Worthing 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 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.

At our last assessment we did not rate this key question. At this assessment we rated effective as good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this. We assessed 6 quality statements.

We found women were involved in assessments of their needs. Staff reviewed assessments taking account of people’s communication, personal and health needs. Staff worked with agencies involved in women’s care for the best outcomes and smooth transitions when moving between services. The service monitored women’s health to support healthy living. Staff made sure people understood their care and treatment which allowed them to give informed consent. Staff involved those important to people and took decisions in people’s best interests when they did not have capacity.

However, staff did not always have up-to-date guidance that followed legislation and current evidence-based good practice. The trust did not always effectively use benchmarking to ensure that outcomes were positive and consistent.

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 people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Staff attended maternity huddles, which were held twice daily 7 days per week. We attended 2 huddles which were attended by midwives, midwifery support workers and doctors. Staff clearly communicated key information. Staff used the Situation, Background, Assessment and Recommendation (SBAR) tool to communicate important information about a patient's condition to their colleagues.

Staff carried out risk assessments for women during antenatal care in line with national guidance. These included social assessments, risk assessments for blood clots and mental health assessments. Staff made referrals to consultant led clinics for women with medically high-risk pregnancies. We found staff carried out risk assessments for women in line with national guidance. Staff used a nationally recognised tool, the Modified Early Obstetric Warning Score (MEOWS) to identify women at risk of deterioration and escalated them appropriately. We reviewed 3 MEOWS records and staff had completed them correctly.

The evidence showed some shortfalls. Staff did not always have up-to-date guidance which followed legislation and current evidence-based good practice and standards. However, the service planned and delivered people’s care and treatment with them, including what was important and mattered to them.

A clinical effectiveness team were aligning all guidance and policies in relation to maternity care, to ensure consistency trust wide. There was a clear process and audit of which policies and guidance that needed reviewing, however, there was still a significant back log.

We found many policies were significantly out of date for review, such as the baby abduction policy, post-partum haemorrhage policy, induction of labour protocol and the sepsis policy. All were due for review in 2022. The service had started to review out of date policies but there was a backlog in completing this. This meant that staff could be accessing policies that could provide outdated processes or procedures.

Staff told us that 78 documents and policies still needed approval. They told us that 4 separate approval processes and conflicting pressures had caused the backlog. However, a clinical effectiveness team had a clear process and audit of which policies and guidance needed reviewing and aimed to complete this by the end of 2025.

The service did not have an audit schedule, and staff did not routinely carry out local audits. Following the assessment, the service told us that an audit schedule had been in development and was now in place. We saw from the schedule that the service had audits planned that included post partum haemorrhage proformas and documentation.

The department were not currently auditing sepsis cases meaning there is no data proving numbers of cases or any action taken as a result of any increased numbers. The department also did not audit the Newborn Early Warning Trigger and Track (NEWTT2) tool. The trust told us this was due to issues with incorporating it onto the electronic notes system. The trust told us that there had been no incidents with concerns about sepsis management in any recent (before February 2025) incidents. However, this did not provide adequate assurance regarding the monitoring of sepsis and early deterioration. The service did contribute to national audits, such as perinatal mortality, and Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK (MBRRACE-UK).

Staff had access to guidelines on the trust’s intranet system, however many of these guidelines and policies were out of date. Managers communicated changes in national guidance through monthly newsletters, departmental alerts, during huddles and through presentations to staff.

Practice development midwives made use of noticeboards to communicate best practice guidance. For example, we saw noticeboards displaying a change in fetal monitoring guideline change from NICE and information on care bundles for obstetric anal sphincter injuries (OASI) that can occur during birth.

Midwives and obstetricians stressed the importance of monitoring fetal movements to women at each antenatal contact as a method of fetal surveillance. They documented these conversations in all 5 of the patient’s records that we reviewed on site.

The service completed a World Health Organisation (WHO) surgical safety checklist audit. The WHO surgical safety checklist aimed to decrease errors and adverse events before, during and after a surgical procedure. Staff at Worthing Hospital did not routinely audit the compliance of the WHO surgical safety checklist at the time of our assessment. Data provided showed that 97% of caesarean section procedures had a checklist correctly documented, and that 89% of perineal repairs had a checklist correctly documented, however there was no date range provided for this audit.

The evidence showed a good standard. The service worked well across teams and services to support people. Staff made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Staff told us that multidisciplinary working between midwives, midwifery support workers, paediatricians, consultants and other staff was positive.

Midwives told us they found most consultants approachable when they needed advice, for example, around risk assessments.

Bereavement services had links with the hospital’s chaplaincy team and external support agencies to support women after loss.

Some staff told us they had difficulty raising safeguarding concerns at weekends or outside the working hours of the safeguarding team. They described calling the safeguarding lead out of hours as their only option.

