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

At our last inspection we rated this key question good. At this inspection responsive remained good.

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 service made sure women were at the centre of their care and treatment choices.

There were positive examples of person-centred care and during elective caesarean sections we saw how women and their partners were supported and kept informed throughout the procedure.

Women deemed ‘low risk’ could choose to birth at home, midwifery led birthing unit or on the labour ward. Working relationships between the obstetric and maternity teams was positive and teams worked together to support women and their birth choices.

Women 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. We looked at women’s notes and found these were comprehensive and showed that individualised care was provided, such as for those women who had complex care needs or whose pregnancy was ‘high risk’.

The ‘My Maternity Choices’ resource was produced by the local maternity and neonatal systems (LMNS) alongside other local NHS maternity services. Staff had reported that they felt the resource was not being used consistently, therefore it was encouraged that the resource was referred to at each antenatal appointment.

There were examples of person-centred care observed throughout the assessment. For example, in theatre, soft lighting, choice of music for parents, boards with the father’s name and welcome to baby added, which made it feel inclusive for both the woman and their partner.

We scored the service as 3. The evidence showed a good standard. The service understood the diverse health and care needs of women and their local communities, so care was joined-up, flexible and supported choice and continuity.

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 maternity service used statistical process control (SPC) charts to allow early identification of changing rates in maternity data and to action an early response to any concerns or themes and trends identified. For example, the trust monitored the percentage of women most at risk of health inequalities, to understand the needs of service users from diverse groups.

Senior leaders told us there had been an increase in women choosing to have a planned caesarean birth. This meant an extra early shift was added to the staffing template to support an additional section list. The service was currently identifying a multidisciplinary working group which included women who had used the service. The group was to produce an enhanced care pathway for women experiencing a planned caesarean section, to reduce the stay following the birth of their baby and to improve flow around the service.

Home visiting models received positive feedback, with staff demonstrating flexibility in tailoring antenatal appointments to meet women’s needs.

Staff could access emergency mental health support 24 hours a day, 7 days a week for women with mental health problems and learning disabilities.

Specialist midwives worked with women who required specific support including, drug and alcohol support and teenage pregnancy. There was a proactive approach to understanding the needs of different groups of women and delivering care that met their needs.

We scored the service as 3. The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

The trust website included virtual tours of the maternity unit and provided information on maternity services. There was adequate signage at the hospital for women and their families to navigate the different departments of the maternity services.

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.

There were large posters available in different areas around the departments displaying key information for women. For example, on Hazel ward there was a room dedicated to information regarding infant feeding.

The trust website offered a comprehensive selection of maternity leaflets and resources designed to support expectant and new parents throughout their journey. The resources covered a range of topics, including perinatal pelvic health, safe sleep and information to a resource app for expectant fathers.

We scored the service as 3. 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 understood the policy on complaints and knew how to handle them and had a had a trust-wide complaints policy.

From July 2025 to January 2026 the service reported 23 complaints, with 11 of those because of clinical care and 5 due to the behaviours of staff. There were 23 complaints reported between July 2025 to January 2026 with 19 complaints closed. Most of the complaints were due to a lack of communication from staff.

The service monitored patient experience bi-monthly with the perinatal leadership team, MNVP, midwifery leads and consultants. Feedback was triangulated to identify themes and create actions.

Senior leaders had oversight of complaints and women received feedback from their complaint from maternity managers. The service had created the role of patient experience coordinator for maternity and neonatal services. The post was created to review feedback received from women and to identify and improve services for women and their families. The aim for women was to have a positive maternity experience.

We were told the patient experience co-ordinator role had enabled prompt responses to concerns raised by women and their families. The feedback received enabled senior leaders to be responsive to feedback received and it was reported that several complaints were mitigated due to the input from the patient experience co-ordinator.

We reviewed feedback from the patient experience coordinator following conversations they had with women in November and December 2025. Women said staff were “amazing”, “supportive”, “lovely” and “kind”. Women felt seen and heard, amazing aftercare and treated like an individual. The negative feedback centred around a lack of communication and support following a caesarean section, long waiting times to see the medical team within the maternity care centre and delays in the induction of labour process. The service had introduced a doctor daily within the maternity care centre. The service had adopted a new process to start the induction of labour. The process had shortened the length of the induction of labour process and flow through the unit.

Women shared with staff that they were not prepared for their induction of labour experience and felt the experience was different to the information leaflet given prior. The service was responsive and the team completed an educational video to map the women’s journey through induction of labour to give a more realistic journey of the procedure.

We scored the service a 3. Women could not always access care, treatment and support in a timely way. However, the service was working with women to improve access.

Improving the flow of the maternity unit was a driver for the leadership team and was reviewed during the executive review meeting structure.

The service was in the process of improving the flow throughout the maternity unit, these improvements were revising the process and method of induction of labour, improving the access for take home medications for women and implementing an enhanced recovery pathway for women experiencing elective caesarean sections.

Elective caesarean sections accounted for approximately 18.5% of total births, based on the maternity dashboard data. The elective activity at times contributed to pressures on theatre flow and scheduling. This was managed within the service, and we were told this did not represent a significant or sustained impact on overall flow or women’s experience.

There were 2 delays reported of delays over 24 hours in December 2025. An additional 5 long day theatre list to try to meet the demand of increased caesarean sections was ongoing. However, there was not always sufficient staff to support the elective and emergency caesarean sections. The service had completed a review of incidents relating to caesarean section delays and a situation, background, assessment and recommendation tool was developed with revised management of caesarean sections and staffing arrangements.

Delays for women undergoing induction of labour were monitored through the daily situational risk meeting. The induction of labour daily lists was reviewed by the consultant. The service had recently moved to using a different process for inductions of labour which had shown an improvement in the experience for women and had improved the maternity unit flow.

Delays for women undergoing induction of labour were monitored through the daily situation report (SITREP) meeting with the perinatal senior team to ensure appropriate and safe escalation. Between October 2025 and January 2026 there were 23 cases of women who waited longer than 24 hours for their induction of labour, which was mostly due to high acuity on the unit. However, the maternity and neonatal quality and safety report for January 2026 demonstrated an improvement showing there had been no reported safety events because of delays in induction of labour.

Women accessed the maternity services via their GP, local children’s centre or by direct referral. Women could also self-refer to the service by the phone or completing a booking form on-line.

We scored the service as 3. 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 service monitored women’s outcomes and experience across maternity care to identify any potential inequities such as ethnicity, age, disability and socioeconomic status, findings were reported through governance structures to action.

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 was heard to improve service user outcomes and drive improvement to the service.

The service facilitated an infant feeding support group on the maternity ward for women to attend to ask questions and get advice and support.

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.

Where women had specific needs, such as mental health needs, they were referred to the appropriate team to support them.

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.