Macclesfield District General Hospital

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• 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

At this assessment the rating has remained as good.

Complaints handling and duty of candour complied with national standards and legislation. Staff provided person centred care and support for diverse needs and worked with partners to maintain continuity.

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.

We observed positive interactions between staff and people who used the services. We saw staff understood their needs and provided appropriate care and treatment.

Care records included hospital passports for patients with extra needs, which included patients’ preferences and choices.

Care records we saw included reasonable adjustment and support for women from ethnic minorities, different demographic backgrounds and neurodiversity. Records demonstrated staff had delivered care and treatment in accordance with legislation and national guidance.

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 understood the diverse health and social care needs of the women that used their service. Services were planned to meet the needs of pregnant women.

Staff were aware of how to escalate key risks that could affect people’s safety, such as staffing and capacity. Shift coordinators and managers reviewed these risks throughout the day to ensure the service was safe.

The service had escalation and diversion policies in place, which provided guidance for staff on how to escalate and manage risks in the event of staffing challenges or capacity issues.

In the last 12 months the maternity unit had closed on two occasions; for a two-hour period and an eight-hour period. This was due to an episode of high demand on the service and no peadiatric registrar availability. The provider had an escalation process in place for women during these occasions.

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 service had information leaflets for women about the different stages of pregnancy and what to expect. These were available in other languages. There were information boards to support pregnant women. For example, ultrasound, the ABCs of safe sleeping, breast feeding and support available.

Staff told us they had all the information they required to plan the pregnant women’s care and treatment.

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.

Managers told us they reviewed complaints, compliments and feedback from surveys to support learning and improvement.

The service had 2 open complaints at the time of our assessment in relation to the maternity service. The service investigated complaints which were coordinated by the trust complaints team. We were told complaints could be challenging due to managing expectations of the complainant.

The service identified improvements from complaints to support care and treatment. Communication between patients and clinicians was the main theme. The CQC 2024 maternity survey results score was 6/10 for the opportunity to ask questions about labour and birth. A tool was developed to support clinicians’ conversations with women when discussing risks and benefits of care and treatment options. This helped to support the opportunity to ask questions about their labour and birth.

Women accessing maternity services would receive a family and friends test (FFT) text message to provide feedback. Social media posts were also used to request feedback.

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 service is offered to pregnant women living in East Cheshire and neighbouring areas. For more specialist support, women were referred to other hospitals for tertiary care. Examples included if a person had insulin dependent diabetes or were expecting triplets or higher multiples.

Women could access the service when they needed it and received the right care promptly. The service monitored delays in care and treatment and took action to make improvements.

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 experience of women we spoke to was positive. We reviewed care records and saw care and treatment was delivered in line with national guidance and did not discriminate against protected characteristics under the Equality Act.

Most staff completed equality, diversity and human rights training.

However, the provider had not undertaken equality and impact assessments on all of their policies and procedures to ensure they did not place vulnerable people or people with protected characteristics at a disadvantage.

The service had completed a quality improvement project to improve the experience and outcomes for post-partum hemorrhage (PPH). This included the identification and recognition and management of women at higher risk of PPH. Documentation tools were developed to record and escalate blood loss which significantly improved communication between the team in theatre. The trust saw a reduction in PPH rates.

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.

People who use the service were supported to make birth plans and choose their preferred place of birth. Birth plans were reviewed and changes were discussed to ensure safe delivery of the baby.

We saw care records were personalised and took account of the patient’s needs, wishes and feelings.

Staff coordinated discharge planning with other healthcare professionals such as community midwifery teams.

Staff wrote discharge letters and shared these with other healthcare professionals, such as GP’s and community midwifery teams.