Queen's Hospital

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

The service did not consistently uphold standards of kindness, compassion, and dignity, particularly in the triage area, where women experienced long waits without sufficient seating, food, or drink. Privacy and dignity were compromised as labouring women remained in overcrowded waiting areas due to bed shortages. Breaches of confidentiality were observed, with unsecured patient notes and visible patient details compromising privacy. Staffing shortages and high acuity occasionally limited the level of compassionate care provided, impacting the overall experience for women.

Despite these challenges, many women reported feeling respected and cared for by staff who were attentive to their needs. Initiatives like collaboration with 'The Baby Loss Counselling' charity and cultural sensitivity in NICU support demonstrated the service's commitment to emotional wellbeing. Women appreciated the flexibility and inclusivity of the service, including accommodations for cultural, religious, and communication needs. The birth options clinic and trauma-informed care approaches enabled women to retain independence and control over their care decisions.

This service scored 65 (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 did not always treat women with kindness, empathy, and compassion or respect their privacy and dignity. During the inspection, women in the triage waiting area were observed waiting for extended periods without sufficient seating or access to food and drink, which compromised their comfort and dignity.

Despite these challenges, women frequently reported that staff were kind and compassionate, responding promptly to their pain, discomfort, or distress. Observations during the inspection supported this, with examples of staff demonstrating compassionate care and attentiveness. However, women expressed that staffing shortages and high acuity occasionally impacted the level of personalised and compassionate care they received.

The service collaborated with 'The Baby Loss Counselling' charity to provide up to five counselling sessions for women who had experienced baby loss. This initiative was well-received, with feedback from women highlighting the supportive and empathetic nature of the service. From April to September 2024, 25 women were referred to this counselling service, with 16 actively engaging. Women spoke positively about the cultural sensitivity of the support offered and appreciated practical measures such as parking concessions for families with babies in the Neonatal Intensive Care Unit (NICU).

Patients' notes were not always secured; trolleys containing notes were left unlocked, and patient details displayed on boards were visible to anyone approaching the ward desk. These practices risk compromising patients' privacy and undermine the service's efforts to maintain confidentiality.

While many women reported feeling respected and cared for by staff who were compassionate and responsive to their needs, systemic issues such as overcrowding, delays, and a lack of privacy in triage areas limited the service's ability to consistently uphold high standards of dignity and emotional wellbeing.

The service consistently treated people as individuals, ensuring that their strengths, abilities, aspirations, cultural backgrounds, and unique characteristics were taken into account. Women attending the antenatal clinic expressed that the service demonstrated flexibility in accommodating their appointments, which was particularly appreciated by those with complex schedules or additional needs.

The service prioritised meeting the personal, cultural, social, and religious needs of women using the service. Women reported feeling respected, with staff making accommodations such as ensuring female-only staff were available when requested for cultural or religious reasons. These efforts reinforced a sense of dignity and inclusivity, ensuring women felt comfortable and supported during their care.

Communication needs were effectively addressed to enable meaningful engagement in care, treatment, and support. Translation services were readily available and promoted to support women whose first language was not English. This was further complemented by welcome signs in labour rooms displayed in multiple languages, reflecting the diversity of the service's user population and fostering a welcoming environment.

The service also ensured reasonable adjustments were made to support women with disabilities or sensory loss, demonstrating a commitment to inclusivity. Staff had access to communication aids andwere trained to support individual needs, which allowed women to actively participate in their care. Information leaflets were available in various languages, and staff ensured that interpreters or signers could be accessed promptly when needed.

Staff demonstrated a commitment to enabling women to retain control over their care and treatment, reflecting a person-centred and empowering approach to maternity care. The service promoted independence, choice, and control, ensuring that women understood their rights and could actively participate in decisions about their care, treatment, and wellbeing.

