Musgrove Park 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

We looked for evidence that people and communities had the best possible outcomes because their needs were assessed. We checked that people’s care, support and treatment reflected these needs and any protected equality characteristics, ensuring people were at the centre of their care. We also looked for evidence that leaders instilled a culture of improvement, where understanding current outcomes and exploring best practice was part of their everyday work.

This is the first inspection since maternity became a standalone service group. This key question was not included in the 2024 inspection of maternity services. This key question has been rated good.

This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

We have not awarded this service a score for Effective.

Find out about when we will not publish a key question score and what we look at when we assess Effective.

We scored the service as 3. The evidence showed a good standard. The service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Staff completed a comprehensive health assessment of women in a timely manner. We reviewed 7 sets of records and found all assessment areas were completed, including relevant risk assessments. Women had access to their records, and this was confirmed when speaking with women. Staff updated care plans when necessary.

Care plans were personalised and holistic. Community midwives assessed women throughout their pregnancy for any risks and discussed these with them so that they could be incorporated into their birthing plan. As much information was obtained as possible, even if out of the Somerset area. If a home birth was requested outside of guidance, a referral was made to a consultant to discuss home birth where a plan of care would be agreed. This was in line with the policy.

The service had a draft policy for when women with no medical indication for a caesarean birth requested this. Alternative birth options were discussed and the royal college of obstetricians and gynaecologists (RCOG) leaflet on ‘Choosing a Caesarean Birth’ would be provided. If the decision remained, they would be referred for obstetric review to discuss the overall benefits and risks considering their individual circumstances.

Women were screened for their risk of depression using a recognised tool. Women were referred to the women requiring extra nurturing (WREN) if required.

Women’s communication needs were assessed and met to maximise the effectiveness of their care and treatment. Staff told us they had access to translation services, these were either face to face interpreters (booked in advance) or phone interpreters if last minute. Double appointments were usually used in these cases to allow more time.

The home birth team completed visits to discuss preparation for delivery, what to expect and cases where deviation of the plan may occur. We observed a home birth assessment during our inspection and found the woman was able to ask questions and the midwife was very supportive.

We scored the service as 2. The evidence showed some shortfalls. The service did not always plan and deliver people’s care and treatment with them.

There had been an increase in the number of staff receiving appraisals since our last inspection. At this inspection there was 69% compliance for midwives and medical staff, 74% for specialty midwives and 100% compliance for antenatal clinic staff. Therefore, this had improved but was still below trust target in some areas.

Data collected in relation to the World Health Organisation (WHO) surgical safety checklist (a tool which aims to decrease errors and adverse events in theatres and improve communication and teamwork) showed between July and September 2025 compliance was 80%. This was below the target of 100%. There was a potential system related issue which the service was reviewing. Sign-ins had been completed but not saved which was potentially due to device timeouts. Theatres and maternity used different systems. The trust had agreed a single system was required to improve consistency and support clearer monitoring of compliance.

At our previous inspection we found the service did not have an effective program of regular audits to ensure the safety and quality of the service was monitored. Audits were not completed or reviewed for Situation, Background, Assessment, and Recommendation (communication framework), triage, Maternity Early Warning Scores or patient records. Cardiotocography (which monitors a baby's heart rate) data was not broken down into months for comparison and there were no associated action plans. At this inspection we found these audits were being completed, however they were not always timely. For example, MEWS audits had not been completed for quarter 3 or quarter 4 (October 2025 to March 2026). The service provided evidence which demonstrated staff participated in clinical audit, benchmarking and quality improvement initiatives. New topics for inclusion in the audit programme were considered through a dedicated audit and guidelines meeting.

The service monitored data in relation to the ‘saving babies lives’ (SBL) bundle. Saving Babies Lives is a national framework to improve maternity care quality and outcomes across England. It is a set of evidence-based actions for maternity services to significantly reduce stillbirths, preterm births, and neonatal deaths. The focus is on areas such as, stopping smoking in pregnancy, monitoring fetal growth and recognising reduced fetal movement.

At this inspection we found Newborn Early Warning Trigger and Track (observation framework) forms were used and audited, which was an improvement. Between October and December 2025, the service was between 97% and 100% compliant. This included newborn assessments, observations and escalation and met the target.

Managers ensured that staff had access to regular meetings to keep them updated for example, with any safety information and changes to practice. Staff received the necessary specialist training for their roles.

Staff assessed and met women’s needs for food and drink and for specialist nutrition and hydration. Women confirmed they were able to access food and drink to meet their dietary needs.

The service had access to specialists required to meet the needs of patients in the service. As well as doctors and nurses, staff could contact or refer to talking therapies, perinatal and maternal mental health teams and infant feeding teams. We observed community midwives signposted women to professional guidance and discussed the risks of obtaining information from social media. However, there was no specialist midwife for diabetes.

We scored the service as 3. The evidence showed a good standard. The service worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Staff told us how they could access specialist midwives to support women they cared for and improve outcomes. For example, midwives with expertise in mental health and bereavement care. Multidisciplinary prebirth planning meetings took place to review the woman’s history, risks, triggers, indicators, birth plan, post-natal visits and support required. Women who received specialist support for substance misuse were discussed at monthly meetings between the named midwife and the local drug and alcohol service. The strengthened oversight increased the likelihood of a complete picture of needs.

