Queen Alexandra 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

The capacity and flow of the maternity unit had a significant impact on women accessing the service. There were a high number of times the service was in high level pressure, which meant there was a significant impact on the flow around the maternity unit and women could not always have their preferred place of birth.

However, women were regularly involved in planning and making shared decisions about their care and treatment. They understood their birthing options, including any risks and benefits involved.

At our last assessment we did not inspect or rate this key question. At this assessment responsive was scored as requires improvement.

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 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 could directly refer themselves to the maternity services at the trust if their pregnancy had been confirmed by a positive pregnancy test via a maternity self-referral form before 10 weeks of pregnancy. Women did not have to refer through their GP first.

Feedback from women told us they 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.

During our assessment we reviewed 6 care records which showed examples of person-centred care. Birth plans were personalised and up to date. Feedback from women showed they felt well supported and felt listened to when making decisions about their pregnancy and birth.

The service had a consultant midwife, and part of their role was to support women who chose to birth outside of guidance. They provided women with up-to-date guidance and discussed the 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 which mean they are recommended to have their baby within the obstetric setting.

We saw positive feedback from women who felt they had person centred care. Feedback such as, “I had the best midwife experience during our birth. Midwife went above and beyond for us including listening to our birth plan and sticking to it”.

“Absolutely amazing, I was terrified of having a caesarean section, however the staff were exceptionally understanding and warming, ensuring I understood everything that was going on. I had a mental health plan in place, and all staff adhered to what my requests were”.

“I felt heard and supported from the moment I arrived, midwives were calm, warm and ensured they were fully informed of my birth plan, postpartum plan and what was important to me. After a traumatic birth with my first child, this experience was so healing and empowering”.

“No piece of my birth plan fell into place, but the whole team was very supportive of whatever choice I wanted to make and continuously presented my options without any pressure”.

Women were supported in accessing maternity information and the service had been trialling the pocket talk tool which was an immediate way for information to be translated to women.

There was an infant feeding team who led on implementing the Baby Friendly Initiative (BFI) standards to ensure all staff were available to support mothers and babies with their chosen method of infant feeding. The MNVP alongside the service worked alongside the breastfeeding network and infant feeding team to create events and awareness to support infant feeding.

The service promoted birth choices such as home births and midwifery led birth centres for low-risk women, however this was not always possible in all midwifery led birthing centres due to staff allocations. The birth centre within Queen Alexandra hospital maternity unit had staff rostered to work within the unit, however, the other two maternity led birthing centres there was no staff rostered and women could only birth in the units if there was available staff within the labour ward and community.

The service did not have inhouse counselling services for women experiencing loss. However, bereavement midwives offered pastoral and emotional support and coordinated referrals for women and their partners for counselling.

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.

The service had an emergency department (ED) pathway for pregnant and post-partum women and there was reported to be positive feedback on the integrated working between both maternity and emergency department teams.

A dedicated perinatal mental health team was in place Monday to Friday to support women requiring perinatal mental health assessment and intervention. 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 CQC maternity survey showed women thought the level of mental health support provided by the service was just under the national average.

There were 5 established maternity continuity of carer (CoC) teams as part of an ongoing model of care. The CoC teams provided 25% of the births within the locality with teams delivering the full continuity pathway including intrapartum care. 30% of the CoC caseloads were women from black, Asian and ethnic minority backgrounds.

CoC teams worked with women from high deprivation with high levels of safeguarding needs, unemployment, smoking, high body mass index and lower educational attainment.

Bereavement Specialist Midwives offered pastoral and emotional support and coordinated onward referrals for counselling or psychological support. For example, women had access to a 24-hour chaplaincy service and were able to invite their own faith leaders into the unit for support.

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.

There were informative notice boards around the maternity unit displaying best practice guidance for breastfeeding.

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.

Women had access to interpreting services so they could understand and make decisions about their care. Women confirmed they had been provided detailed information in a way they could understand. This included leaflets in multiple languages.

The MNVP worked with the service to develop ‘what matters to me boards’ for women to communicate their preferences and needs during labour.

The Maternity department had dedicated social media pages which provided a wide range of information on pregnancy, parenting and newborn care. There were also videos which gave parents a chance to see the midwifery led birthing centre before labour and make an informed choice on if this was their preferred place for birthing and equipment. However, staff told us that not all women were able to choose to birth in the midwifery led birthing centres outside of Queen Alexander Hospital.

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.

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.

Senior leaders worked closely and dynamically with the local maternity and neonatal voice partnership (MNVP) to contribute to decisions about care in maternity services. Following on from feedback from the MNVP the service introduced more photos and images using women and families from a diverse background.

Women were able to share their experiences with the maternity service through an online feedback form. The online feedback enabled the identification of themes, concerns and areas of good practice. Examples of the feedback reviewed was, “I was very pleased with my care whilst I was here. Everything was made clear to me, and nothing was too much for them which was lovely”, “Amazing staff that couldn’t do enough to help and look after our new bundle of joy. Thank you to everyone for support with breastfeeding”.

