William Harvey 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

People were involved in decisions about their care. The service provided information people could understand. People knew how to give feedback and leaders listened effectively, and acted on it. The service was easy to access and worked to eliminate discrimination. People received fair and equal care and treatment. The service worked to reduce health and care inequalities through training and feedback. Women were involved in planning their care and understood options around choosing to withdraw or not receive care.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

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.

Women could self-refer for maternity care or be referred by their GP. Women were advised to self-refer before the end of their ninth week of pregnancy to ensure they had the option of the full range of screening tests. Women deemed low risk could choose to birth at home, at the midwifery-led unit or on the labour ward, which met women’s choices responsively.

The service provided a patient triage telephone line 24 hours, 7-days a week for women to speak with a midwife about any concerns. Day care staff also ran a weekly iron deficiency clinic for women who required a blood transfusion during pregnancy and a discharge summary was completed before every woman left the department

Staff maintained a tracker for women identified as group B streptococcus positive (GBS +) during pregnancy. This bacterium carries a small risk of spreading to the unborn baby and could make the baby very ill. Staff ensured women received early interventions such as leaflets and prophylactic antibiotics and highlighted their status with GBS+ stickers in notes.

Staff listened to feedback from service users. For example, leaders had extended appointments in the day assessment to provide holistic reviews. Staff ensured care was tailored to meet individual needs. For example, we saw a woman who had requested limited intervention to a moderate rise in BP. The woman requested a space to meditate whilst waiting a doctor review and staff found a space for them to do this.

Leaders had completed a significant piece of work around leading with kindness and compassion. The senior team attended training to build positivity within the team, providing positive feedback as well as constructive feedback when necessary, using approved models to support those conversations.

There was an infant feeding team whose main remit was to lead on implementing the Baby Friendly Initiative (BFI) standards to ensure all staff were available to support mothers and babies with their chosen method of infant feeding. The team also provided expertise with feeding matters. However, the CQC maternity results (2024), showed the response rate for breastfeeding support was below the national average and we saw evidence that lack of support mostly happened during night shifts.

On this inspection, we saw rooms on the midwifery led unit had been refurbished to make them less clinical and included features such as murals and mood lighting. Staff offered aromatherapy to aid comfort and relaxation during labour.

Translation support posters were displayed on the wards with contact information in different languages.

Women and partners we spoke with on the day of inspection told us the staff provided enough information in a format they could understand. They could access the service via telephone 24/7 and had a prompt hospital-based review as needed.

The service understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

We found the service was providing suitable services to meet women’s individual needs. Midwives assessed women’s mood during antenatal visits and were able to signpost women to sources of help for anxiety and depression or fear of pregnancy or giving birth, which was affecting their birth choices.

Women told us they could access antenatal and postnatal appointments at a time which suited them and their partners, and staff were pro-active in ensuring this.

Staff could access emergency mental health support 24 hours a day, 7-days a week for women with mental health problems and learning disabilities. The service had systems and specialist staff to help care for women in need of additional support or specialist intervention. For example, they had mental health midwives and specialist bereavement midwives. Staff completed maternity support forms to alert all staff about any specialist support women required; this information was shared with different teams.

Maternity triage was a 7-day a week service (24-hours-a-day). The day unit was open Monday to Friday 8am to 5pm weekdays and 8am-3pm during weekends

Staff in triage monitored attendances and wait times and reasons for attendance. The data was captured every day, and the ward clerk was tasked with entering it on a spreadsheet.

The data was easy to access and showed that during November 2024, 967 women attended triage. This included women who used maternity triage when they could not access a GP appointment for medical conditions. For example ,186 women had attended triage with conditions unrelated to pregnancy.

The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. Women had access to interpreting services so they could make decisions about their care. Women we spoke with during the inspection confirmed they had been provided detail information in a way they could understand. This included leaflets in multiple languages, videos and being signposted to local charity websites.

