Worthing 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 that the health and care needs of women 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 our last inspection we did not rate this key question. At this assessment the rating for responsive was good. This meant women’s outcomes were consistently good, and women’s feedback confirmed this. We assessed 7 quality statements.

Women were involved in decisions about their care. The service provided information women could understand. Women knew how to give feedback and were confident the service took it seriously and acted on it. 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.

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 evidence showed a good standard. 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 were either referred to maternity services by their GP or could refer themselves to the hospital. Staff advised women to self-refer before the end of their ninth week of pregnancy to make sure they went through the necessary screening processes.

Women considered low risk could choose to give birth at home or on the hospital labour ward. There was no Midwife Led Unit (MLU) at Worthing Hospital although women could be cared for at St Richard’s Hospital in Chichester which did have an MLU.

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 specialised midwives. These included a practice development midwife, perinatal mental health midwife, breastfeeding team, bereavement midwifes and safeguarding midwives.

Data showed that 97% of nursing and midwifery staff and 80% of medical staff had completed a training programme that focuses on improving skills to care better for women with neurodevelopmental conditions and those with a learning disability. However, some staff told us that they still felt they needed additional support caring for women with these additional needs.

Staff made birthing rooms on the labour ward feel as homely as possible. They provided battery operated tealights, birthing balls, music and dimmed lighting to create a calming atmosphere. They displayed positive birthing affirmation posters in the rooms. The service provided birthing pools on the delivery suite, that were available on a first come, first served basis.

The service adopted a newly redesigned maternity pathway for adults who had been a looked after child (LAC). A child who has been in the care of their Local Authority (LA) for more than 24 hours is known as a looked after child. Midwives were encouraged to decide who would benefit from extra support and to ask questions in a non-judgemental way. This meant they could provide individualised care to women to make sure they did not feel judged. The service felt this was an improvement on the previous pathway, which had automatically referred adults to children’s services when they became pregnant, even if there were no concerns about their current circumstances.

Staff could refer women who presented with drug or alcohol misuse to a fortnightly multi-agency one stop clinic for specialist support. This service included a paediatrician, obstetrician, specialist midwives and the smoking cessation team. It also included a substance misuse and addiction service that helped people to understand their situation and create a plan to help them reach their goals. However, staff told us that currently no outcomes were recorded from this clinic, which meant there was a missed opportunity to measure the effectiveness of the clinic and the support provided.

Staff ran a pregnancy wellbeing clinic for women that had a body mass index (BMI) of 30 or above. Staff told us that the clinics were set up to help women stay healthy during pregnancy and covered healthy eating in a friendly and non-judgmental way.

Staff were proud of the ‘hope boxes’ that the service had introduced for women who would be legally separated from their babies after birth. These contained items from the baby and mother, such as the baby’s blanket so that the scent could help the women feel connected to their baby. Inside the box was a positive affirmation which said ‘hold on, pain eases’.

The evidence showed a good standard. 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.

The service met women’s individual needs. Midwives assessed women’s mood during antenatal visits and could signpost women to sources of help for anxiety and depression or fear of pregnancy or giving birth, which affected their birth choices.

Women were given a named midwife and contact number on booking, and a named consultant if admitted or considered higher risk. 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.

Dedicated triage midwives assessed risks and signposted women to the most appropriate maternity care, at the right time. This included advice during the antenatal and postnatal periods.

Staff could access emergency mental health support 24 hours a day, 7 days a week for women with mental health needs and learning disabilities. The service had mental health midwives and specialist bereavement midwives to care for women in need of extra support or specialist intervention.

The community midwives offered an on-call system for homebirths. The homebirth midwife would normally stay with women throughout the birth, even if the patient was transferred to hospital. However, staff told us this service had stopped temporarily because staff had been allocated to the main hospital wards during periods of short staffing. They told us this had occurred around 3 times in the last 12 months.

Community midwives told us about an increase in women choosing ‘free births’ and an increased number of concealed pregnancies. Free births are where women plan to birth at home without the assistance of midwives or other healthcare professionals. Staff told us that some women chose to have ‘birth keepers’, which are non-medically qualified people who provide holistic and spiritual support during pregnancies.

Midwives could refer women to the birth afterthoughts service. This is a reflections service which provides women with an opportunity, following a birth experience, to have questions answered that they may not have previously asked.

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

Midwives identified patients who would need interpretation services at booking. Staff within the hospital were made aware before admission and interpreting services put in place. These were primarily face to face although if this was not available, telephone interpreter services could be accessed

Women had access to relevant leaflets available throughout the maternity wards and departments and they told us they found these informative. The leaflets had information on the back on how to access the information in different languages. Staff told us these were printed off as and when they were needed.

Women received information on mealtimes, medication rounds, and information on baby sleeping positions.

The trust website held a large amount of information and advice for both prospective and current women and relatives. This included signposting to external support as well as contact details for specialist midwives and how to book appointments. There was adequate signage at the hospital for patients to navigate the different departments of the maternity services. Women could also access a virtual tour of the maternity unit. However, the trust noted it was only partially compliant with some of the web content accessibility guidelines. This meant that some documents were not accessible to all website users. The website contained contact information for patients who needed to access information in a different format such as large print or braille.

