Princess Royal University Hospital Also known as Farnborough 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

We looked for evidence that people and communities were always at the centre of how care was planned and delivered. We checked that the health and care needs of people and communities were understood, and they were actively involved in planning care that met these needs. We also looked for evidence that people could access care in ways that met their personal circumstances and protected equality characteristics.

At our last inspection we rated this key question requires improvement. The service was in breach of receiving and acting on complaints. Since then, the service had made improvements and is no longer in breach of this regulation. This is because the service now managed complaints in a timely manner. This rating also indicated that people’s needs were met through effective organisation and responsive service delivery

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.

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 deemed low risk could choose to birth at home or in the Midwife Led Unit (MLU). Women had access to birthing pools which had integrated lighting to create a calm atmosphere. The pools were available on a first come first served basis. The birthing rooms on the midwife led unit were spacious and made to feel homely. Birthing balls, music and dimmed lighting could all be used to create a calming atmosphere. Staff told us this helped to contribute to normalising birth.

Staff made sure that women and their families were regularly involved in planning and making shared decisions. Staff also supported women to make informed decisions about their care. We observed a doctor’s ward round where women were actively involved in decision making. Women we spoke with also reported that they were always involved in decision making and the service was responsive when additional support was required from specialist teams.

The service had specialist midwives to support women individual needs. This included a consultant midwife, a safeguarding midwife, bereavement midwives, a specialist midwife for perinatal mental health and an infant feeding specialist midwife. Staff we spoke to knew how to contact these specialist midwives and reported that they were visible. Women’s care plans fully reflected their physical, mental, emotional and social needs, including those related to protected characteristics under the Equality Act.

The service promoted personalised care and ensured all midwives received personalised care training. At the time of the assessment 94% of midwives were up to date with this training. The service also had a choice and personalised care in maternity services guideline for midwives to refer to. This guideline provided guiding principles to support staff in facilitating personalised care, including when they fall outside clinical recommendation.

The service provided women appointments with the consultant midwife to support informed choice discussions and facilitate the coproduction of a personalised care plan that may potentially fall outside clinical recommendations. Midwives had clear referral criteria to follow and completed the referral form via the electronic patient record system (EPR). The coproduction of a personalised birth plan involved women and relevant members of the multidisciplinary team. This ensured women were at the centre of their care and treatment but that they also received safe care and treatment. The consultant midwife was also on-call to support community midwives with complex home births in which a personalised care plan had been in place.

Staff gave women and those close to them help, emotional support and advice when they needed it. Staff also made sure women living with mental health illnesses and learning disabilities, received the necessary care to meet all their needs. The service had 24-hour access to mental health liaison and specialist mental health support.

The service had access to 24-hour translation services including British sign language (BSL) either via telephone, face to face via iPad or in person. Data provided by the trust showed good use of interpreting and translation services. The service also showed evidence of a translated duty of candour letter into the native language of a woman who used the service.

Women were given a choice of food and drink to meet their cultural, religious and vegan preferences. The service also ensured food and drink was available 24 hours a day and not just at set mealtimes. Menus were also available in 13 different languages for women whose first language was not English.

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.

Managers planned and organised services, so they met the needs of the local population. The service had community midwives that organised outpatient appointments for women throughout their pregnancies and postnatally. These appointments took place at women’s homes, general practitioner (GP) surgeries and children centres. The service also had a continuity team which was a team of 5 midwives that provided dedicated care for women who were at risk of poorer outcomes (women who were a part of the global minority or lived in areas of deprivation). Each woman had a named midwife throughout the antenatal and postnatal period. The trust reported that there is currently work ongoing to expand this to intrapartum care too.

Obstetric antenatal appointments for high-risk women and ultrasound scanning were provided off-site at the Harris Birthright Centre. The service identified that this location was difficult for some women to attend so they also provided emergency scan appointments on the birth centre.

Inpatient maternity services were available 24 hours a day, 7 days a week. The service remained fully operational and did not close to the public at any point between the months of January 2024 and January 2025.

Managers worked to keep the number of delayed and cancelled appointments, treatments and operations to a minimum. During the assessment we did not observe any delays or cancellation of care provision or discharge. Data provided by the service showed that the service maintained 100% continuity of antenatal outpatient clinics.

