Queens 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 looked for evidence that women and communities had the best possible outcomes because their needs were assessed. We checked that women’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.

We looked for evidence that women were protected from abuse and avoidable harm.

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

This meant people’s outcomes were 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.

The service made sure women’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

We reviewed 6 patient records and found that staff carried out thorough assessments of women's needs and developed care plans that reflected their individual circumstances. Care plans were person-centred and demonstrated how staff would meet identified needs throughout the woman's care journey.

Staff planned and delivered care in partnership with women, taking account of their individual needs, preferences and wishes. Care records demonstrated that women’s choices and specific requests were clearly documented and reflected in the care provided. Women we spoke with confirmed they were involved in decisions about their care and had received treatment in accordance with their preferences.

The records we looked at showed that women who attended triage had a risk assessment completed on arrival. Risk categories were assigned and reviewed as required, and women were seen within the timescales associated with their risk rating. However, a review of learning from patient safety events (LFPSE) from January to June 2026 highlighted not all women in triage had been seen for medical review within set timescales based on their risk categorisation. 

Staff completed comprehensive risk assessments for all women whose records we reviewed. These included assessments of venous thromboembolism (VTE) risk, pressure ulcer risk and mobility needs. Assessments were recorded clearly and informed care planning and ongoing clinical decision-making.

Women were involved in planning their care. Care plans were reviewed and updated throughout the woman's journey to ensure they remained responsive to changing needs and clinical circumstances. This supported the delivery of individualised care and treatment.

Staff took account of the wider needs of women and involved relevant specialists when required. Staff told us that women with additional needs, including mental health conditions, learning disabilities, autism or substance misuse concerns, were referred to specialist midwives to ensure they received appropriate support and intervention. 

The service planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based best practice and standards. 

The service mostly provided care and treatment in line with current legislation, national guidance and evidence-based best practice. Women we spoke with told us they received care and treatment that reflected their wishes and preferences. Staff delivered care in accordance with recognised standards and evidence-based guidance.

However, at the time of our inspection, staff in the triage area were not consistently directing women to the most appropriate care pathway to meet their needs. This created a risk that women may not receive timely assessment or care in the most suitable setting. We raised this concern with the trust during the inspection, and leaders took action to introduce processes aimed at improving the consistency of triage decision-making and patient streaming.

Staff assessed and met women’s needs for nutrition and hydration. Women had access to specialist support when required, including dietitians, specialist midwives and consultant midwives. Care records showed referrals were made appropriately and specialist advice was incorporated into care planning to support positive outcomes.

The service demonstrated a commitment to delivering evidence-based care and treatment through participation in national safety initiatives and the use of audit and monitoring processes to improve clinical practice.

The trust was engaged with NHS Resolution’s Maternity Incentive Scheme (MIS) programme and demonstrated improving compliance over time. In 2025/26, the trust declared compliance with all 10 Safety Actions. The trust provided a forward audit plan for 2026/27 which detailed a broad range of clinical audits scheduled throughout the year. This showed a structured approach to reviewing practice against recognised standards and demonstrated engagement from medical staff in auditing clinical documentation and care processes. For example, the service monitored compliance with venous thromboembolism (VTE) risk assessments to ensure women received care in line with national guidance. Data provided by the trust showed compliance exceeded the overall trust target of 95% in May 2026. This demonstrated oversight of clinical practice and provided assurance that these risks were being identified and managed appropriately.

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 worked well across multidisciplinary teams to deliver coordinated care and support for women. We observed positive and respectful interactions between midwifery, medical and specialist staff. Consultant midwives worked collaboratively with hospital and community midwifery teams to ensure high-risk women had clear, personalised and effective birth plans in place. Specialist teams were integrated within services and provided timely support, assessment and treatment for women when required.

Electronic patient records (EPR) systems supported effective communication and information sharing between teams. While some staff told us they did not always have sufficient time to complete records fully, staff could access a woman’s complete maternity journey from confirmation of pregnancy through to discharge. This supported continuity of care and informed clinical decision-making. Handovers between clinical areas and community teams were comprehensive, structured, and included the information required to support safe, ongoing care.

Staff mostly had effective working relationships with other teams across the organisation. Including with care coordinators, discharge teams and specialist services. We observed multidisciplinary team (MDT) working in theatre during an elective caesarean section. When a woman sustained a bladder injury during surgery, a urologist attended promptly to provide specialist expertise and support the team in delivering appropriate treatment.

Multidisciplinary teams regularly met to review incidents and outcomes, including cases involving postpartum haemorrhage. Staff from different professional groups contributed their individual clinical perspectives, supporting shared learning, reflection and opportunities to improve the quality and safety of care provided to women.

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, reduced their future needs for care and support.

Women were supported to make informed choices and adopt healthier lifestyles throughout their pregnancy. Midwives assessed health and wellbeing needs at the initial booking appointment, including smoking status, nutrition, and screening for low blood counts. These assessments were routinely reviewed at subsequent antenatal contacts to ensure women received ongoing support and advice appropriate to their individual needs.

Women identified as smokers were offered referral to smoking cessation services. Midwives also provided advice on healthy eating, vitamin supplementation, and other measures to promote a healthy pregnancy and positive outcomes for women and babies.

