Basingstoke and North Hampshire Hospital

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

The service had a vision for what it wanted to achieve and a strategy to turn it into action. They engaged with women, staff, partners, stakeholders and the wider community to develop the six-year maternity strategy.

The maternity service had been through a very difficult period where there had been extremely low staffing levels and significant pressures on staff. Staff told us there had been a large investment in maternity services and the new leadership team worked tirelessly to improve outcomes for women and babies, improve the culture and make the service a positive place to work for staff.

The maternity service was led by the director of midwifery (DOM) and a head of midwifery (HOM) at each obstetric location.

All staff we spoke to were extremely complimentary of maternity senior leaders and told us they were visible, inclusive and responsive. Leaders were highly valued by staff who told us they were well supported by their line managers.

All staff we met were committed to learning and improving services. They had an excellent understanding of quality improvement tools and had the skills to use them. Staff told us leaders encouraged innovation and encouraged research. We saw several examples of initiatives, innovations and quality improvement throughout our assessment.

At our last assessment we rated this key question as requires improvement. At this assessment the rating has changed to ‘Good’.

We have not awarded this service a score for Well-led.

Find out about when we will not publish a key question score and what we look at when we assess Well-led.

The service had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of women and their communities.

Maternity services were part of the family, children and support services division. The governance framework was in place to comply with national strategies and to manage risk and safety.

Maternity services were led by a divisional quadrumvirate structure and was part of the perinatal culture and leadership programme. A divisional quadrumvirate is a leadership structure found in healthcare which consisted of key roles to ensure accountability and responsibility throughout the team. The service worked closely with neonatal teams and had introduced a ‘partnership between maternity and neonatal leads to provide cultural and scoring and culture engagement survey (SCORE) to identify future working and to provide a shared voice and direction to maternity and neonatal services.

The service had a vision for what it wanted to achieve and a strategy to turn it into action. They engaged with women, staff, partners, stakeholders and the wider community to develop the six-year maternity strategy.

The vision and strategy were focused on sustainability of services, working together, identifying the best use of resources and was aligned to local plans within the wider health economy. The service worked alongside the Local Maternity and Neonatal System (LMNS), Maternity Voices Partnership and integrated care board.

The maternity service had been through a very difficult period where there had been extremely low staffing levels and significant pressures on staff. Staff told us there had been a large investment in maternity services and the new leadership team worked tirelessly to improve outcomes for women and babies, improve the culture and make the service a positive place to work for staff.

Targeting pathways were in place to reduce inequalities and promote inclusivity and diversity within maternity care. There was a culture of inclusivity that celebrated diversity, and enabled the service to deliver compassionate care.

There were two continuity maternity teams across the service to provide an equitable access to maternity care for all women from black, Asian, ethnic minority women and women who had a higher level of need.

The service launched a maternity culture and improvement programme following the last assessment. The aim of the programme was to identify maternity culture, develop leadership and management skills through improvement initiatives.

The service launched a maternity culture and improvement programme following the last assessment to identify maternity culture, leadership and management skills. One of the new additions developed and was being piloted was the 'Applied Culture Training' (ACT). A multi-professional ACT faculty delivered interactive training to create a shared understanding of the impact of human behaviours and communication with the aim of improving patient safety through positive workplace cultures.

The service had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.

The maternity service was led by the director of midwifery (DOM) and a head of midwifery (HOM) at each obstetric location.

All staff we spoke to were extremely complimentary of maternity senior leaders and told us they were visible, inclusive and responsive. Leaders were highly valued by staff who told us they were well supported by their line managers.

We were given examples throughout our assessment where the DOM had supported on the ground floor when needed. Senior leads were consistently described as visible, inclusive and responsive by staff.

The staff survey showed staff were proud of the midwifery retention rates and low turnover of staff. Staff felt there was a strong approach to multi-professional teamworking and effective escalation processes to ensure the team was supported with safe staffing levels if the demands of the service changed.

Sustaining staff morale was important to leaders and we saw initiatives during our assessment. For example, the team had embedded ‘Time for Tea’ to encourage staff to take time out, and have a break together.

There was a back-to-basics question sessions for community staff lead discussions where there was a focus on ‘there are no silly questions.

Matrons told us they had weekly drop-in sessions with staff called ‘Tea with the matron’ this was well attended and offered a relaxed environment for staff to talk about how they are feeling, improvement ideas and discussions.

The service fostered a positive culture where women felt they could speak up and their voice would be heard.

Women, and their families knew how to complain or raise concerns, and how to give feedback on the service and their treatment.

Staff felt supported, respected and valued. Staff we spoke with during the assessment told us they felt able to speak with leaders about difficult issues and when things went wrong.

Staff told us when practice needed to be improved there was a no blame culture and they were supported to learn and develop within their roles.

Teams fostered a culture where speaking up was welcomed as well as an opportunity to learn and improve.

Senior leadership team raised the awareness of the trusts freedom to speak up team and would work with them when concerns were reported. Midwifery students were introduced to the freedom to speak up guardian so they knew how and where they could raise concerns and have the confidence to do so.

