Queen's Hospital

On this page

• 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

The service assessed and met women's health, wellbeing, and communication needs, providing personalised care aligned with national guidelines and evidence-based practices. Initiatives like the `Cradling Culture Project' and specialist clinics demonstrated a commitment to equity, health promotion, and holistic care. Multidisciplinary collaboration was robust, ensuring continuity of care and addressing both physical and psychological needs. Women reported feeling supported and empowered to make informed decisions, with staff demonstrating knowledge of consent processes and mental capacity legislation. Monitoring through audits and national benchmarking reinforced a culture of improvement, with outcomes generally meeting clinical and patient expectations.

However, there were areas for improvement. The dual use of paper and electronic records created inefficiencies, delaying access to essential information. Facilities and interactions for birthing partners required enhancement to ensure inclusivity and respect. While consent processes were generally strong, routine procedures occasionally lacked explicit consent, and delays in addressing clinical pathways highlighted a need for more proactive management. Addressing these issues will further enhance the effectiveness and equity of care.

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.

The service effectively assessed and reviewed women's care, ensuring their health, wellbeing, and communication needs were addressed. Women reported feeling actively involved in planning their care, particularly in the antenatal clinic, where personalised birth plans were developed in collaboration with staff. Communication needs were thoroughly assessed and met, with translation services available to support non-English-speaking women, despite occasional connectivity challenges due to the building's infrastructure.

A notable initiative was the 'Cradling Culture Project', which offered tailored and equitable support for women from Black, Asian, and Minority Ethnic backgrounds. Volunteers from this programme provided advocacy and practical support, including attending appointments and births, staying overnight as additional birthing partners, and helping women navigate their care. Staff were well-informed about this project, and its benefits were widely promoted across clinical areas.

However, the needs of birthing partners were not always fully considered. Feedback from women indicated that facilities for their partners could be improved, and staff interactions with birthing partners were sometimes perceived as less respectful, highlighting an area requiring further attention.

The service aimed to provide care and treatment in line with legislation and evidence-based good practice. It was one of five trusts that implemented induction of labour at 40+7 weeks as per NICE guidelines. These guidelines highlight the increased risks of continuing pregnancies beyond 40+7 weeks, including higher likelihoods of caesarean births, neonatal intensive care unit (NICU) admissions, stillbirth, and neonatal death.

Care and treatment were delivered based on national guidance and evidence-based standards, with managers ensuring that staff adhered to up-to-date policies and procedures. Staff were encouraged to stay informed about relevant legislation and clinical standards, which were integrated into care planning and delivery. This approach supported the consistent provision of high-quality care aligned with current best practices.

Psychological and emotional needs were considered during care planning, particularly during handovers, where staff routinely discussed these aspects. This holistic approach contributed to personalised care that reflected the individual needs and preferences of women and their families.

The service ensured that the rights of women subject to the Mental Health Act 1983 were protected and adhered to the associated Code of Practice, demonstrating its commitment to meeting legal and ethical standards in care delivery.

Managers and leaders supported staff to learn about innovative approaches to care, fostering an environment of continuous improvement. While no specific innovations were observed during this inspection, the service's commitment to embedding evidence-based practices and national guidelinesinto its care model ensured that patients received treatment aligned with the latest clinical recommendations.

Despite staff feeling stretched, there was collaborative working across teams that sought to support patients and promote continuity of care. Multidisciplinary working was evident across all clinical areas, with doctors, nurses, midwives, and allied healthcare professionals collaborating to provide comprehensive and coordinated care. Regular and effective multidisciplinary team meetings were held to discuss patient care and identify opportunities for improvement.

Staff reported that they had access to the information necessary to assess, plan, and deliver care, treatment, and support effectively. However, the use of both paper and electronic notes created challenges, as finding information could be time-consuming. The service has planned to address this issue by introducing an electronic patient record system in September 2025, which is expected to streamline information sharing and improve efficiency.

Information sharing between teams and services was observed to be robust, ensuring continuity of care. Staff used the SBAR (Situation, Background, Assessment, Recommendation) format during handovers and when transferring patients between clinical areas. Comprehensive handovers at the start of shifts were conducted in a structured manner, ensuring all team members were updated on patient needs and care plans.