Women reported feeling empowered to make informed decisions, particularly regarding their method of delivery. For instance, one woman highlighted that she felt like an equal partner in the decision-making process, with risks and implications thoroughly explained by a consultant, enabling her to make an informed choice.

The service aimed to provide compassionate, trauma-informed care, with an emphasis on empowering birthing individuals. Women had the choice of where to deliver, with high-risk women who preferred to deliver in the low-risk birth centre being accommodated through the weekly birth options clinic. This clinic, led by a consultant midwife, allowed for personalised planning, ensuring women's preferences were respected and aligned with safe clinical practice.

Women had access to their friends and family while using the service. Birthing partners were supported to stay throughout the delivery process, and visiting hours were available for inpatient wards, helping to maintain important relationships and networks that contributed to women's overall wellbeing.

Staff supported women in understanding their care and treatment, using clear communication and, where necessary, aids to ensure comprehension. Feedback mechanisms were available to women and their families, enabling them to voice their experiences and contribute to service improvement.

The service demonstrated responsiveness to women's immediate clinical needs, particularly in emergency situations. Women consistently reported that staff acted quickly and effectively to provide the necessary care during emergencies, ensuring that their immediate health concerns were prioritised. This responsiveness was evident in the ability of staff to quickly recognise when someone required urgent help or support.

However, the service faced challenges in meeting non-clinical needs and responding to all immediate needs effectively. Women with young children noted that the service did not always adequately accommodate their families, highlighting a gap in addressing broader personal needs.

During the inspection, we observed instances where the service was unable to immediately transfer patients to the appropriate clinical area due to capacity issues. For example, one patient on the ward required urgent transfer to the labour ward but was delayed because no beds were available, this failedto uphold their privacy and dignity during a vulnerable time. Despite this, staff worked to manage the situation as effectively as possible within the constraints of the environment, providing care in the current location while escalating efforts to arrange the transfer.

These delays reflect the broader challenges with access and flow across the unit, which have impacted the service's ability to always respond to women's needs in a timely manner. While staff made commendable efforts to adapt and provide care in less-than-ideal circumstances, the delays in moving patients to the right clinical area could impact the overall quality and experience of care provided.

The service demonstrated efforts to care for and promote the wellbeing of staff; however, there were areas requiring significant improvement. Overall, staff reported a generally positive culture, feeling supported by their colleagues and senior leadership. Nevertheless, they also highlighted incidents of incivility, which had negatively impacted their wellbeing. Staff noted that while these concerns were being addressed under new leadership, with initiatives such as a perinatal culture and behaviour forum for leaders, the incidents contributed to feelings of being undervalued.

Staff reported that poor staffing levels and increased workloads exacerbated the pressure, leading to difficulties in maintaining morale. They expressed that while they felt able to have open conversations and raise concerns, actions in response were not always evident.

Resources and facilities for safe working were not consistently prioritised. Staff reported that they were not always able to take breaks during their 12-hour shifts, and inspectors observed midwives leaving the unit up to two hours after their scheduled end of shift due to unsafe conditions in clinical areas caused by high acuity and staffing shortfalls.

Pastoral support for internationally educated midwives (IEMs) was a strength of the service. Initiatives included creating WhatsApp groups for peer support and communication, both within IEMs and with local staff. The service also signposted IEMs to The Society of Afro-Caribbean (SOAC) for additional networking and support. Monthly forums, an open-door policy from the education and senior leadership teams, and mentorship opportunities further reinforced the support structure. IEMs reported feeling valued by these initiatives but noted challenges with perceived inequities in reasonable adjustments, development, and progression opportunities compared to UK-trained midwives.

Managers supported staff development through tailored inductions and annual appraisals, with clinical educators facilitating learning and development needs. However, staff reported that the increased workload and limited resources often undermined their ability to fully benefit from such opportunities.

The service showed awareness of the need to improve workforce wellbeing and had initiated some measures, but further action was required to ensure staff felt consistently valued and supported, with adequate resources to manage workloads effectively.