Women were involved in the assessment of their needs. People’s communication needs were considered, the service displayed various posters in multiple languages. Sstaff had access to mobile phones so they could call language line, and the trust had designated sign language translators.

The service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Information was clearly displayed throughout the unit and the maternity website on how to raise concerns and make a formal complaint. Staff involved people in decisions about their care and told them what had changed as a result.

Leaders told us they shared feedback from women with staff and the trust board. They also presented a mothers’ story at the clinical governance meetings and the maternity and neonatal care oversight group. They told us listening to the stories of women were powerful.

The lead consultant and midwife for clinical governance and risk held weekly meetings, which included any themes from complaints and related learning.

There was good oversight of complaints and leaders monitored their compliance to their complaints policy. We saw there had been a 30% reduction in complaints related to estates and facilities during 2024. There were 16 complaints received between 1 September 2024 to 30 November 2024, and 1 related to care from 2022.

We saw local resolution meetings were always offered and leaders placed importance on listening to the perspective of the complainant and any staff member involved. Staff involved in complaints were asked to complete a document reflecting on the complaint and their reflections.

The service made sure people could access the care, support and treatment they needed and when they needed it. Women told us they could access antenatal and postnatal appointments at a time which suited them and their partners, and staff were pro-active in ensuring this. The maternity dashboard recorded data on equality and diversity. The leadership team used this data to target resources on improving services for all. They had recently secured funding for a ‘community bus’ to take information and support to more deprived communities in the local area.

The trust had recently appointed a consultant midwife whose main remit was to lead on equality, diversity and inclusion. They were also going to provide 1-1 care for women who were particularly vulnerable because they did not want to engage with health services.

Midwives working on the triage-line triaged calls, assessed any risks and signposted women to the most appropriate place for their care. This provided easier access for women and helped ensure they received care at the right time. This included advice during the antenatal and postnatal periods. We saw all pregnant women were given details of the advice line at their antenatal booking appointment, and the telephone number was displayed throughout the maternity areas we visited. Leaders had demonstrated a reduction in pregnant women attending AE or calling an ambulance as a result. In addition, staff confirmed the introduction of the advice line had reduced the amount of time consultants spent on the phone in the maternity assessment unit, freeing them up to provide care.

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.

Tackling health inequalities was a key priority for the service and a core part of delivering their clinical strategy. Staff told us about areas of deprivation within their population and the efforts made to take care into the heart of the community. Funding had recently been secured for a community bus which would be used to provide care and support nearer to where women lived. This was expected to reduce costs of attending appointments and encourage women to participate fully in antenatal care.

The MNVP were running a project in partnership with Canterbury and District Early Years called Baby Explorer. This involved working with parents from marginalised communities within Canterbury to better understand how their baby's brain developed and to improve connection.

Leaders had asked the MNVP to focus on the experience of the birth partners so they could better understand their needs. The MNVP had completed assertive outreach with children’s centres and community groups. They had heard from people from underserved communities including people whose first language was not English and although this was in its early stage we saw evidence this feedback was positive.

People who did not speak English as their first language could access the service. Staff had access to face-to face interpreters or telephone interpretation services.

Leaders monitored outcomes and investigated demographic data to identify when treatment and outcomes differed for different groups of people.

Women were supported to plan for important life changes and make informed decisions about their future. They were assessed and offered support to improve their health during pregnancy and the postnatal period. This included but was not limited to advice on stopping smoking and referrals for specialist support, improving diet and exercise and emotional and psychological support. Care notes reflected discussions and appropriate referrals.

Staff discussed contraception, sexual and mental health people prior to discharge. They reinforced key information (such as the importance of cervical screening) with written information and links to accredited websites with evidenced based information and support.

Women were clear about discharge plans and who to contact with any concerns. Discharge summaries were shared electronically with health visitors and GPs and follow up arrangements were made prior to discharge.

In addition, staff shared details of support groups and encouraged mothers to join the maternity and neonatal voice partnership to help design and continually improve their maternity services.