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

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

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

Women were either referred to maternity services by their GP or could refer themselves to the hospital. Women were advised to self-refer before the end of their ninth week of pregnancy to ensure they went through the necessary screening processes. Women deemed low risk could choose to birth at home, at a birth centre or in the hospital labour ward which met women’s choices responsively.

The service provided a patient triage telephone line 24 hours, 7 days a week for patients to speak with a trained midwife about any concerns they may have.

The service had adapted their midwife to birth ratio to 1 midwife to every 21.9 births to meet the needs of the local population. The maternity unit had used a nationally recognised acuity tool to calculate the required number of midwives needed in the service, including the number needed to maintain 1-to-1 care for women in labour, and continuity of care during the antenatal and postnatal periods. Leaders informed us that this had been calculated based on the specific needs and acuity of the local population.

On this inspection, we found the midwifery led unit labour rooms had been refurbished, to make them less clinical in appearance, and included features such as murals and mood lighting. Staff also offered aromatherapy. Staff told us this helped to contribute to normalising birth.

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

Women and their 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 women 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 that 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.

The service supplied appropriate, accurate and up-to-date information in formats tailored to individual needs. Women had access to interpreting services so they could understand and 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.

The service made sure women could access the care, support and treatment they needed 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 good at 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.

Midwives working on the line triaging calls, assessed any risks and signposted women to the most appropriate place for their care, which provided easier access for women to the right maternity 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 been able to demonstrate a reduction in pregnant women attending AE or calling an ambulance as a result. 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.

The service made sure women could access the care, support and treatment they needed 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 good at 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.

Midwives working on the line triaging calls, assessed any risks and signposted women to the most appropriate place for their care, which provided easier access for women to the right maternity 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 been able to demonstrate a reduction in pregnant women attending AE or calling an ambulance as a result. 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 women 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.

Women who did not speak English as their first language could access the service. Staff had access to in person or via telephone interpretation services. This had been particularly useful when providing antenatal care for the high amounts of refugee women housed in the local area.

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

Women were supported to plan for important life changes, so they could have enough time to make informed decisions about their future. At all antenatal appointments women were assessed and offered support to improve their health; this included advice on stopping smoking, improving diet and exercise and emotional and psychological support. Women we spoke with during the inspection confirmed they had been offered and accessed support as needed during their pregnancy.