Good Hope 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

We rated responsive as requires improvement. We looked for evidence that the service met people's needs. At our inspection published in 2017, we rated this key question as good. At this assessment the rating changed to requires improvement. This meant people's needs were not always met. The service did not always ensure timely access to care, support, and treatment.

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 service did not consistently ensure women were at the centre of their care and treatment decisions. Women were not always seen promptly when raising concerns such as reduced fetal movements. The maternity assessment centre, which allowed pregnant women to self-refer by phone, did not always provide timely appointments, falling short of national guidance. Delays were primarily due to limited availability of doctors and ultrasound scanning slots.

During the onsite assessment women experienced delays in waiting for doctors, risk assessments including reduced fetal movement assessment. Documentation was also not consistently aligned with national standards.

The service's risk register highlighted sonography as a concern, citing "delayed intervention/missed findings due to insufficient capacity of appointments in Fetal Medicine." This was attributed to a shortage of appropriately trained medical staff. Although the service had attempted to recruit and mitigate risks, this remained an ongoing issue. This was an issue particularly for babies at risk of fetal growth restriction and placental insufficiency. Missed diagnoses of `small for gestational age' babies had also been identified as a recurring theme in perinatal mortality review tool findings.

The service was unable to always provide scans ensuring timely person-centred care due to capacity, staffing, and availability of scan appointments.

Women did not always feel supported in their infant feeding choices. Feedback from the Maternity and Neonatal Voices Partnership (MNVP) and the 2024 maternity feedback survey indicated a lack of encouragement to breastfeed, with some women feeling pressured to use formula. Staff acknowledged during periods of low staffing they were unable to provide adequate breastfeeding support. While midwives discussed feeding preferences antenatally, postnatal support was inconsistent.

Women were mostly involved in planning and making shared decisions about their care. Positive feedback included comments such as, "Midwives have explained my options and the doctor who saw me went over my plan again and asked if I was happy with it," and "The plan for care and delivery was explained in detail and in a language I could understand."

However, women did not always have a choice in their place of birth. The MNVP reported frustration over limited access to the midwifery-led unit, which had only 21 births in the 12 months prior to the assessment. This was due to staffing shortages.

The postnatal ward had recently implemented 24 hours a day, 7 days a week visiting hours to ensure birthing partners felt welcome and had unrestricted access.

Midwives and maternity support workers took time to understand birth preferences and support communication, including the use of pictorial charts to support women in expressing their needs.

The service made reasonable adjustments to ensure women received appropriate care. Women with mental health needs or learning disabilities were provided with individualised care plans, supported by the hospital's vulnerabilities team. Handovers included holistic assessments, including mental health considerations.

Antenatal clinic appointments were scheduled to meet family needs where possible. A range of specialist clinics were available, including diabetic, endocrine, substance misuse, and mental health clinics.

We did not look at Care provision, Integration and continuity during this assessment. The score for this quality statement is based on the previous rating for Responsive.

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

Women could get information and advice which was accurate, up-to-date, and provided in a way they could understand, and which met their communication needs.

People could have information tailored to individual needs. This included making reasonable adjustments for disabled people, interpreting and translating for women who did not speak English as a first language, and for D/deaf people who used British sign language. Staff used a video telephone interpreter when needed. We were told a midwife had used it continuously during a woman's labour as they wanted the extra support in their language. However, the MNVP team told us there was no clear interpreting service for people who were deaf or hard of hearing. Women had fed back to them there was a lack of interpretation services. Managers told us this was an area they were working hard to improve.

There was a communication box on the delivery suite to assist with communication needs for women who needed further support such as women who were deaf or hard of hearing. However, there were no communication boxes on other wards within the maternity service.

Women were provided with information about their care and the different options they could choose. One woman told us, "I am happy with the staff; all are very calm and help me when I ask for information." Another told us, "Everyone explains things very clearly, so it is easy for me to understand."

There was a lack of antenatal education, particularly for women who had protected characteristics. We were told women found it difficult to access antenatal classes and clinics when English was not their first language. The consultant midwives were working to improve this through spending time with charities, working with groups already set up in the community and collaborating with the MNVP to understand the requirements needed to improve access.

