Stroud Maternity Hospital Also known as Stroud Maternity Unit

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

At our last assessment we rated this key question as requires improvement. At this assessment, the rating has improved to good.

This meant the service was consistently managed and well-led. Local leaders and the culture they created promoted high-quality, person-centred care.

We have not awarded this service a score for Well-led.

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

We scored the service as 2. The evidence showed some shortfalls. The service did not have a strategy which was based on transparency, equity, equality and human rights, diversity and inclusion, and engagement.

Most staff knew about the provider’s (Gloucestershire Hospital NHS Foundation Trust) vision and values and how they were applied in the work of their team. We saw information regarding their compassionate culture which listed the behaviours and values desired of employees.

There was not a clear strategy for trust-wide maternity services. The maternity strategy concluded in 2024. The trust was working on a new maternity strategy that was in line with their overall strategic plan. Senior leadership from the trust told us they had been concentrating on addressing and improving maternity care across the trust which delayed setting a new strategy.

Staff morale was mixed. Some staff reported anxiety and uncertainty about the transformation project and how it would impact on the way Stroud Maternity Hospital would operate in the future. While others welcomed the planned changes as necessary to meet the changing needs of women giving birth. Although the overall culture was viewed positively, staff expressed concerns about ongoing changes and workload. This variation in morale and confidence had the potential to affect staff engagement and the consistency of care delivery.

The service worked alongside the Local Maternity and Neonatal System (LMNS), Maternity Voices Partnership and Maternity and Newborn Safety Investigations (MNSI) programme in addition to other services to better respond to the needs of the local population.

We scored the service as 2. Some staff said senior leaders were not visible or accessible and some staff felt there was a blame culture and did not feel able to raise concerns. However, Leaders understood the context in which the service delivered care, treatment and support. They mostly embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively, and did so with integrity, openness and honesty. Staff praised local leaders and felt they could raise concerns with them and be listened to.

Senior leaders were not always consistently visible or accessible to women and staff. There was a clear leadership structure for maternity services. The Director of Midwifery led the maternity services which was part of the Women’s and Children’s services, and a Non-Executive Director held responsibility for maternity. At Stroud Maternity Hospital, staff had access to a lead midwife and matron. Staff said they were visible and approachable.

Staff felt able to raise concerns or personal issues with the lead midwife and matron and reported feeling supported during incidents.

Local leaders had a good understanding of the services they managed. They could explain clearly how the teams were working to improve the quality care.

Local leaders understood the needs of the local population, including how health inequalities affected treatment and outcomes for women, babies and families from ethnic minorities and disadvantaged groups. They collaborated with various stakeholders such as the maternity and neonatal voices partnership (MNVP) and the local maternity and neonatal system (LMNS). They also attended various meetings and had a programme to improve the equity of experience and outcomes.

Safety champions completed visits and dates of these were announced to enable staff to attend.

We scored the service as 3. The evidence showed a good standard. The service fostered a positive culture where people felt they could speak up and their voice would be heard.

Staff had access to a Freedom to Speak Up Guardian (FTSUG). None of the staff we spoke with had used them. Staff felt they could approach their local leaders if they had any issues. The FTSUG was promoting a restorative culture focused on repairing harm and relationships rather than assigning blame. There was 20 Freedom to Speak Up Champions across the trust, independent of any specialty to maintain impartiality. However, there was no FTSUG based at Stroud Maternity Hospital which could make accessing them at times more difficult.

Managers and staff had access to the feedback from women and their family. Staff used the feedback to make improvements.

We scored the service as 3. The evidence showed a good standard. The service valued diversity in their workforce. They work towards an inclusive and fair culture by improving equality and equity for people who work for them.

Staff were supported in the workplace. Staff were able to apply to work flexibly, for example, flexible working agreements to account for personal circumstances such as caring responsibilities and health issues.

Managers made reasonable adjustments for staff members to help them carry out their role.

Staff reported having opportunities to develop their skills and knowledge. The trust offered programmes to support unqualified staff who wished to train as midwives.

The trust undertook equality monitoring of staff within the service to ensure it is diverse in its make-up and representative of the patient group. We were provided with the Workforce Race Equality Standard (WRES) data for 2024-2025. Staff were asked a series of questions, and this was reviewed based on race. The data showed the number of staff from Ethnic Minority Backgrounds had increased across all bandings of staff in the Women’s and Children division.

We scored the service as 3. The evidence showed a good standard. The service had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver good quality, sustainable care, treatment and support. They act on the best information about risk, performance and outcomes, and share this securely with others when appropriate.

Stroud Maternity Hospital was part of Gloucestershire Hospitals NHS Foundation Trust, and they followed and used the same governance tools to oversee and monitor service provision. The trust had implemented a new governance structure in October 2024, and this included new forums which fed information into the pathway to the board. The governance team provided data to each forum and groups for example, incidents, and themes from learning. The governance lead for maternity also had management responsibilities for other services meaning they had less time to devote to governance of this service.

Staff had access to team meetings which followed a standard format. This ensured essential information, including learning from incidents and complaints, was consistently shared and discussed.

