told would provide support to these groups. Staff said a learning disabilities nurse could be approached for advice and to provide support for people with learning disabilities.

Staff within the service and the wider organisation promoted a culture in which the people using the service felt empowered to give their views. One example was when women were asked what type of care they wished to receive by 12 weeks of pregnancy. The trust had a target of 100% for this area. Staff confirmed the service had achieved 88% compliance by 12-weeks of pregnancy.

Staff said transitional care babies were currently admitted to Pannal ward which had 2 transitional care spaces open at the time of the inspection. The service could flex the number of bed spaces available for Transitional Care as required. The strengthening maternity and neonatal safety report for June 2025 confirmed 8 babies were admitted to Pannal ward in June 2025. Staff said the development of a transitional care unit was currently under review.

The infant feeding coordinator had provided a tongue tie division service for the past 1.5 years when 4 -6 procedures weekly were carried out. Two midwives were trained in the procedure, and a third midwife was being trained. To ascertain satisfaction an audit of the service was completed in 2024/25.

Staff completed 3-yearly equality, diversity, inclusion and human rights training and compliance for 2024/25 ranged from 92% to 100%.

We support people to plan for important life changes, so they can have enough time to make informed decisions about their future, including at the end of their life.

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

The service completed its self-assessment against the National Bereavement Care Pathway (NBCP) pathway on the 30 July 2025. The next review was planned for November 2025. The NBCP tool enabled trusts to self-assess their current position against the nine NBCP standards which underpinned best practice in bereavement care, and developed an action plan to improve services to reach those standards accordingly. The trust scored 108 out of 120 which meant as the score was above 90, they were championing the NBCP standards. The trust submitted an action plan which included 9 actions as part of this review. We saw ongoing work had been planned against 8 actions, whilst one action was completed in July 2025. The actions also included additional training for staff groups, some specific mandatory training days were planned for September / October 2025.

The Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) clinical guideline advised staff in this area. The ReSPECT process created a personalised recommendation for a person’s clinical care in emergency situations and consisted of conversations between the women and / or family and healthcare professionals. We also asked how many staff had completed ReSPECT training in 2024 / 25, this information was not provided by the trust.

Additional staff guidance which related to this area included: Adult - Do not attempt cardiopulmonary resuscitation (DNACPR), Care in the last days / hours of death and care after death (Adults) under the care of HDFT v1 (Hospital and Community) and guidelines for caring for women with stillbirth, late miscarriage or neonatal death.

Following a perinatal loss, parents who consented to a postmortem were sent to a local NHS Trust for the postmortem to be performed by a perinatal pathologist. People could attend the bereavement group and would be signposted to the appropriate support agency, for example, counselling. Annual review reports were produced by the charity which included positive client feedback.