Furness General Hospital

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• 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

This means we looked for evidence that women’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question Good. At this assessment the rating has remained good. This meant women’s outcomes were consistently good, and women’s feedback confirmed this.

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

Clinical pathways we saw in women’s records were completed comprehensively.

We saw there were appropriate care pathways in place and enhanced support midwives ensured pregnant children and young women aged under 18 were supported throughout pregnancy and the post-natal period both in community and hospital.

There were systems and pathways which ensured support for vulnerable women or women who lacked capacity. Anyone identified as vulnerable at antenatal appointments were immediately referred to the enhanced midwife for screening, this was usually done at booking. This included teenage pregnancy, substance misuse, domestic abuse, asylum seeker, non English speaker, financial deprivation and families being supported by children’s services.

The specialist midwives worked closely with community midwives and they had autonomy to manage their case loads, especially important for complex and high-risk women to provide continuity of care. All care notes for these women were recorded in a confidential section of the electronic notes. The enhanced support midwife continued care and contact for up to 28 days and sometimes longer if necessary for safety.

Any strengths, needs or potential risks were identified, and an individualised management plan was devised. Referrals were made as required to partner agencies such as children’s social care, adult social care, and learning disability team. The service had a learning disabilities lead for advice and support within office hours.

The band 7 coordinator was supernumerary. If the coordinator was ever required to work clinically this was always reported as an incident, however we were told that this was very rare.

If a woman’s first language was not English, they were also referred to the enhanced support midwife to assess any additional support required. Additional communication aids were identified and a consideration made for a more specialist assessment when needed.

Information and communication aids available included easy read information with simplified terminology, translation services for printing information and texting, letters for dyslexic women were printed on green paper and translation services used were available in both audio and visual using a screen.

The service has access to translation services, which also translated patient information. Staff were aware of the translation service and did not use family members unless the women had chosen this. Staff said they ensured that they always had time alone with the women to determine whether there were any safeguarding issues they needed to be aware of such as domestic violence.  

Best interests documents we saw included women’s views, beliefs, values (including religious, cultural, moral or political) and how they would likely influence decisions.

Women with vulnerabilities and who lacked capacity were supported postnatally with accessing contraception

The evidence showed a good standard. The service planned and delivered women’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 good practice and standards.

Staff accessed policies and best practice guidance on the trust’s electronic system. Guidelines and policies were regularly reviewed. We reviewed 10 policies and guidelines on site and further off site following the inspection and found that all were in date and in line with relevant national and local guidance. Staff had access to the most up to date best practice guidance to practice in accordance with it.

Staff followed legislation and current evidence-based good practice and standards. For example, in theatre, we saw that all stages of World Health Organisation (WHO) safer surgery checklist were completed with no gaps. The checklist was recorded on the whiteboard and in the women’s electronic record. We checked 10 women’s electronic records and found this was consistently recorded. A formal record could be audited to provide assurance that staff always delivered evidence-based care and treatment in accordance with best practice guidance.

We reviewed WHO audits from January, February and March 2025 and saw 100% compliance consistently.

The service was compliant with all elements of the saving babies lives care bundle (version 3). This was based on national guidance such as National Institute for Clinical Effectiveness (NICE) and Royal College of Obstetrics and Gynaecology (RCOG) to target a reduction in perinatal mortality. The service was 100% compliant against the 70% requirement with all six elements at their last assessment, shown in the LMNS quarterly assurance record, dated 11 November 2024.

The evidence showed a good standard. The service told women about their rights around consent and respected these when delivering person-centred care and treatment.

Staff understood how and when to assess whether a woman had the capacity to make

decisions about their care. They gained consent from women for their care and treatment in line with legislation and guidance. Staff could access relevant policies including Mental

Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS). Although the consent policy was overdue review, it referenced current relevant best practice guidance, such as making best interests decisions and Gillick competency.

Staff made sure women consented to treatment based on all the information available and clearly recorded consent in the woman's records. We observed staff gain consent where required and consent was recorded in all of the maternity records we reviewed where applicable.

The service had developed postmortem consent boxes in line with national guidance to obtain informed consent. The boxes provided information on postmortem examinations and gave support and guidance for women and families. The bereavement midwife had been trained to gain postmortem consent.