The service provided a range of information resources to support women and their families to maintain healthy pregnancies and prepare for parenthood. Women were encouraged to download a smartphone application which contained information to support informed decision-making and active involvement in their maternity care and birth journey. Topics included gestational diabetes, smoking cessation, immunisations, breastfeeding, safer sleep, healthy eating, emotional wellbeing and reducing the risk of sudden infant death syndrome (SIDS). Information was generally available in English and could be translated to meet individual needs.

There was an infant feeding team available to support women in their chosen method of feeding their baby. Midwives referred women requiring mental health support to appropriate specialist services and organisations. However, staff told us referral thresholds for some services were high, and charitable organisations providing mental health support in the Derbyshire area were oversubscribed. This may affect the availability of support for some women and could mean they experienced longer waits to access services appropriate to their needs.

The service routinely monitored women’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

The service routinely monitored the effectiveness of care and treatment and used a range of local and national audits, performance measures and governance processes to improve outcomes for women and babies.

The service participated in relevant national clinical audits, including the Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK (MBRRACE-UK) perinatal mortality audit. Results from the MBRRACE-UK Perinatal Mortality Surveillance Report, published in March 2026 and based on births in 2024, and the MBRRACE-UK Perinatal Mortality Surveillance Report showed the trust’s perinatal mortality outcomes were in line with, or better than, those of similar services. For births excluding congenital anomalies, the trust's mortality rate was between 5% and 15% lower than the comparator group average.  When babies with congenital anomalies were excluded, fewer babies died around the time of birth compared with similar services.

Managers and staff carried out a comprehensive programme of clinical audits to monitor performance and identify opportunities for improvement. Audits included Saving Babies' Lives Care Bundle Version 3 (Element 4), pre-eclampsia and Local Safety Standards for Invasive Procedures (LocSSIPs). Where audits identified areas of non-compliance, the service developed action plans and monitored progress to support improvement.

The service had effective systems to review audit findings and clinical outcomes. Regular quality governance and audit meetings were held to discuss women's outcomes, review ongoing audits and monitor areas of concern. These meetings were multidisciplinary and involved staff from all specialties contributing to women's care. This supported shared learning and ensured different professional perspectives informed improvements in practice. Managers communicated audit findings to staff and provided feedback on actions taken in response to identified issues.

The trust contributed data to the Clinical Quality Improvement Metrics (CQIMs) programme to benchmark performance against other organisations. Data published in March 2026 showed that 2 out of 7 key maternity metrics reviewed were above the national average. The hospital was within the highest 25% of reporting organisations for third- and fourth-degree perineal tears and postpartum haemorrhage (PPH) of 1,500ml or more. These could potentially indicate poorer outcomes for women. Leaders recognised these results as areas requiring improvement and implemented monitoring and oversight arrangements with the Local Maternity and Neonatal System (LMNS), Integrated Care Board (ICB) and regional NHS England maternity team.

The service demonstrated a commitment to improvement and could evidence positive progress. Data showed a reduction in severe postpartum haemorrhage rates, with performance in January 2026 approaching the national average. Following concerns identified at our last inspection, an Independent Oversight and Assurance Group (IOAG) had been established to provide additional scrutiny and assurance regarding progress against improvement actions. This was an improvement since our last inspection.

Staff used technology effectively to support the monitoring and delivery of care. An electronic patient record system enabled timely access to patient information and investigation results and provided a secure platform for documenting care and treatment. Although some staff told us workload pressures occasionally limited the time available to complete documentation as fully as they would like, records we reviewed supported continuity of care and facilitated ongoing monitoring of outcomes.

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

Staff understood their responsibilities in relation to the Mental Capacity Act (2005) and demonstrated a clear understanding of how and when to assess a woman’s capacity to make decisions about her care and treatment. Women were supported to make informed decisions through the provision of information in ways they could understand, including verbal discussions and written information. Specialist midwives were involved where required to provide additional support and ensure women had the information needed to make informed choices.

Staff sought and appropriately recorded consent for care and treatment. We reviewed six maternity records and found clear documentation of consent in all records reviewed.

Where women lacked capacity to make decisions, staff acted in accordance with legal requirements and made decisions in the woman’s best interests. Staff considered the woman’s wishes, feelings, culture and previous expressed views when planning care. Midwives described supporting a woman who was subject to the Mental Health Act (2005) and lacked capacity to make decisions regarding her care. They told us they worked closely with trust legal teams and mental health professionals involved in the woman’s care to ensure decisions about treatment and care reflected her best interests.

Risk discussions were thorough and well documented. Staff explained the potential implications of individual risk factors and ensured women had the information they needed to make informed choices. This included discussion of increased risks to the mother, such as post-partum haemorrhage and vaginal trauma, and risks to the baby, including hypoxia (oxygen deprivation), cervical spine injury and, in rare circumstances, death. Women were given opportunities to ask questions and reflect on the information provided, supporting informed consent and personalised care planning.

Women who were considering giving birth without the assistance of a midwife or other health professional were offered information and encouraged to contact the midwifery team to discuss their concerns and consider how the service could support their choices. 

Staff understood their responsibilities under the Human Rights Act (1998). Consultant midwives reviewed all women with identified risk factors who requested a home birth. This included women with previous obstetric complications, a history of significant haemorrhage, previous surgery or other conditions that may increase the risks associated with home birth. Consultant midwives also reviewed the care of women who chose a home birth against clinical advice. They met with women to discuss the potential benefits and risks associated with their individual circumstances and worked collaboratively with them to develop personalised care plans. This ensured women were fully informed of the risks and benefits of their chosen place of birth and were supported to make informed decisions about their care and treatment.