The service valued diversity in their workforce. Staff worked towards an inclusive and fair culture by improving equality and equity for women who worked for them. Staff we spoke with on the assessment described a supportive and improved approach to leadership within the maternity department.

Leaders worked with the local Maternity and Neonatal Voices Partnership (MNVP) to contribute to decisions about care in maternity services. The service offered equality and diversity and inclusion (EDI) online training as part of their mandatory package.

The service completed recruitment days rather than individual interviews for maternity support workers (MSWs) to see people in a more relaxed environment and the service had increased the number of MSWs recruited from different countries and cultures.

There was an inclusive culture and the trust had started a health inequalities group to oversee the development and delivery of workstreams and actions to address health inequalities.

Quality and safety improvement training was in place for all staff, to ensure a continuous improvement culture. The training focused on identifying where reducing harm, improvement measures and mitigating risks.

The service had clear responsibilities, roles, systems of accountability and good governance. Staff used these to manage and deliver good quality, sustainable care, treatment and support. Staff acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate.

Maternity governance involved a structured approach to safety and quality of care.

Leaders had the experience, skills and abilities to run the service. They had complete oversight of the service and managed the priorities and issues the service faced.

There was a clearly defined governance structure which detailed the governance oversight and accountability from the service level to the trust board. Leaders operated an effective governance process and monitored key safety and performance metrics through a comprehensive structure of governance meetings.

This detailed the governance oversight and accountability from the service level to the Trust Board.

Key performance indicators were incorporated into the maternity dashboard for monitoring and oversight. The dashboard was presented electronically and shared with both the trust board and Local Maternity and Neonatal Systems (LMNS). The service used the maternity dashboard to identify outlier status and learning.

The maternity dashboard and the reporting of safety measures and outcome data was presented via maternity and neonatal reports to the Quality Committee monthly and the maternity and neonatal quality and safety report was presented to the Trust Board.

Governance was managed by the family, children and support services (FCSS) divisional governance board. The FCSS governance board met monthly. The maternity senior management team reported to the maternity governance group which reported to the quality and performance committee and then to the board of directors.

Responsibility and accountability for governance within maternity services was held by the director of midwifery and the clinical director for women’s health.

The risk and governance midwife worked to deliver the maternity governance programme and supported the director of midwifery and the maternity governance and safety lead. This included leading on patient safety investigations and key performance indicators.

There was a lack of oversight in staff completing maternity audits. There had been a vacancy within the maternity governance team, and the director of midwifery (DOM) told us the service had developed an action plan for managing maternity audits. The director of midwifery (DOM) told us the service was focused on the management of risk and the evidence-based guidelines by prioritising incident reviews, complaints and issues deemed high risk.

A situational, background, assessment and recommendation action plan was currently going through governance and transformation due to low performance in completing SBAR audits

To improve gaps within communication between obstetric and neonatal teams, the service had restructured meetings, so that the neonatal governance lead could attend. A new maternity and neonatal rapid review meeting were introduced in June 2025 and leads reported that this had meant improve team working and better sharing of learning. During our assessment we observed a rapid review meeting and safety huddles where we could see active communication between the teams and a sharing of information.

The service understood their duty to collaborate and work in partnership, so services work seamlessly for women. Staff shared information and learning with partners and collaborate for improvement

Service leaders attended regular meetings with the Local Maternity Network System (LMNS) to review governance and incidents.

Leaders worked with the Maternity and Neonatal Voices Partnership (MNVP) to contribute to decisions about care in maternity services. Meeting minutes showed current work being undertaken between the local MNVP, maternity service and the LMNS.

MNVP attended meetings with the maternity and neonatal safety champions and patient experience meetings were embedded. The MNVP used social media to increase awareness around the maternity service and targeted posts were used to promote national events such as maternal mental health week and international day of the midwife.

The Maternity Strategic Transformation group brought providers, commissioners, and stakeholders to support the trusts maternity and neonatal strategy. The purpose was to escalate decisions, risks and issues and to work on a partnership approach to achieving the trust maternity strategy.

The provider focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for women. They actively contributed to safe, effective practice and research. The service had made significant improvements in multiple areas since our last inspection and the service have shown a commitment to improving services to benefit women.

All staff we met were committed to learning and improving services. They had an excellent understanding of quality improvement tools and had the skills to use them. Staff told us leaders encouraged innovation and encouraged research. We saw several examples of initiatives, innovations and quality improvement throughout our assessment.

The service had a positive culture of learning and most band 7 midwives we spoke with were working on different quality improvement projects, 200 maternity staff had completed the quality improvement training.

Staff wanted to tell us their learning journeys and the quality improvement work taking place to continuously improve the service for women.

We saw examples during our assessment of quality improvement projects, which had led to improvements in service. For example, following a QI project on reducing the number of babies readmitted for phototherapy, the service found funding for bili-cocoons to reduce separation between mother and their baby during phototherapy.

Maternity teams and MNVP worked together to determine how accessible information was and what was needed to improve care and choice for women.

MNVP held quarterly meetings with the service to escalate feedback from women to maternity leads. MNVP leads reported that they had easy access to the senior leadership team to escalate any concerns promptly, and to make a difference to services provided to women.