The service ran one stop clinics for drug or alcohol misuse. This allowed women to attend with multidisciplinary input and access multiple services at once.

Leaders worked with the local Maternity and Neonatal Voices Partnership (MNVP) to contribute to decisions about care in maternity services. A Maternity and Neonatal Voices Partnership (or an MNVP) is a group of parents, service users, maternity services, commissioners and the local maternity and neonatal system. They work together to review and contribute to the development and improvement of local maternity and neonatal care and ensure that service users’ voices are at the heart of decision-making.

The evidence showed a good standard. 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, reduce their future need for care and support.

Staff supported women to make decisions to improve their overall health. This included stopping smoking and making healthy eating choices.

The trust website had a ‘pregnancy advice’ web page with information and advice on supplements during pregnancy, vaccinations and monitoring fetal movements. There were links to external resources such as women’s health physiotherapy during pregnancy. The website also contained the contact details for each maternity site across the trust.

We saw ‘swap to stop’ posters displayed around the unit which is a campaign to encourage smokers to switch to vaping as a way to stop smoking. The service monitored this using a dashboard which showed women were taking this advice and less women were smoking at delivery than at booking.

The evidence showed some shortfalls in the standard of care. The trust did not effectively use benchmarking data to ensure that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves. The service routinely monitored people’s care and treatment.

The service undertook national audits and benchmarked with other trusts nationally. The service completed thematic reviews when outcomes fell below the lower limit or above the upper limit of a data set for national required audits. Additionally, an annual report was written to understand the overarching themes from the previous year.

However, the trust acknowledged that not all data was currently benchmarked, for example the obstetric anal sphincter injury (OASI), skin to skin within one hour data and breast milk at first feed data on their dashboard. They told us that they were planning to add benchmarking to their clinical dashboards following further review from the intra-partum forums.

Between March 2024 and March 2025, there were 8440 births across the trust. Instrumental deliveries accounted for on average 10.4%, which was slightly less than the England average of 11.1%.

At Worthing Hospital, the number of babies born before arrival was monitored and between January 2024 and January 2025, babies born before arrival accounted for 1.4% of all deliveries. Instrumental deliveries accounted for on average 11.5%. The service monitored the number of births where skin to skin contact was made within one hour, and between January 2024 and January 2025, compliance was at 95%.

The service monitored the number of babies who received maternal or donor breast milk at their first feed, between January 2024 and January 2035, compliance was at 76%.

The service monitored the number of third and fourth degree vaginal tears sustained per 1000 births in line with the obstetric anal sphincter injury (OASI) care bundle, set out by the Royal College of Obstetricians and Gynaecologists (RCOG). The average between January 2024 and January 2025 was 31. The service monitored Clinical Quality Improvement Metrics (CQUIMS). These are a set of indicators used to monitor and improve the quality of maternity services. Six of the 7 metrics for the trust were in line with the national average. However, women who were current smokers at delivery was worse than the national average.

The trust took part in the 2023 Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries (MBRRACE-UK) audit. Their stabilised and adjusted stillbirth rate was 3.42 per 1,000 total births. This was around the average for similar trusts. The trusts stabilised and adjusted neonatal mortality rate was 2.07 per 1,000 live births. This was more than 15% lower (better) than the average for similar trusts. The stabilised and adjusted extended perinatal mortality rate was 5.50 per 1,000 total births. This was lower (better) than the average for similar trusts.

The service learned from neonatal deaths through a Child Death Oversight Panel. These were then presented to the Board through a series of meetings. Learning was also shared system wide through the Local Maternity and Neonatal System (LMNS) Quality and Safety Forum and the Board.

Following the Ockenden review, the trust monitored key recommendations monthly as part of their maternity dashboard. This included progress with Ockenden audits, and training compliance of staff in fetal monitoring and multidisciplinary (MDT) skills.

Whilst there was data recorded there was limited benchmarking available to see if the areas were in line with national figures or trust targets.

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

Staff could access relevant policies including Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS). Staff demonstrated an understanding of (DoLs) and how this was applied in practice.

Staff made sure women consented to treatment based on all the information available and clearly recorded consent in the woman's record. Staff asked for and recorded verbal consent where appropriate, such as before a trans vaginal scan. They obtained written consent for procedures such as caesarean section.

Staff were seen fully explaining procedures and the associated risks of accepting the treatment or not.

The trust’s consent policy highlighted the duty to appoint an Independent Medical Capacity Advocate for patients when indicated by relevant codes of practice. The policy outlined the use of ‘Gillick competencies’ in relation to children. Gillick competence reflects a child’s increasing development to maturity and that parents cannot overrule the child’s consent when the child is judged to be Gillick competent.