The evidence showed a good standard. The service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment, and support. Staff involved people in decisions about their care and told them what had changed as a result.

The trust had a ‘voice of the user’ section on their maternity dashboard. Managers monitored themes from people and their families such as the number of complaints received, Friends and Family Test results and Maternity Voice Partnership meetings held.

There were clear directions on the trust’s website for how patients or their relatives could raise concerns. The website directed patients and their relatives to raise concerns with staff on site where they could, or to the Patient Advice and Liaison Service (PALS). The PALS service was available on site, over the telephone or via email. There was also information on how to make a formal complaint.

The service received 28 formal complaints between January 2024 and February 2025. Themes of complaints included attitude of nursing staff/midwives, error in performing a procedure on a patient and communication with patient.

We reviewed 4 complaint responses and found that they addressed women’s concerns and provided an apology. We saw changes had been made after complaints and actions taken, such as referral to the counselling midwife.

The trust’s complaint policy stated that complaints should be acknowledged in 3 working days, non-complex concerns should be responded to in 25 days and complex concerns in 60 working days. Between January 2024 and February 2025, only 44% of complaints were responded to within 60 days. The service acknowledged that this fell below the standard. The service told us that that with the establishment of a divisional complaints working group in September 2024, alongside support from the divisional PA to work with complaint investigators would help to improve compliance with this target.

We reviewed the latest NHS Maternity Services Survey 2024, we saw that when women were asked if at any point during their maternity care journey, did they consider making a complaint about the care you received, the service scored about the same as the national trust average when compared with all other trusts in England. The trust score falls within the top five best scores when compared with the national average.

The trust provided a service called Birth Afterthoughts. This allowed women to discuss their birth experiences with an experienced midwife. As part of this service, women had the opportunity to discuss and understand events and address any concerns related to the birth, including future pregnancies or labour.

The evidence showed a good standard. The service made sure that people could access the care, support and treatment they needed when they needed it.

The NHS guidance is for a first midwife appointment (also called the booking appointment) to be before the women is 10 weeks pregnant. This is because some tests may need to be done before 10 weeks. The trust’s maternity dashboard showed an average of 67.58% of women receiving antenatal care at Worthing Hospital (from February 2024 to January 2025) saw a midwife for their booking appointment by 10 weeks. There was no trust target therefore, it was not easy to see if the trust was in line with expectations and monitor the percentages for themes and trends.

Women with higher risks due to a body mass index over 30 were identified at the booking appointment and offered additional support.

The service gave women a discharge date when they booked in for a planned caesarean section. This allowed women to plan discharge arrangements and family support if needed.

Staff had access to a telephone translation service for women whose primary language was not English. The trust policy indicated not to use family and friends to translate. The service tried wherever possible to use face to face translation services, however we observed staff using a relative to help translate to a patient. Staff told us they knew this was not the correct process as they could not guarantee that the relative would translate accurately for the patient.

The hospital site was accessible to all women and their relatives. There was a manned desk at the main reception to help or direct women and relatives who were not sure where to go. There was clear signage and lifts available throughout the site. The car park had dedicated ‘blue badge’ bays for those who had a disability.

The evidence showed a good standard. Staff and leaders actively listened to information about people who are 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 part of their clinical strategy. Staff told us about areas of deprivation within their population and the efforts made to include all women and families in the community. The community midwife team described an increase in the number of concealed pregnancies, free birthing (where a patient chooses to not have any medical intervention throughout their pregnancy and birth) and the use of ‘birth keepers’. Birth keepers are described as holistic childbirth supporters who provide non-medical, emotional and spiritual guidance. The community midwifery team had attended home birth emergency workshops, which the local ambulance trust had also attended.

Data showed across the trust, fewer parents came from the most deprived areas when they booked, compared to the national average (4% in the most deprived decile compared to 13% nationally and 6% in the 2nd most deprived decile compared to 12% nationally).

Across the trust, women who had third or fourth degree tears was above national average, but not significantly so. Tears were also one of the themes noted when reviewing the trust’s patient safety incidents data. The trust did not set a target, red, amber, green (RAG) rate or benchmark these figures to check for outliers, identify any increases or trends in induction numbers.

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 and we observed staff using the telephone interpretation service for a non-English speaking patient during our assessment. However, we also heard an example of where a woman’s husband had been used to translate.

Mothers who had been a looked after child (LAC) were previously referred to social services when they became pregnant. We saw training videos given to staff where women who were previously LAC gave their view and experience of how it had felt to be referred without having any of their current situation taken into consideration. The updated process encouraged staff to look at individual needs and work with the patient to understand what support they may need without judgement.

Leaders monitored outcomes and investigated demographic data to identify when treatment and outcomes differed for diverse groups of women. Equity in experiences formed part of divisional quality meetings and was part of the work that the Maternal and Neonatal Voices Partnership (MNVP) were involved in.

The evidence showed a good standard. The service supported people to plan for important life changes, so they had enough time to make informed decisions about their future.

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

There was a women’s physiotherapy service which aimed to see every woman that came into the unit. This meant that all women should receive a physiotherapy review prior to them leaving the unit. The physiotherapist could advise and treat women who had suffered third and fourth degree tears during childbirth to help with the ongoing management.