Basingstoke and North Hampshire 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

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.

Information was accessible, safe and secure and women and birthing people felt listened to.

The service were in the process of developing an alongside midwifery unit (AMU) in line with National Institute for Health and Care Excellence (NICE) guidance. The AMU was part of the 3-year maternity single delivery plan.

Senior leads told us they recognised that women birthing in obstetric led units were more likely to have an increased risk of intervention and complications such as post-partum haemorrhage, obstetric anal sphincter injuries and unplanned caesarean sections.

The responsive key question was not rated in the last assessment. During this assessment we rated the service as ‘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.

The provider made sure women were at the centre of their care and treatment choices and they decided, in partnership with women, how to respond to any relevant changes in women’s needs.

Staff told us they personalised care plans for women with care based on their individual needs and preferences. 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.

At the time of the assessment the service offered obstetric led care only and there was not an alongside midwifery unit available (AMU) available. The service recognised it was not meeting all women’s birth choices and there was a plan in place to open an AMU within the next year alongside the current obstetric unit.

Senior leads told us they recognised that women birthing in obstetric led units were more likely to have an increased risk of intervention and complications such as post-partum haemorrhage, obstetric anal sphincter injuries and unplanned caesarean sections. Therefore, providing an AMU was in line with NICE guidelines. It also met the maternity services themes from the 3-year single delivery plan, which was, listening to and working with women and families with compassion, supporting our workforce; developing and sustaining a culture of safety; and meeting and improving standards and structures.

The consultant midwife was supportive in supporting women who wanted to birth outside of guidance with personalised care plans with support from multidisciplinary teams if needed. We observed the team actively supporting women to have the birth experience they wanted.

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.

The service worked with the local maternity and neonatal systems (LMNS) and the Maternity and neonatal voice partnership (MNVP) to be part of the Birth Equity and Equality programme, working in collaboration with local health care providers to improve outcomes for black, Asian and mixed ethnic groups and women living in deprived areas.

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, which was affecting their birth choices.

The service provided two continuity teams to vulnerable and at-risk women to improve outcomes. Continuity team midwives had smaller caseloads, so that midwives were able to spend longer with women and their families during appointments to take time to share information in a way that women could understand, answer questions and to provide additional mental health support. Antenatal and postnatal appointments were carried out at the women’s home making access to care easier for those without transport.

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

Women had access to interpreting services so they could understand and make decisions about their care. Women we spoke with during the assessment confirmed they had been provided detail information in a way they could understand. This included leaflets in multiple languages, videos and being signposted to local charity websites.

The antenatal and postnatal forum was a multidisciplinary meeting where operational and clinical issues were reviewed, to ensure a transparent pathway for decisions relating to antenatal and postnatal care through enhancing communication with women and their families and driving improvements. The multidisciplinary group aimed to improve professional relationships and communication in antenatal and postnatal care. There was a separate multi-professional forum for intrapartum care discussions with service user representatives.

There was a trauma informed service group, chaired by the maternity neonatal voice partnership (MNVP) with maternity staff and the local maternity mental health service to improve trauma informed care in maternity services and providing information to women and their families.

The service made it easy for women to share feedback and ideas, or raise complaints about their care, treatment and support. Information was clearly displayed throughout the unit and the maternity website on how to raise concerns and make a formal complaint. Staff involved women in decisions about their care and told them what had changed as a result.

Leaders told us they shared feedback from women with staff and the trust board. They also shared women’s birthing journey at board level meeting. Sharing women’s birthing journeys with the board gave the executive team a wider understanding of the complexities of maternity services and ensuring services met diverse needs.

The service had a good understanding and oversight of what women and families wanted from the service and we saw examples where the service had listened and changed practice. The service reviewed feedback and put together a ‘you said, we did’ posters to reflect on how the service listened to women. For example, women reported that they wanted to be part of the discussion around their care and treatment and the service had started to trial bedside handovers. Women were provided with postnatal discharge ‘chats’ and signposted to a postnatal online information board called a padlet to review information and the healthier together app to provide information postnatally and following discharge home.

The service made sure women could access the care, support and treatment they needed when they needed it.

Women told us they could access antenatal and postnatal appointments at a time which suited them and their partners. The maternity dashboard recorded data on equality and diversity. The leadership team used this data to target resources on improving services.

Staff understood the importance of supporting equality and diversity and ensuring care and treatment was provided in accordance with the Equality Act 2010.

The trust had a health inequalities group to oversee development and delivery of workstreams and actions to address health inequalities. For maternity, the service provided a continuity of care team which focused on women from Black, Asian and minority ethnic communities and from the most deprived groups.

Leaders monitored waiting times to ensure women and birthing individuals could access maternity services, including unplanned care in triage, within agreed timeframes and national targets. However, some women and birthing individuals experienced delays before being seen by doctors.

As part of the work completed by the birth equity group the service incorporated equity and diversity and the voice of the woman to all maternity staff through maternity specific training.

The service made sure maternity information leaflets informed women of their choices and integrated core equity and equality values.

Reasonable adjustments and communication aids, such as interpreters and language lines, were used to assess and care for women whose first language was not English.

Staff and leaders actively listened to information about women who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

Since our last assessment the service had developed a birth equity group.

The birth equity group used feedback from women, their partners and families to increase staff awareness of racism, listened to women’s birthing journeys and to improve the feedback received from women.

As part of the work completed by the birth equity group the service incorporated equity and diversity and the voice of the woman to all maternity staff through the maternity specific training

The service made sure maternity information leaflets informed women of their choices and integrated core equity and equality values.

Maternity services had implemented a specialist vulnerable women’s community multidisciplinary team in midwifery care which provided continuity of carer and enhanced care during the antenatal and postnatal period for those at higher risk of poor outcomes in pregnancy.

Following feedback from lived experience stories from women through birth equity meetings the service introduced impact and actions included unconscious bias and microaggression training. Birthrights training focusing on ensuring safe and respectful maternity care.
Personalised experience and communication was provided through staff asking women what was important to them and sharing with women what services were available to them. For example, mental health support.

Everyone had equal access to care, treatment, and support. Senior managers reported that the service worked closely with external organisations, such as the local integrated care board and the Maternity and Neonatal Voices Partnership (MNVP), to identify barriers to patient experience and discuss improvements.

The Maternity triage service was available 7 days a week. The service did not have dedicated medical coverage for triage and the day assessment unit, however the obstetric on call team covered this service.

Women were supported to plan for important life changes, so they could have enough time to make informed decisions about their future.

Since our previous assessment there had been a large investment in midwifery staff. The 24-hour maternity telephone triage line had been expanded from labour assessments only to include antenatal triage and referring women to the most appropriate place for their care

Women were supported to plan for important life changes and make informed decisions about their future. They were assessed and offered support to improve their health during pregnancy and the postnatal period.

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.

The trust had a health inequalities group to oversee development and delivery of workstreams and actions to address health inequalities. For maternity the plan was to have continuity of care for women from Black, Asian and minority ethnic communities and from the most deprived groups. A significant investment was made by the Trust, utilising nationally allocated funding following the Ockenden Review, at the time of the last assessment in 2021. However, not all available posts had been filled at that stage. The service increased recruitment and focused on retaining staff, to maintain appropriate staffing levels. This was monitored yearly using the Birthrate Plus maternity staffing tool.