Horton General 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 looked for evidence that people and communities were always at the centre of how care was planned and delivered. We checked that the health and care needs of people and communities were understood, and they were actively involved in planning care that met these needs. We also looked for evidence that people could access care in ways that met their personal circumstances and protected equality characteristics.

At the last assessment in 2024 we did not assess this key question.

At this assessment the key question has been rated as good.

This meant people’s needs were met through good organisation and delivery.

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 made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

Staff consistently prioritised individual women’s needs, preferences, and values throughout their care journey. Women were placed at the centre of their care, which was delivered in a respectful, responsive, and compassionate manner. Staff demonstrated a clear commitment to tailoring care to each individual, rather than adopting a “one size fits all” approach.

Patient records showed that women were actively involved in decision-making and were supported to make informed choices about their care, rather than being passive recipients of it. Individualised care plans clearly documented women’s preferences for antenatal, labour, birth, and postnatal care.

Midwives supported women to make informed decisions, including when these choices felt outside of local or national guidance, ensuring women understood the risks and benefits and that their autonomy was respected.

Women were treated with kindness and dignity, with staff ensuring privacy and respecting personal, cultural, and spiritual beliefs.

The service operated a continuity of care model, meaning care was provided by a known midwife or a small team. This approach helped build trusting relationships between women and staff and was shown to support positive experiences and improved outcomes.

The service made sure people received care and treatment that was integrated across the maternity healthcare and community services, with a clear focus on continuity of care.

The midwifery-led unit (MLU) provided care focused on women with low-risk pregnancies and births. Midwives led the planning, organisation, and delivery of care from booking through to the postnatal period. Care was delivered using a holistic approach that addressed women’s physical, mental, and social needs, with midwives actively advocating for women’s preferences throughout their care journey. The MLU environment was specifically designed to support the physiological birth process and promoted a calm, supportive setting for women and their families.

The MLU did not operate in isolation and was well integrated with the wider maternity services within the trust, as well as external healthcare and community services. For example, referrals were made to a local antenatal group for women aged over 18 with additional social care needs. This group provided coordinated access to antenatal care, education, and social support within a single setting, supporting joined-up care and early intervention.

The service used an electronic patient record system that could be accessed by the MLU team, GPs, and other authorised healthcare professionals. This supported integrated care through effective information sharing and ensured care was coordinated across different services and care settings. Women were also able to access their own records via the system’s app, allowing them to view appointments and monitor their baby’s development, which supported involvement and continuity.

Continuity of care was a key feature of the service. Women were allocated a named midwife who provided the majority of their antenatal, intrapartum, and postnatal care. This enabled the development of trusting relationships over time, which is known to improve safety and clinical outcomes. Where complications arose and transfer to the obstetric unit was required, continuity was maintained wherever possible. The midwife accompanied the woman to the obstetric unit and provided a structured handover to the receiving medical team, ensuring safe and seamless transition of care.

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

The trust had an up-to-date website that provided accessible information about maternity services, including the Horton midwifery-led unit (MLU) and the services it offered. This included access to maternity information leaflets. The website featured a range of inclusive tools, such as a “speak” function that allowed information to be read aloud, a translation function enabling content to be translated into multiple languages, and a picture dictionary where clicking on selected words displayed an image to explain their meaning.

Within the midwifery-led unit, there were several information display boards available for women and their families. This included a large noticeboard in the waiting room and additional display boards along the unit corridor. A wide range of information leaflets covering many topics were available, including versions in different languages relevant to the local community. There were also topic-specific noticeboards, such as one promoting the importance and health benefits of skin-to-skin contact, another on newborn hearing screening, and one on reduced fetal movements, which displayed information in six languages.

There was a daily staffing board listing the midwife, maternity support worker, and housekeeper working in the unit that day.

The service used an electronic patient record system with a digital app that allowed women to access their own medical records, care plans, and educational resources.

The unit held open days, enabling women expecting a baby and their families to visit the unit, meet the team, have a tour, and ask questions. During these sessions, information was provided on specific topics such as the use of the birthing pool, infant feeding after birth, and postnatal care, either through written materials or discussions with staff.

The service had access to comprehensive translation services, including face-to-face interpreters as well as telephone and video interpreting services. The trust also offered free, tailored antenatal classes for English-speaking migrants and Tetum speakers who were having their first or second baby in the UK. These classes were developed as part of a community project aimed at improving access to care, experiences, and health outcomes for mothers and babies in the local area. The classes were delivered by midwives from the trust, with maternity advocates interpreting the content into Tetum.

The trust had policies and procedures in place for producing, publishing, and managing all types of patient information, ensuring minimum quality standards were met for information produced for patients and carers. This policy outlined the steps staff must take to ensure that all patient information, across all media formats (including printed materials, digital content, and video), was fit for purpose. Information was required to be accurate, safe, up to date, accessible, inclusive, and written in clear, understandable language that avoided medical jargon. It also had to meet equality, diversity, and inclusivity objectives, follow trust branding guidelines, avoid duplication of existing resources, and provide access to valid national information.

In line with the Accessible Information Standard, all patient information was expected to be available in accessible formats to meet the legal requirements set out in the Accessible Information Act 2016.

During observations within the unit and during telephone triage, midwives were seen communicating effectively with women using open dialogue and active listening. Information was gathered sensitively and relayed back calmly and clearly.

