Stroud Maternity Hospital Also known as Stroud Maternity Unit

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 looked for evidence that people and communities had the best possible outcomes because their needs were assessed. We checked that people’s care, support and treatment reflected these needs and any protected equality characteristics, ensuring people were at the centre of their care. We also looked for evidence that leaders instilled a culture of improvement, where understanding current outcomes and exploring best practice was part of their everyday work.

This location was last inspected under the maternity and gynaecology framework in 2015. Following a consultation process CQC split the assessment of maternity and gynaecology in 2018. As such the historical maternity and gynaecology rating is not comparable to the current maternity inspection and is therefore retired. This has been rated as good at this assessment.

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 scored the service as 3. The service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

During the site visit, no women were giving birth at Stroud Maternity Hospital; therefore, we were unable to review patient records relating to intrapartum (labour) care. We saw results of a documentation audit completed across all maternity services before our site visit, however there was no date as to when this was conducted. This demonstrated that all mandatory areas within the electronic records system were completed in full. There were some areas where they needed to improve completion as these were not mandatory, for example, the consent area in booking forms and labour assessments had compliance ranging from 60% to 77%. Actions were being developed to improve this. Women had access to their records on an electronic app, and this was confirmed when speaking with women. Comments received from women were “good when working” and “connectivity issues at times.” Staff told us they updated care plans when necessary.

Women were screened for their risk of depression using a recognised tool. Women were referred to the perinatal mental health team if required.

Women’s communication needs were assessed and met to maximise the effectiveness of their care and treatment. Staff told us they had access to translation services via their phones or video for British Sign Language. Obtaining face to face interpreters was more difficult as they had to be booked in advance.

We scored the service as 2. The service did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. They did not always meet national guidance to make sure women and babies received good standards of care.

The trust had a dedicated midwife who monitored their data in relation to ‘saving babies lives bundle.’ Saving Babies' Lives" (SBL) refers to a major UK NHS initiative. It is a set of evidence-based actions for maternity services to significantly reduce stillbirths, preterm births, and neonatal deaths, focusing on areas for example, stopping smoking in pregnancy, monitoring fetal growth, and recognising reduced fetal movement. It is a national framework to improve maternity care quality and outcomes across England, supporting clinicians and families.

The trust participated in The Maternity Incentive Scheme (MIS) Year 7. They had declared themselves non-compliant with 3 safety actions. For example, the Perinatal Mortality Review Tool (PMRT). The trust was not always able to publish reports within the 6-month time period. Actions were being implemented to address these short falls. The MIS is an NHS Resolution program rewarding UK hospital trusts for implementing safety actions to improve maternity & neonatal care.

Staff followed evidence based good practice and standards. Staff used recognised tools to improve the detection and response to clinical deterioration in women as a key element of patient safety and improving patient outcomes. We were sent evidence following our site visits regarding policies and procedures which were updated and amended as required and when new guidance was issued.

We observed recognised assessment tools being used, for example, MEOWS and venous thromboembolism (VTE). These were being continually monitored, and we saw MEOWS was 100% completed for August 2025.

Staff assessed and met women’s needs for food and drink and for specialist nutrition and hydration. Domestic staff told us they were able to access food and drink to meet women’s dietary needs.

Staff told us they no longer had structured clinical supervision sessions but had access to practice facilitators to support them with their work performance.

Managers ensured that staff had access to regular meetings to keep them updated for example, with any safety information and changes to practice.

Managers identified the learning needs of staff and provided them with opportunities to develop their skills and knowledge. For example, staff received specialist training, including a 1-day fetal monitoring course followed by competency assessments to confirm proficiency.

We scored the service as 3. The evidence showed a good standard. The service worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Staff held regular handover meetings at shift change over times. Women who were giving birth were discussed and care handed over to the incoming staff. Staff also shared information to community midwifery teams when women were discharged to ensure continuity of care.

Staff told us how they could access specialist midwives to support women they cared for and improve outcomes. For example, midwives who had expertise in mental health, safeguarding and bereavement care.

The teams had effective working relationships, including good handovers, with other relevant teams within the organisation.