Staff we spoke with were positive about the practice development lead and simulation training. Staff told us they felt multidisciplinary teams worked well in these scenarios.

Staff held regular and effective multidisciplinary meetings. Staff shared information about women at handover meetings within their team. Staff also shared information to community midwifery teams when women were discharged to ensure continuity of care. Multidisciplinary discharge meetings were held for vulnerable patients or those with safeguarding issues where support for the family was discussed.

The service worked closely with the maternity and neonatal voices partnership (MNVP). MNVP were quorate members of meetings, and they formed part of coproduction of services, so the voice of women were included into service design and developments.

The service worked with the regional maternity and neonatal team, commissioning support unit and Southwest neonatal network to pilot the Southwest in utero facilitated transfer (SWIFT) service. The aim of the pilot was to standardise transfer requests and ensure pre-term infants were delivered in the most appropriate setting. Staff we spoke with said this had been positive. If no one was available in SWIFT, the task fell to a midwife.

However, some staff we spoke with felt there was a divide between the trust’s maternity sites. Some staff said there was not always a cohesive cross site service. Some staff did not feel cross site working worked well.

We scored the service as 3. The evidence showed a good standard. The service supported people to manage their health and wellbeing to maximise their independence, choice and control. The service supported people to live healthier lives and where possible, reduced their future needs for care and support.

Staff assessed women’s health on admission and supported individual needs. A well-being questionnaire was sent 4 weeks after birth for mental and physical health and new parents were signposted for further support. Smoking status was checked at booking using carbon monoxide monitoring. Women were offered cessation advice and referral to specialist services.

Women were mostly supported to initiate breastfeeding in hospital and after discharge where able. Information boards and printed materials promoted healthy lifestyles and offered guidance on topics such as breastfeeding.

We were told vaccination uptake was good, conversations were had throughout pregnancy and drop in vaccination clinics were available within the community.

We scored the service as 2. The evidence showed some shortfalls. The service did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.

The service saw an increase of babies readmitted to hospital under 30 days old during February 2025; but had since recorded a reduction month on month up to June 2025. The service was aware of this and had made some changes to the community midwife teams, with other areas in consultation. It was recognised improvements were needed in relation to infant feeding teams and there was a drive to improve outreach for neonates.

The service had implemented the saving babies lives care bundle (SBLCB). The saving babies lives care bundle is a national initiative intended to reduce stillbirth, neonatal deaths and preterm births by bringing together 6 elements of care which are widely recognised as best practice. Overall, the service had partially implemented these interventions at 78%. There was an action plan with quarterly oversight.

Performance was monitored using an audit system. Audit results were reviewed by leaders within the service and included transfer rates from midwifery led care to obstetric care, this showed the average transfer rate over 2 years remained below the national average. Consultants were in attendance for any return to theatre; audit results showed the service was 98% compliant and within target between July 2025 and September 2025. This was the most recent evidence provided. Data for the induction of labour (IOL) audit was dated June 2024. The audit showed the service were below the national average for IOL rates however, an action plan had been produced, and 3 monthly reviews were planned from January 2026. We were not sent evidence of the latest review. The last completed audit for time from decision to delivery of caesarean sections was November 2024. The report had been presented at the cross-county meeting, where proposed actions had been discussed, resulting in an agreed action plan. A re-audit was planned to review activity between 1 April and 30 June 2025, with analysis and reporting scheduled for completion by January 2026. However, we were not sent results of this.

Staff participated in benchmarking and quality improvement initiatives. Clinical Quality Improvement Metrics (CQIMS) are a set of metrics derived from the Maternity Services Dataset for the purpose of identifying areas that may require local clinical quality improvement. In June 2025, CQIMS data showed the service performed worse than the national average for women who had a post partum haemorrhage (PPH) for a period of time before recording a reduction between July 2024 and January 2025. Since then, PPH rates had started to increase again. Leaders told us the service had not responded fast enough to changes in national guidance but was now within normal national levels.

Construction of a new local outcome data dashboard was commissioned and there had been several demonstrations but none of them were suitable due to lack of functionality. For example, the data could not be filtered for ethnicity, deprivation or language barriers. The internal informatics team produced a temporary dashboard and reviewed the data manually for adverse incidents relating to ethnicity, deprivation or language barriers. Ethnicity and individual deprivation details had been added to incident review proformas. Work was ongoing to produce the dashboard. The service had secured funding to have a dedicated digital maternity team.

We scored the service as 2. The evidence showed some shortfalls. The service did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

Midwives understood how to assess decision-making capacity. Our review of records confirmed consent forms were completed for caesarean sections, we observed consent being obtained before treatment commenced. We requested the audit of documentation including consent, and we received the maternity qualitative record keeping audit, however this did not include consent. Therefore, there was no evidence the service was assured they were compliant with obtaining consent from women for care and treatment.

Women reported mostly receiving sufficient information, including risks and benefits, to make informed decisions about their care and treatment. Staff discussed birthing plans and respected individual wishes.

Staff told us they had access to policies and procedures, which were accessible to them through the trust’s intranet site. However, not all policies and procedures were available and there was a programme of work to update these.