Good Hope Hospital

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We rated effective as good. Staff assessed people, so the care and treatment provided met their needs. This included their physical health and any personal circumstances that needed to be considered. Staff worked in line with evidence-based practice. Staff worked together and with others when assessing people's needs and mostly shared information to maintain continuity of care.

In our previous assessment, this key question was not rated. In the current assessment, it received a rating of Good. This meant people's outcomes were consistently good, and people's feedback confirmed this.

We have not awarded this service a score for Effective.

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

We did not look at Assessing needs during this assessment. The score for this quality statement is based on the previous rating for Effective.

The service planned and delivered people's care and treatment with them, including what was important and mattered to them. Staff mostly did this in line with legislation and current evidence-based practice and standards. Policies referred to national guidelines and staff acted in line with the guidance. The service used National Institute for Health and Care Excellence (NICE) guidelines to ensure care was evidence-based. There was an ongoing action plan for the implementation of NICE guidance; this was included in the quality and safety report. At the time of assessment, the service had 14 guidelines which were compliant out of 32, and 8 had overdue actions or actions which had not been completed.

The venous thromboembolism risk assessments were not in line with the Royal College of Gynaecologists. This had been raised in clinical governance and was being reviewed. At the time of our assessment, it was still under review.

Staff gave clear information to women about the care and treatment needed to support their health. Several clinics and specialist midwives supported women with their physical and mental health needs.

The trust kept its database of guidance up to date. Staff used information given regularly in handovers and newsletters to implement new guidance or changes to existing procedures.

The trust's intranet contained a comprehensive range of up-to-date policies that reflected current practice. It had guidance for staff around all aspects of maternity care to ensure the right people delivered evidence-based care and treatment.

A review of the service's perinatal mortality review tool reports revealed antenatal care was not always delivered in line with national guidance. Failsafe procedures were not consistently effective, and some women and babies at risk, such as those with small gestational age, were not identified. Some women were not assigned to the appropriate antenatal care pathway, resulting in missed opportunities of care.

Women's nutrition and hydration needs were mostly met in line with current guidance. People told us the food was mostly good. However, 1 woman who chose to eat a diet based upon her culture felt there was not sufficient choice. The hospital only provided limited options that suited her diet. We fed this back to managers, and they had started to look into making improvements to the range of food offered as this was something they had already identified. On the postnatal ward, women were encouraged to serve themselves with food. Midwife support workers completed regular drink rounds. People told us they were regularly offered drinks.

The unit achieved the United Nations Children's Fund (UNICEF) `baby-friendly initiative' accreditation and was reassessed in February 2025. They were given an action plan of areas that needed further input such as bottle feeding and had 1 year to submit audits and continue with their accreditation.

The service worked well across teams and services to support people. There were lots of support services for women.

There were good relationships between doctors, consultants, midwives, and midwife support workers who worked together closely to provide care to women. One member of staff told us it was a lovely place to work, and people were very respectful of each other and their roles. However, some staff felt relationships could be improved.

Staff had access to the information they needed to appropriately assess, plan, and deliver women’s care, treatment, and support. There were handovers at shift changeover for both the medical and midwifery teams. We observed the medical handover and 2 midwifery handovers and found it to be engaging and informative. We observed one-to-one handovers at the women’s bedside from midwife to midwife.

The service did not always share information between teams to ensure continuity of care. The use of risk assessment handover tools such as ‘situation, background, assessment, recommendation’ (SBAR) was not consistent. Records were not always updated to show the risk-assessed handover had taken place. However, a few women felt there was good continuity of care. For example, 1 woman told us “Even though I have seen numerous staff, everyone seems to be consistent with their advice and plans.”

Plans for transition, referral, and discharge considered women’s individual needs and circumstances. Individualised care plans were made for women where required. For example, there were specific discharge plans where there were mental health needs for women.

There was good collaboration within the Local Maternity and Neonatal Services (LMNS). This was a partnership of organisations involved in maternity and neonatal care working together to improve services. Staff had a virtual ‘huddle’ each day with 2 other hospitals in the LMNS to identify concerns with staffing and any other issues. They discussed site acuity, induction of labour patients, and any potential risks. Within the meeting, the services determined if anyone needed help and redeployed resources to support it. We observed a huddle on 25 March 2025 and found it to be supportive and efficient.

The service worked together with other hospitals within the LMNS to provide safe care for the women and their babies. The service had held a cross-site multidisciplinary team meeting a few weeks before our assessment for a woman who was 28 weeks pregnant to complete a risk assessment before transfer to a different site. This multidisciplinary team meeting was attended by the consultant, safety and capacity matron, and midwives.

