Birmingham Heartlands Hospital

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Most women were treated with kindness, empathy, and compassion. Their privacy and dignity were respected, and they understood that they and their experience of how they were treated and supported mattered. Staff ensured they took women’s wishes into account and respected their choices, to achieve the best possible outcomes for them. Those women we spoke with said they experienced caring from staff, but in the NHS Friends and Family Test and 2024 NHS Staff Survey raised some concerns, the latter of which required urgent investigation.

At our last assessment, we rated this key question good. At this assessment, the rating remained good. This meant people felt well-supported, cared for and treated with dignity and respect.

We have not awarded this service a score for Caring.

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

The service treated people with kindness, empathy, and compassion, while respecting their privacy and dignity. Most people we spoke with reported being treated with compassion and felt staff communicated with them in a way they could understand. One woman told us, “The staff are brilliant, always kind and caring.”

Feedback reviewed during the inspection supported these findings. People felt listened to and appreciated the clear, respectful communication from staff. We observed staff using a video interpreter to support a woman who spoke Arabic, ensuring she fully understood her pain relief options and had the opportunity to ask questions before entering established labour. Interactions between staff, patients, and families were observed to be kind and considerate.

However, during an elective caesarean section, we observed a delay of 10 minutes before the baby was given to the parents, as staff completed checks. This moment felt overly clinical and lacked empathy for the parents’ experience.

There was generally a culture of kindness and mutual respect between colleagues. Staff reported the workplace culture had improved significantly since the previous assessment, with greater respect shown for one another and for each other’s cultural backgrounds.

The bereavement service was outstanding. It was staffed 24 hours a day, 7 days a week, and supported families who experienced bereavement beyond 12 weeks of pregnancy. The purpose-built environment, including a mortuary, allowed families the time and space to be with their loved ones. Care was individualised, and families were supported to stay as long as they needed with some for up to 3 weeks. Incident reviews highlighted exceptional care following the birth of an extremely premature baby. The bereavement team provided exemplary support to the woman, her baby, and their family. Feedback from families who used the Eden Suite included comments such as, “The staff in Eden Suite were incredible. They gave me, my husband, and our baby so much dignity. We received the highest level of care and respect,” and, “The love, care, and sensitivity shown by the team at Eden was above and beyond our expectations.”

However, a thematic review conducted by the Maternity and Neonatal Voices Partnership, covering feedback from the previous 15 months, identified recurring concerns. These included poor communication, insufficient infant feeding support, a lack of compassion, limited informed choice, and inappropriate language used by staff.

We did not look at Treating people as individuals during this assessment. The score for this quality statement is based on the previous rating for Caring.

We did not look at Independence, choice and control during this assessment. The score for this quality statement is based on the previous rating for Caring.

The service listened to and understood people's needs, views and wishes. Women were treated with dignity and respect. Women felt staff were attentive to their needs and responded promptly.

Staff gave women emotional support and advice when they needed it. Staff understood the emotional impact a person's care and birthing experience had on their wellbeing and on those close to them. This was reflected in numerous thank-you cards displayed on the wards, expressing gratitude for compassionate and supportive care. Messages included, "Thank you so much for your help and support after a very traumatic first birth with my daughter. I was elated to deliver my baby boy naturally yesterday. Thank you for everything you do." Another said "with your support and help I gave birth to a wonderful daughter. You gave me 2 of the best gifts I could have ever asked for; my baby, and a positive birthing experience."

The service actively sought feedback through digital platforms, using this information to recognise positive contributions from staff and to identify areas for improvement. Staff collaborated with the Maternity and Neonatal Voices Partnership to enhance care, although it was noted feedback was not always positive and the partnership was not consistently informed of changes, limiting their ability to communicate updates to the wider community.

Monthly `safety champion walks' led by the chief nurse provided opportunities to engage with staff and service users, resulting in actionable improvements. Efforts were also made to reduce mother-baby separation, including a new initiative allowing babies requiring intravenous antibiotics to receive their first dose in the delivery suite, supported by a neonatal nurse and a senior midwife.

The bereavement team provided sensitive and individualised support. One example included accommodating a woman's wish to hold her baby without seeing them, which was arranged with care. A South Asian baby loss group met monthly at a multifaith centre, offering support not only for bereavement but also for broader issues, such as housing and mental health.

Feedback from the NHS Friends and Family Test highlighted both positive and negative experiences. Positive comments praised the attentiveness and compassion of staff, while negative feedback pointed to concerns about staff attitudes, communication around discharge processes, and inconsistent care during night shifts. In response, the ward manager was developing an action plan to address these issues.

Staff were generally observant and communicative, taking time to engage with women about their immediate needs and birth preferences. However, there were instances where urgent needs were not promptly recognised or escalated. For example, in 1 case, a suspicious cardiotocography trace was not escalated for consultant review, and the baby was delivered over an hour later without such a review. In another case, there was a delay in responding to increasing blood loss.

The service cared about and promoted the wellbeing of their staff and supported and enabled them to deliver person-centred care. Managers supported one another and worked collaboratively to ensure their teams felt valued and cared for. Most staff told us their managers really cared about their wellbeing, supported them and they felt valued. Observations across wards reflected effective teamwork, with staff describing a collaborative environment where colleagues helped one another.

There were effective support mechanisms for staff experiencing difficulties, with several examples shared of managers making thoughtful adjustments during challenging times. Regular team meetings were held to share updates and gather staff input, with minutes circulated to ensure transparency. Additional communication channels included a closed social media group and newsletters.

Staff mostly felt appreciated by both their leaders and peers. Managers were visible and approachable, conducting regular walkarounds to maintain open lines of communication. One midwife told us, "There is very good support all the way up." The director of midwifery was recognised for their clear vision and emphasis on collective responsibility for improvement.

Opportunities for staff to provide feedback, raise concerns, and suggest improvements were embedded in the service. Leaders responded promptly and thoughtfully when needed.

A culture of wellbeing was promoted through inclusive practices, active listening, and open dialogue, which empowered staff to perform their roles effectively. A study day on personalised care and cultural humility was well received, with staff noting its positive impact on their approach to care.

A newly appointed head midwife for equality and inclusion was actively working to enhance workplace culture. Bi-weekly cultural inclusion meetings were held to drive improvements, and attention was being given to supporting neurodiverse staff. One manager, for example, attended a neurodiversity conference and used the insights gained to better support their team.

Recognition and appreciation were visibly encouraged through `shout out' boards on each ward, where staff and students left messages of gratitude and praise. These messages highlighted teamwork, clinical competence, and compassionate care. A QR code system allowed staff to provide end-of-shift feedback, which managers used to identify themes for improvement. Additionally, `buddy badges' helped staff identify colleagues available for extra support.

However, the 2024 NHS Staff Survey results showed just over 40% of staff experienced harassment and bullying by staff on the obstetric wards. This was the highest of staff groups across the trust and required urgent investigation.