Managers monitored delays in time critical activity. Data supplied by the service showed that between January and March 2025 there had been 6 delayed or cancelled time critical activities. This included 1 cancelled elective caesarean section however, the cancellation was due to clinical reasons and not capacity or staffing issues. The service did not provide detail on the remaining time-critical delays.

Managers ensured that women who did not attend appointments were contacted. The service had guidance for the management of pregnant women not attending for planned care. Community midwives we spoke with reported following up women who did not attend their appointments and made sure they were rearranged as soon as possible.

Managers and staff started planning women’s discharge as early as possible. Staff reported that the midwife in charge was allocated to arrange all discharges for the day. This process included; organising discharge paperwork, informing appropriate teams of the discharge, coordinating safeguarding discharge meetings, for women with complex mental health and social care needs. Data from the maternity services survey 2024 showed that the trust performed about the same as the national average regarding delays in discharge.

The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Women could get information and advice that was accurate, up-to-date and provided in a way that they can understand, and which meets their communication needs. The service provided women with access to several leaflets available on their website. These included but was not limited to antenatal colostrum harvesting, going home after your baby is born and pregnancy and sickle cell. These leaflets were also available in other languages by request via the patient advice and liaison service (PALS) which was an improvement from the last inspection. It was noted that discharge paperwork, including leaflets were not available in other languages. However, staff would go through this information with women prior to discharge with the use of an interpreter or translator if necessary.

The service also used social media to provide appropriate, accurate and up-to-date information to women. The service held Instagram live sessions hosted by various multidisciplinary staff and allowed women to ask questions about a specific topic. The last Instagram live was hosted by staff from the early pregnancy unit.

As part of the EPR system, women had access to an application called ‘my chart’ that allows them to have real-time communication with staff, access to their diagnostic results and letters. Women could also allow their family and friends to access their records by proxy. Data supplied by the trust showed high rates of patient activation of the app. The service did not specify if the application was available in different formats or languages.

The service also organised parent education classes for pregnant women which was coordinated by community midwives. Topics for these classes included but was not limited to labour and birth, birth after caesarean, infant feeding and baby basics. These sessions were mostly available virtually, but the service also provided face to face sessions and opportunities to attend the birth centre for tours. All this information was available via the maternity and neonatal voices partnership (MNVP) Instagram page and women could book on to classes via this route.

The MNVP worked with maternity services to bridge the gap with women that could be harder to reach. They did this by doing monthly walk arounds the unit, hosting listening events and using social media platforms to connect with women and understand their needs.

The service made it easy for women to share feedback and ideas or raise complaints and involved them in decisions about the service.

The service clearly displayed information about how to raise a concern in patient areas. Women could also make complaints via the ‘my chart’ application. Staff knew how to respond to complaints and reported that learning from this was routinely shared to improve the service. This was an improvement since the last inspection.

Women and their families could complete the friends and family test (FTT) via iPads on the unit. Data from the trust showed that between January and March 2025 over 90% of responses were positive. The system also allowed women to add comments on what the service can do to improve. The trust reported that this information is collated and allows them to pull out trends relating to patient experience.

The service reported that they had received 8 complaints related to various areas within the service between January and March 2025. According to the trust’s complaints policy each complaint should be red, amber, green (RAG) rated. The RAG rating identified the timescale in which the complaint should be investigated and responded to by. Complaints RAG rated as green were to be closed within 25 working days, amber within 40 working days and red within 60 working days.

The service had oversight of complaints. Data provided by the service showed information including but not limited to; which part of the service the complaint originated from, the ethnicity of the complainant, a description of the complaint, the date of receipt, due date of closure and the stage of the complaint. It was unclear however, who was responsible for the investigation of each complaint. The main themes of the complaints were poor staff attitude and lack of diagnosis, assessment and monitoring of conditions. Out of the 8 complaints 1 was rated as green, 3 amber and 4 red. Two of which breached the timescale for an investigation and response set out by the trust. However, one of the breached complaints was now closed and the other was awaiting sign-off.

Feedback from women was also discussed at ward meetings and used to inform changes to daily practice. The service also had a listening clinic that women could self-refer to. The listening clinic is run by clinicians and gives women an opportunity to discuss their care and experiences of pregnancy, labour and birth, postnatally. This service does not offer mental health support and appropriate referrals were made if this support was required.