Midwives supported women in their decision-making by explaining the risks and benefits of different options, such as choosing to give birth at the MLU, enabling informed choice. They also provided clear information about postnatal follow-up, so women understood what to expect after birth. Information was tailored to individual needs and made accessible for women with disabilities or language barriers.

The service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support and acted on it.

The service actively used feedback and complaints from women who had accessed their care, to identify areas for improvement and drive enhancements in the overall quality of care. By listening to service users’ experiences, the organisation was able to implement meaningful changes that better met patient needs and expectations.

There were many ways for people to give feedback. The unit displayed boards featuring photographs of the maternity team, including clear information about who to contact if women had concerns or worries about their care.

Banners were displayed advertising the Oxfordshire Maternity and Neonatal Voices Partnership, providing information on how people could share feedback to help improve maternity and neonatal services across the county.

Women who used services at the Midwifery-led unit (MLU) and outpatient clinics were invited to complete the NHS Friends and Family Test (FFT). For September 2025, 85% of respondents reported that they had a good or very good experience. Six per cent rated their experience as poor, primarily due to waiting times for outpatient appointments. No respondents rated their experience as very poor.

The trust website gave people information on how to raise concerns or complaints, including ways to make a formal complaint about their care and treatment.

The midwifery-led unit received very few formal complaints. Concerns raised included limited space for some postnatal clinics and a lack of privacy, as conversations could be overheard in the waiting room. In response, the service reconfigured rooms to create two designated postnatal clinic rooms and introduced a radio in the waiting area to help improve privacy.

The service made sure that people could access the care, support and treatment they needed when they needed it.

The midwifery-led unit (MLU) was primary for low-risk, straightforward pregnancies as there was no immediate access to obstetricians, theatres and neonatal intensive care.

The service worked to promote equity in access to the MLU and aimed to reduce barriers for women from diverse backgrounds. Information about the MLU, including eligibility criteria and how to access care, was shared in a range of formats and discussed during antenatal appointments to support informed choice.

The service took steps to ensure access was inclusive for women with protected characteristics and additional needs. Interpreting services were available for women whose first language was not English, and staff were able to access translation support to help ensure women could understand information about their care and make informed decisions. Written information could be provided in alternative formats on request.

The MLU worked closely with community midwifery teams to identify and support women who may face barriers to accessing services, including those from deprived areas, younger parents, and women with complex social needs. Individualised care planning was used to support equitable access and ensure women were signposted to appropriate services.

The service monitored uptake of the MLU and considered feedback from women to understand whether any groups were under-represented. Where inequalities were identified, the service worked with wider maternity services and local partners to improve awareness and access to the MLU.

The MLU suspended intrapartum care on 2 occasions between October 2024 and September 2025, once in October 2024 and once in November 2024, due to short-term staffing shortages. On both occasions, there was no impact on women’s care, safety, or access to maternity services.

The maternity service delivered outpatient clinics at the local unit, reducing the need for women to travel to the main maternity hospital, which was approximately 30 miles from the Horton General Hospital. The trust had recently invested in the development of these outpatient facilities, enabling the introduction of 3 additional high-risk obstetric clinics each week. These clinics were delivered by specialist multidisciplinary teams from the main maternity hospital. Further improvements included the installation of a new ultrasound machine, allowing timely diagnostic assessment and specialist input to be provided locally. As a result, women and families were able to access expert maternity care closer to home, improving accessibility and continuity of care.

In August 2025, the maternity service published a briefing report addressing maternal and perinatal health inequalities within the trust. The report brought together ongoing work across the maternity service aimed at reducing health inequalities and improving equitable access to care. It highlighted both opportunities and challenges arising from service developments, including the transition to a fully digital care record system. While this digital transformation improved efficiency and information sharing, the report acknowledged the risk of digital exclusion for some service users and outlined the mitigations in place to ensure continued access to maternity care for all.

Staff and leaders actively listened to information about people who were most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

The service routinely used performance data to monitor key indicators, including number of births, obstetric anal sphincter injuries (OASI), and transfers to the obstetric unit and the reasons for transfer. This enabled the service to understand overall performance and to identify whether outcomes were comparable across different groups of women. Where variation or potential disparities were identified, these were reviewed to understand contributory factors and to inform service improvement actions.

The service used the electronic patient record system to support analysis of outcomes and had plans in place to further develop a maternity health inequalities dashboard. This would integrate clinical, demographic, and outcome data to provide improved oversight of equity in access, experience, and outcomes, and to identify areas where additional action was required.

Patient experience data, including surveys, complaints, compliments, and incident reports, were reviewed to assess satisfaction and identify themes affecting experience and outcomes. When reviewing incidents and adverse outcomes, the service considered the potential impact of ethnicity, deprivation, language, and cultural factors to ensure learning took account of health inequalities.

The service demonstrated an understanding of the diverse local population, including the presence of asylum accommodation and a concurrent increase in pregnant asylum seekers. In response, additional clinics were introduced to support pregnant refugees, newly arrived, and otherwise vulnerable migrant women with complex needs, supporting more equitable access to maternity care and improving experience and outcomes for these groups.

We did not look at Planning for the future during this assessment. There is no previous rating for the Responsive key question so we cannot yet publish a score for this area.