Birmingham Heartlands Hospital

Ratings - Maternity

• Overall

  Good

• Safe

  Requires improvement

• Effective

  Good

• Caring

  Good

• Responsive

  Good

• Well-led

  Good

Our view of the service

This assessment was conducted to follow up on concerns and breaches of regulation identified during our previous assessment published in August 2025.

We reviewed 15 quality statements across 4 key questions: Safe, Effective, Responsive, and Well-led. The ratings for these areas have been combined with those from the previous assessment to determine the overall rating. At our previous assessment we rated caring as good. We did not re-inspect caring during this assessment, but we did see many examples of caring and compassionate staff.

We refer to women in this report, but we recognise some transgender men, non-binary people, and people with variations in sex characteristics or who are intersex may also use services and experience some of the same issues.

We rated the service overall as good. Since our last assessment, the service had made significant improvements and was no longer in breach of regulations relating to premises and equipment and good governance.

Staff assessed and managed risks effectively, and there was evidence that learning, quality improvement and governance processes were embedded across the service. Staff demonstrated a strong commitment to continuous improvement and described taking a considered and sustainable approach to implementing change. There was a clear and shared vision for the future of the maternity service, which staff at all levels understood and supported.

We found a positive and supportive culture across the midwifery workforce. Staff told us they felt able to speak up and raise concerns, and consistently described senior leaders as compassionate, visible, approachable and responsive. Leaders had taken meaningful action to address cultural challenges and promote an open, inclusive and collaborative working environment.

However, we still found breaches in regulations relating to safe care and treatment and safe staffing levels. We identified some prescribing errors on medication charts and poor medicines management. Some medical records did not always contain sufficiently clear documentation of patient management plans, which could affect continuity of care. Triage by medical staff remained a problem for the department at night and weekends with doctors having multiple pressures on their time. The service did not have the capacity to deliver the service safely in the right place for women at all times due to restrictions around the environment and this impacted on flow. There were staffing gaps, but it was an improving picture.

We found improvements were needed within the medical workforce. There were some inequalities in training opportunities between trust-employed doctors and trainee doctors. In addition, some medical staff described a poor culture within the medical workforce, and a lack of support at times indicating further work was needed to strengthen teamworking and staff experience in this area.

In instances where CQC has begun a process of regulatory action, we may publish this information on our website after any representations and/or appeals have been concluded, if the action has been taken forward. Or, if we have requested an action plan, this will be requested upon publication of the final report.

People's experience of this service

The annual CQC maternity survey for 2025 reported a significant improvement in women’s experience compared with the 2024 results. There were no areas where scores had decreased. The results provided assurance that actions implemented by maternity teams were having a positive impact on the experience of women and their families.

Women we met were mostly positive about the staff treating them with kindness and providing effective care and treatment. Although one woman we spoke to felt the doctors could have shown more compassion. Most women felt staff made them feel safe and included them in decisions about their care and treatment.

Before our on-site visit we met with a representative of the Maternity and Neonatal Voices Partnership (MNVP). The MNVP is an independent organisation that runs local teams who meet and speak directly with women and their families to enable them to share their experiences and help services to improve. We met with one of the team from MNVP at the end of March 2026. They told us how feedback from women had significantly improved to be around 99% positive. In our previous report, MNVP told us about recurring concerns around poor communication and a lack of compassion. On this visit, MNVP said there had been a significant turnaround in the experience of women who had almost overwhelming praise for the staff, their care and treatment.