We scored the service as 3. The evidence showed a good standard. The service supported people to manage their health and wellbeing to maximise their independence, choice and control. The service supported people to live healthier lives and where possible, reduce their future needs for care and support.

Staff assessed women’s health during antenatal checks and on admission and supported individual needs. Smoking status was checked at booking, along with carbon monoxide monitoring. Women were offered cessation advice and referral to specialist services.

Women were supported to initiate breastfeeding in hospital and after discharge where able. We saw at Stroud Maternity Hospital, women could join a breastfeeding group for support and guidance. This service was not provided by the trust. The trust provided an online platform with feeding and nurturing resources for parents. Information boards and printed materials promoted healthy lifestyles and offered guidance on topics such as breastfeeding.

We scored the service as 2. The service routinely monitored people’s care and treatment to continuously improve it. However, they did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of women themselves.

The trust monitored performance using a systematic audit system. Audit results were reviewed by senior leaders within the maternity unit, and results were shared with staff through updates. Some of audit results were above national averages when compared to other trusts.

Staff participated in benchmarking and quality improvement initiatives. Clinical Quality Improvement Metrics (CQIMS) are a set of metrics derived from the Maternity Services Dataset for the purpose of identifying areas that may require local clinical quality improvement. In the most recent month of data (May 2025) Gloucestershire Hospitals NHS Foundation Trust were higher than the national average and in the upper 25% of all organisations for 1 metric, women who had a 3rd or 4th degree tear at delivery. The trust result was 49 per 1,000 births compared to a national average of 30.

The performance for this metric was also monitored in the national Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries (MBRRACE) rates between May 2022 and May 2025. This trust had recorded a consistently higher rate of 3rd or 4th degree tears over time with the only exceptions being 2 periods of reduction between August and November 2022, and April and May 2024. A midwife and physiotherapist were appointed to support staff with the management of 3rd and 4th degree tears; if a woman at Stroud Maternity Hospital experienced a 3rd or 4th degree tear they would be transferred to Gloucestershire Royal Hospital maternity unit for treatment. Although a care bundle was available, staff had not received training on its effective use. A care bundle is a set of interventions that, when used together, significantly improve patient outcomes.

The rate of women with Postpartum Haemorrhage (PPH) of 1,500ml or more at this trust had shown significant fluctuation over time and was consistently higher than the national and MBRRACE rates between September 2023 and August 2024. Performance appears to have been more consistently in line with the national picture from around February 2025.

The rate of babies born with an APGAR score between 0-6 had also fluctuated over time was consistently higher than the National and MBRRACE rate between June to September 2024. This appears to have stabilised in recent months. APGAR stands for A Appearance (Skin colour), P Pulse (Heart rate), G Grimace (Reflex response), A Activity (Muscle tone) and R Respiration (Breathing). The APGAR score is a quick test given to a newborn baby at 1 minute and 5 minutes after birth to determine if the need medical support.

Staff used technology to support women effectively. Women were able to access their computer records and information regarding their care and treatment.

The service used the National Perinatal Mortality Review (PMRT) Tool to review and report perinatal deaths. Senior staff told us these were reviewed at the PMRT group.

We were sent copies of the Newborn Early Warning Trigger and Track (NEWTT) trust-wide audit for August and September 2025. This demonstrated 100% compliance. NEWTT2 was due to be implemented in November 2025. NEWTT is a standardised monitoring tool for early intervention for deteriorating newborns.

Key performance indicators were incorporated into the perinatal dashboard for monitoring and oversight. As part of this dashboard, they also monitored the number of babies born before arrival at the unit.

We scored the service as 2. The evidence showed some shortfalls. The service did not always document when they told people about their rights around consent and did not always respect their rights when delivering care and treatment.

Women reported receiving sufficient information, including risks and benefits, to make informed decisions about their care and treatment. Staff discussed birthing plans and respected individual wishes.

Midwives understood how to assess decision-making capacity. Women said consent was obtained before treatment. A trust-wide audit of randomly selected records showed consent documentation was completed in 60% of booking records and 77% of community follow-up records. Senior staff acknowledged this section cannot be made mandatory in the electronic system and have an action plan to improve compliance.

Staff told us they had access to up-to-date policies and procedures, which were accessible to them through the trust’s intranet site.