The findings of the care quality commission maternity services survey 2024 showed the trust wide maternity service performed at about the same level as other trusts in 22 questions, and somewhat worse than expected in 2 questions. The question the service performed somewhat worse than expected in was pain management in labour and staff being aware of medical history. The service did not highlight any actions in response to this.

Due to the decreasing birth rate on the birth centre the service decided to maximise the space by turning part of the birth centre into a social space. The service held a focus group to involve women in the codesign of the new space. This included an area for parent education classes and listening events. This allowed the opportunity for women to come in for a tour of the birth centre and allowed women to build community.

Staff understood the duty of candour. They were open and transparent and gave women and families a full explanation if and when things went wrong. The service provided evidence of duty of candour letters delivered to women when things went wrong. The letters also highlighted findings from investigating the incident and identified a plan to improve the service in response.

Women could access care, treatment and support when they needed to however, this was not always delivered in a timely way.

Women were referred to the service either through their GP or through the community midwives. Women could also self-refer using the trust’s website. Women were able to access the maternity assessment unit 24 hours a day through self-referral or after calling the maternity telephone assessment line, which was also available 24 hours a day. Women could also contact community midwives for non- urgent concerns during working hours. Data from the maternity survey 2024 showed that the trust was performing above the national average when it came to women contacting a midwifery team and getting the help they needed.

Facilities and equipment were physically accessible to women with additional needs.

Although there were delays in doctor reviews on the maternity assessment unit, staff reported that they were able to transfer women who needed immediate admission to the labour ward quickly.

Most of the delays in clinical activity identified by maternity red flags were linked to delays in induction of labour (IOL). The service provided audit data of clinical delays between January and March 2025. The data showed 20% of the clinical delays were delays admitting women from home for an IOL and, 73% were delays in ongoing IOLs. Staff we spoke with onsite reported that although there were delays in the IOL process, they were able to transfer women progressing in labour to an appropriate environment with minimal delays as the IOL bay was located within delivery suite.

Although delays in induction of labour were the most frequently reported red flag incidents, the service had clear systems in place to mitigate associated risks. These included regular review of delayed cases during safety huddles, daily ward rounds to reprioritise women based on clinical urgency, and continuous monitoring of outcomes. These actions demonstrated a proactive approach to maintaining safety despite operational challenges

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.

Leaders and staff were alert to discrimination and inequality that could disadvantage different groups of people using their services. The service showed evidence of exploring the demographics of women in their community. They did this as a support focused effort to improve experience and outcomes for women. This data included but was not limited to the ethnicity, age and mode of birth of women. The next steps were to consider how the MNVP committee could use the data to ensure their membership was representative of the local population and produce targeted projects.

The service worked closely with the MNVP chairs and the local maternity and neonatal system (LMNS) to ensure that the voices of women experiencing discrimination and or inequality was heard. This was done by the MNVP chairs conducting walk arounds the maternity unit using the NHS England 15 step toolkit. This is a toolkit that explores different healthcare settings through the eyes of those who use them and their relatives and carers. These walk arounds included the MNVP team, midwifery staff and service users. The MNVP chair also communicated directly with women during these walk arounds, and hosted listening groups in the community. The feedback collated was then fed back to the service with an aim of improvement.

The service then proactively looked for ways to address barriers to improve women’s experience. We saw evidence of the experience of women from marginalised communities being discussed at quality and safety meetings which was also attended by representatives from the LMNS. The discussion highlighted issues with cultural awareness, communication barriers and lack of clear accessible information. In response to this the service reported that there was a project with the LMNS underway to develop foreign language parent education.

The trust organised a monthly face to face Black and Black mixed heritage antenatal education class. The service also had a group via a messaging application for LGBTQ women to join. These initiatives aimed to support women with these protected characteristics to develop learning and community.

People were supported to plan for the future, so they could have enough time to make informed decisions about their future care.

The service had relevant information promoting healthy lifestyles and future decisions such as vaccinations, infant feeding and pelvic floor health and wellbeing. The service also supported women during their transition from the unit and home postnatally. They did this by arranging community midwives’ visits after discharge and providing women with information and relevant contact details they may require.

Data from the maternity services survey 2024 showed that the trust performed about the same as the national average regarding information and explanations being given postnatally prior to discharge from the unit. The survey also showed that the service performed about the same as the national average regarding women’s decisions about infant feeding being respected and receiving enough support and advice to feed their babies.

Women we spoke to reported that explanations given were easy to understand and they felt able to ask questions.