The service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment, and support. Staff involved people in decisions about their care and told them what had changed as a result.

Women knew how to give feedback about their experiences of care and support including how to raise any concerns or issues. The service displayed information about how to raise a concern in patient areas. All women were given a QR code with a link to a feedback questionnaire. All women who had surgery were given a paper questionnaire to give their feedback about their experience.

However, partner agencies and feedback from women showed complaints responses were slow and generic, and responses were described as not feeling personalised. We were told a woman had put in a complaint in December 2024 and continued to await a response in March 2025. The service reported receiving 48 complaints between October 2024 and March 2025. Themes included delays to care, mismanagement in labour, communication with patients, and inappropriate treatment.

Staff understood the policy on complaints and knew how to handle them. All formal complaints went through the hospital Patient Advice and Liaison Service. Managers investigated the complaints and identified themes within their areas. Managers gave staff feedback and learned from complaints. For example, we were told they had recently brought in 1 hourly `fresh eyes' wellbeing checks by the maternity support workers with each woman to try and ensure their needs were met.

There was an `afterthought clinic' run by the consultant midwives who listened to the experiences women had at the service.

We were told the managers of the delivery suite used to complete a walkaround of the patients and capture any immediate feedback; this had been undertaken by the delivery suite coordinators in the absence of the ward manager and matron. Feedback was collated and reviewed monthly. Themes for January 2025 included noise at night and food being bland but most of the comments were the care was kind and compassionate.

The service did not always ensure timely access to care, support, and treatment. Women could not always access ultrasound scans promptly, even when at high risk; some waited up to 48 hours. As of 25 March 2025, 30 women were waiting for a scan. Although scan capacity was available from 8am to 8pm daily, with an additional list on Thursdays, this was insufficient to meet demand. A business case was in progress to increase scan availability.

The antenatal clinic lacked capacity for weekly scans, and women were transferred to the maternity assessment centre; this was on the risk register.

Managers attributed reduced capacity to increased scanning for women with reduced fetal movement. A review of 5 sets of notes revealed inconsistencies with scanning practices. This included scans being conducted after a first episode of reduced fetal movement, contrary to local and national policy. In one case, staff cited the woman’s ethnicity as the reason for deviating from policy.

Managers were revising the reduced fetal movement guideline to classify a second episode if it occurred within t3 weeks of the first, though this was not aligned with national guidance.

Women attending triage were not always seen promptly due to limited doctor availability. Between January and March 2025, doctors met the target of seeing over 85% of women within the recommended time on only 9 out of 73 days. On 2 days, no patients were seen within the timeframe. Although 2 doctors were assigned to the maternity assessment centre from 9am to 5pm, they were often redirected to the postnatal ward. Doctor coverage after 5pm and on weekends was poor. While breaches in triage times were discussed in daily governance meetings, no actions were observed to address the issue.

There were delays for women requiring induction of labour due to staffing and bed shortages. Although 4 low-risk and 2 high-risk inductions were scheduled daily, not all women could attend. Consultants reviewed the list twice daily and provided assessments and monitoring until admission. Some women reported not receiving clear information about the induction process and said they might have opted out if they had.

Women did not have a choice of birth location. The midwifery-led unit was mostly closed, and low-risk women had to give birth in the delivery suite. Service users expressed frustration to the Maternity and Neonatal Voices Partnership, stating they were not informed in pregnancy that the unit would be closed. There was no midwifery-led unit available within the trust.

Women requiring surgery had prompt access. A surgical team was available 24 hours a day, 7 days a week next to the delivery suite. The theatre team lead attended daily huddles to prepare for potential admissions. Elective caesarean sections were performed at Birmingham Heartlands Hospital. Category 3 planned caesareans were booked in advance with input from the delivery suite coordinator.

There was a steering group was to address health inequalities. Priorities included ensuring informed choices, accessible information, and interpreter use. A text message survey was sent to women who missed appointments to understand the reasons. Improvements included aligning ultrasound and obstetrician appointments at the same site and allowing children at antenatal appointments. Clinics were also being redesigned to allow longer time slots when interpreters were needed.

We did not look at Equity in experiences and outcomes during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Planning for the future during this assessment. The score for this quality statement is based on the previous rating for Responsive.