Collaboration extended to external agencies and services when necessary, including referrals for mental health assessments for women presenting with signs of mental ill health or depression. This demonstrated the service's commitment to a holistic approach to care, ensuring patients' physical, psychological, and emotional needs were met.

The service supported women to manage their health and wellbeing, empowering them to make informed decisions and take greater control over their care. Women consistently reported feeling supported by staff who demonstrated an understanding of their individual needs and preferences.

Specialist clinics and services within the antenatal department, such as vaccination clinics, smoking cessation support, and diabetic midwife clinics, played a key role in promoting healthier lifestyles and addressing specific health risks. Women with gestational diabetes, in particular, highlighted the positive impact of education classes led by an empathetic diabetic midwife. These classes provided practical knowledge, eased anxiety, and offered ongoing telephone support, enhancing both health outcomes and overall wellbeing.

The service identified women suitable for targeted support early, often during their booking appointment with community midwives. This proactive approach ensured timely interventions, enabling women to access services that aligned with their health needs and goals.

Women also reported that antenatal health assessments and checks were regular and comprehensive. The service provided appropriate contact details for women to raise concerns about their health, ensuring they felt supported throughout their care journey.

The service prioritised health promotion by offering tailored advice and practical support, which helped women make healthier lifestyle choices. This holistic focus on wellbeing aimed not only to address current health needs but also to reduce the risk of future care requirements.

The service routinely monitored the effectiveness of care and treatment through a comprehensive programme of audits, using the findings to drive improvements and ensure outcomes met both clinical expectations and the needs of women using the service.

Staff actively participated in national clinical audits, benchmarking their performance against relevant standards to identify areas for enhancement. Audit findings were shared with staff, ensuring they were aware of trends, outliers, and necessary changes to improve care delivery.

Outcomes for women were consistent and generally positive, reflecting alignment with national standards and evidence-based guidance. The service demonstrated a commitment to continuous improvement by investigating audit outliers and implementing targeted interventions to address identified issues. These interventions were monitored over time to ensure sustained improvements in care quality.

Accreditation under relevant clinical schemes further highlighted the service's adherence to high standards of care and treatment. However, where areas of improvement were identified, such as delays in specific clinical pathways, the service engaged in proactive measures to refine processes and outcomes.

By maintaining a strong focus on monitoring and improvement, the service sought to deliver positive and consistent outcomes that supported the health, wellbeing, and satisfaction of women under its care.

Perinatal mortality data published in February 2025, covering the reporting timeline of this assessment, indicated a perinatal mortality rate of 4.37, which was classified as an outlier. The trust had already been addressing this issue prior to publication. Board meeting minutes from September 2024 and March 2025 evidenced discussions about perinatal mortality and highlighted a focus on health inequalities. The trust had identified deprivation as a key determinant influencing poorer outcomes for women and had implemented a strategy aimed at addressing this disparity. This work reflected the trust's proactive approach in using outcome data to identify inequities and implement targeted interventions that were subject to ongoing review and oversight.

The service worked to respect people's autonomy and support informed decision-making, with systems in place to ensure compliance with consent-related legislation and guidance. Staff demonstrated a commitment to ensuring that people understood their rights around consent and respected these when delivering care and treatment. Women reported that staff generally explained procedures and provided information in a way that enabled them to make informed decisions about their care. However, some women noted that consent for routine procedures, such as blood draws, was not always explicitly sought, with staff often informing them of actions rather than directly asking for their agreement. Despite this, women felt comfortable speaking up if they wished to decline a procedure, highlighting a sense of empowerment and mutual respect.

We observed that consent forms were consistently completed for all surgical procedures, ensuring compliance with legal and professional standards. Staff followed national guidance for gaining consent and demonstrated an understanding of how to support women who lacked the capacity to make decisions. This included taking into account individual wishes, cultural considerations, and best interests when making decisions on behalf of women who could not consent themselves.

The service ensured that staff were trained in the Mental Capacity Act 2005 and knew how to access policies and advice when needed. Staff also demonstrated an understanding of the legal requirements around consent and decision-making, including Gillick Competence and Fraser Guidelines for supporting young people in making decisions about their care.

The service provided information about care and treatment in accessible formats, enabling people to make informed decisions. Advocacy and support services were available where needed, ensuring that women had the necessary resources to understand and consent to their care.