Staff undertook or participated in local clinical audits which were fed back in the trust governance arrangements. The audits were mostly sufficient to provide assurance and staff acted on the results when needed.

Staff at Stroud Maternity Hospital told us they could escalate concerns when required to their local leaders which were shared with senior staff at trust level.

Stroud Maternity Hospital used a production board to display key compliance data, including MEOWS and fetal monitoring, both of which were recorded at 100% in August 2025. The board was updated monthly. A new pressure‑ulcer assessment tool showed 67% compliance for August 2025, with senior staff expecting improvement over the coming months.

Service-wide risks were recorded on the risk register. Risks were scored, discussed at governance meetings, and actions documented, with evidence of board-level review. Examples included staffing.

Senior staff networked with other maternity units within the southwest to learn from each other and share good practice.

Staff understood the arrangements for working with other teams, both within the provider and externally, to meet the needs of the patients.

We were sent a copy of the trust’s action plan to meet the requirements of Ockenden report which was published back in 2022. Some of actions were still being addressed. These included areas for workforce and sustainability.

Data and notifications were submitted to external organisations. The service submitted all qualifying maternity safety incidents to the Maternity and Newborn Safety Investigations (MNSI) programme, as required for NHS trusts. These incidents were investigated and, where appropriate, safety recommendations were made.

The service held monthly perinatal delivery group meetings chaired by the Director of Nursing from the trust. We were sent copies of the agendas but no minutes. The agenda showed areas discussed and these included saving babies’ lives, perinatal quality and safety and maternity safety support programme (MSSP). MSSP is a national support programme provided by NHS England to maternity services where significant concerns have been identified regarding the safety and quality of services.

The service collected and analysed reliable data. The trust submitted data to the Maternity Services Data Set (MSDS). The MSDS is a national dataset that captures patient-level information from the booking appointment until discharge.

Maternity safety champions held regular quarterly meetings with a set agenda. We were told actions from previous meetings were reviewed, as well as any quality improvement projects. The service shared the Maternity Safety Champion Director of Midwifery and Non-Executive Directors Walk Around schedule for 2025. Feedback from the walk arounds were shared during Maternity Safety Champion meetings.

We scored the service as 4. The evidence showed an exceptional standard. The service clearly understood and carried out their duty to collaborate and work in partnership, and services worked seamlessly for people. They always share information and learning with partners and collaborate for improvement.

Directorate leaders engaged with external stakeholders such as commissioners.

Facilities at Stroud Maternity Hospital have been upgraded through funding from the Stroud Hospitals League of Friends, which also supported the pre and post‑natal services such as singing and yoga. Additional programmes for new mothers provided practical and wellbeing support and were delivered free of charge in collaboration with maternity staff. Staff and women gave consistently positive feedback about these services.

The trust was working with the local Integrated Care Board (ICB) to undertake a maternity needs assessment. This involved gathering feedback from women and staff on their experiences and priorities for future service development. This insight was intended to identify gaps, inform targeted improvements, and ensure maternity services remained inclusive, responsive, and equitable for families across Gloucestershire.

Service leaders attended regular meetings with the Local Maternity Network System (LMNS) to review governance and incidents. The LMNS is a collaborative partnership for all maternity and neonatal care across Gloucestershire, aiming to improve services, and Gloucester's maternity services are a key component of this local system, working within the wider Southwest Neonatal Network for complex cases.

At the time of the assessment the trust did not have their own MNVP role. MNVP stands for Maternity and Neonatal Voices Partnership, which is a group in the UK that brings together parents, families, midwives, and commissioners to review and improve local maternity and neonatal care, ensuring service users' experiences shape decisions for better safety, quality, and experience for everyone using services. This was being overseen by the regional MNVP, but funding has been agreed for a specific post to work with this trust.

We scored the service as 3. The evidence showed a good standard. The service focused on continuous learning, innovation and improvement. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people.

Senior staff were working on implementing a version of the Maternity Disadvantage Assessment Tool (MATDAT). This tool was to identify complexity, risk, and need early in pregnancy. It would also be used to assess midwife-to-woman time requirements based on complexity, ensure fair and accurate caseload distribution based on women's needs, and support better outcomes and equity for women. They had plans to expand its use, but this was in its infancy at the time of our assessment.

A new way of teaching and upgrading community staff skills and knowledge had been devised. This was called the ‘Skill Zone Safety Centre’ which was an immersive home setting, providing firsthand insights into obstetric emergencies in the community setting. This started in June 2025 and staff at Stroud Maternity Hospital told us how beneficial they found this training as it was based more around a home setting and without medical support.

This trust was part of the Maternity and Neonatal Independent Senior Advocate (MNISA) pilot. This pilot is a trial program providing independent support to women, and families who have experienced serious harm, injury, or death during maternity and neonatal care in England, aiming to amplify their voices, help navigate complex systems, and drive learning for future improvements. These advocates ensure families feel heard, understand investigations, and find appropriate support, even if the issues extend beyond the initial providers, supporting system-wide change. This was due to close in early 2026 and senior staff from the trust will use the feedback to make changes to their service.