Following feedback received from women attending antenatal and breastfeeding classes that the classes were cramped and full. The service responded by finding a new location with a larger capacity to make the venue more comfortable and useable for women.

Friends and family feedback in March 2026 received a 93% response rate. Majority of the feedback was positive, with a small number of negative responses. Most of the negative feedback was around staff communication and clinical treatment.

From October 2025 to January 2026 the service had received 16 complaints. Due to reporting timelines, we were unable to identify the number of complaints received between February to March 2026.

There were 8 complaints closed within the trust target timeframe, the 8 remaining complaints were still under review and were within the timeframe of 3 months.

Complaint themes were around delays in care, treatment and a lack of communication within the postnatal ward, delays in induction of labour and care in labour.

A common complaint from women and their families was the short visiting times and partners not being able to stay overnight. Staff told us partners could stay overnight but only if the woman was in active labour or in exceptional circumstances.

Following the CQC survey the trust implemented a quality improvement for birth partners to stay in the induction bay. Since November 2025 partners were offered to stay overnight, with ongoing review to support family bays on the postnatal ward. However, there were limited facilities and there were no recliner chairs available.

The CQC Maternity survey 2025, asked, “Thinking about your stay in hospital, if your partner or someone else close to you was involved in your care, were they able to stay with you as much as you wanted?”. The trust scored 2.9 much worse than the national average of 7.4.

We scored the service as 1. The service did not make sure that people could access the care, support and treatment they needed when they needed it.

The capacity and flow of the maternity unit had a significant impact on women accessing the service and honouring choices in preferred place of birth, particularly for the midwifery led unit. From April 2025 to March 2026 the service reported OPEL 3 status, high level pressure 267 out of 365 days and there were 4 incidents of OPEL 4 status. This meant there was a significant impact on the flow around the maternity unit and a higher number of diverts and closure to service.

The service reported there were regular delays in women receiving an induction of labour (IOL) and during March 2026 there were 17 women whose start of induction of labour was delayed above 6 hours from the point of admission to the induction process. Factors for the delays were due to low staffing and high acuity.

Between October 2025 to March 2026 there were 17 cases where women were transferred to a neighbouring trust for their induction of labour due to operational pressures and delays within the service. During our assessment the service stopped accepting women in labour and women were diverted to another regional trust.

There were 4 moderate harm events reported in December 2025 which was attributed to high activity and acuity on the unit alongside several temporary unit closures and delays in care. In satellite maternity units we saw evidence that women in labour were frequently advised to attend the acute hospital rather than smaller midwife run units. This meant women did not always give birth in the place they had chosen.

There were no on-call staffing arrangements for community midwives based at the midwifery led birthing centres. This meant the service may not be able to accommodate a woman in labour wanting to birth at the birthing centre due to a lack of midwives.

The continuity of carer (CoC) teams operated an on-call system; however, this did not mean all women wanting to birth at a midwifery led birth centre were under their teams.

The CoC teams provided 24 hours on call, 7 days a week intrapartum care for women in areas of the highest deprivation as well as black, Asian and ethnic minority communities to offer personalised antenatal care and improvements. The team’s self‑rostered and worked autonomously, which enabled more flexibility.

Following the introduction of continuity teams, it was identified the number of women not attending clinic appointments had reduced.

The service was at the start of a quality improvement project to provide a pathway of care for migrant women who had been in the country for less than 12 months, to improve the care and support provided to them.

We scored the service as 3. The evidence showed a good standard. Staff and senior 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 worked closely with the MNVP and the local maternity and neonatal system (LMNS) to ensure that the voices of women experiencing discrimination or inequality were heard to improve service user outcomes and drive improvement to the service.

Teams worked with staff and families to gain a better understanding of what support is available to families with babies in the community where they live. Work with local black and ethnic minority groups within the local community took place with senior maternity leads to identify what women want when using maternity services.

Women’s feedback was used to improve maternity experiences, and to stop barriers and delays for women to access care. For example, the service had introduced ‘what matters to me’ boards on the labour ward. The boards encouraged staff to understand what was important to the woman during her labour.

Alongside the local maternity and neonatal systems (LMNS) worked towards a 3-year equity and equality report. The trust had a maternity equality and diversity steering group who analysed data from saving babies lives, continuity of care and ethnicity data collection to identify and reduce inequalities.

Community-based family hubs were developed to deliver individualised, personalised support for infant feeding, mental health, and wider family needs following feedback received on providing better mental health and culturally appropriate care to women.

The service offered support for women from black, Asian and ethnic minority backgrounds to access antenatal results and choices counselling (ARC). This was because women from a black, Asian and ethnic minority backgrounds were less likely to access mental health services due to ongoing stigma around mental health within their community, language barriers or not being aware help and support is available.

The MNVP were actively engaging with the LGBT+ community to strengthen inclusivity and to ensure the services reflected the needs of the community and their families by having community-based drop-in sessions.

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.

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 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.

There was a maternity multi-agency complex care clinic for women with complex, medical, social or psychological needs. The team reviewed and put together care plans to support care during their pregnancy and upon discharge.