There was transitional care for babies who were cared for with women in the postnatal ward. Transitional care was for babies that needed further support postnatally. We reviewed the policy and found it was in line with national guidance. However, the service did not have a specific transitional care area or bay.

The service was engaged with the Maternity Safety Support Program. There was a renewed focus on culture and on health inequalities, particularly noting perinatal mortality review tool themes.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

The service did not always routinely monitor people's care and treatment to continuously improve it. Where data was collected, outcomes were not always favourable. The service participated in relevant national clinical audits such as NHS England Saving Babies' Lives care bundle. The service was not able to meet all the required elements of this bundle. For example, they were struggling to improve their compliance for asking women their smoking status at 36 weeks. In February 2025, they were 60% compliant with this standard; the target was 80%. The managers had attended antenatal clinics to speak to midwives, increased education and looked at individual failure to try and improve compliance.

The service launched a `saving babies' lives' dashboard in December 2024 which allowed them to scrutinise the data for each element of the care bundle.

Outcomes for women were worse than expected from the maternity data reviewed. The service did not report postpartum haemorrhage rates over 500 millilitres, they only reported major obstetric haemorrhage rates over 1.5 litre on the maternity dashboard. At the time of the assessment, the major obstetric haemorrhage rate was 4.4%; the target was 2.9%. The service had a working group looking at improving the outcomes for women. This included introducing pre-emptive medicines to be given for both elective instrumental births and optimum birthing positions to try and reduce their postpartum haemorrhage rates.

There was a comprehensive program of repeated audits to check improvement over time, but managers and staff did not ensure they were always completed on time. The service shared audit plans which showed 6 plans had been completed and 40 maternity audits were overdue.

The service had several dashboards where data was analysed to monitor women's outcomes in line with national standards. The dashboards were sophisticated and allowed managers to look at patient-level details such as outcomes by ethnicity.

The trust was an outlier for babies who were born preterm. The national average was 63/1,000 babies whereas the trust had 97/1,000 babies who were born preterm. Managers had recognised this and highlighted that due to the demographics of their population it was expected to be higher. Each case of preterm baby was reviewed with the neonatal unit and obstetrics to look at any lessons learned.

There was a risk to patient safety due to the lack of capacity for preterm baby clinic appointments which could result in preventable preterm births, morbidity, and mortality. Pregnant women who have had a previous pre-term birth followed by a term birth without intervention should be referred to a preterm birth clinic according to national guidance. This service did not refer women who met these criteria which was a risk to patient safety. This was due to the services guidance not aligning with national guidance. The service has this risk identified as ongoing on the risk register.

Staff assessed and monitored women regularly to see if they were in pain. Pain relief was discussed with women in the antenatal period and when they arrived in the delivery suite. There were `pain relief in labour' leaflets available in each room in the delivery suite which were accessed by a QR code. They supported those unable to communicate using suitable assessment tools and gave additional pain relief to ease the pain. Anaesthetists did daily postpartum ward rounds and reviewed pain relief for women.

The service told people about their rights around consent and respected these when delivering person-centred care and treatment.

Staff gained consent from women for their care and treatment in line with legislation and guidance.

Women were provided with clear information about their proposed treatment, enabling them to make informed decisions. One woman told us, “Even though I have high-risk problems, everyone gave me choices with my care. Everyone explains things very clearly, so it is easy for me to understand.”

Each woman who underwent surgery signed a consent form, confirming staff had discussed the risks and benefits of treatment beforehand. Consent was reviewed before surgery and confirmed using a checklist within the surgical pathway; this was completed in all records reviewed. During an observation, a patient was asked about their consent form upon arrival in the theatre room. We looked at 4 sets of women’s notes and consent was recorded in all these records.

The Maternity and Neonatal Voices Partnership reported instances where women felt pressured into procedures without fully understanding the implications. For example, one woman who wished to have a home birth despite risk factors was discouraged in a manner she found dismissive. Concerns were also raised about consent not being fully respected in some cases. One woman underwent a procedure without feeling she had consented to it, and others reported being induced without a clear understanding of the process or associated timelines.

An audit conducted in January 2025 showed consent was documented in 100% of cases for caesarean sections, vaginal examinations, instrumental deliveries, and analgesia. However, consent for perineal repair was recorded in only 75% of cases. The service was continuing to monitor this through an ongoing Obstetric Anal Sphincter Injury audit.

Staff demonstrated an understanding of how and when to assess a patient’s mental capacity to make decisions about their care.