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 people and communities had the best possible outcomes because their needs were assessed. We checked that people’s care, support and treatment reflected these needs and any protected equality characteristics, ensuring people 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 assessed all quality statements in this key question.

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

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.

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.

We scored the service as 3. 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.

Consultant midwives worked across both Worthing Hospital and St Richard’s Hospital. The consultant midwife led the physiological birth working group, which was a collaborative initiative involving midwifery and obstetric staff from all four maternity sites. The group focused on improving clinical practice through staff training, including supporting optimal maternal positioning during labour and developing strategies to improve care during the early stages of labour.

Leaders attended two cross site risk meetings each morning. 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 woman’s condition to their colleagues. This ensured staff used accurate and up‑to‑date information to inform assessments. This supported appropriate clinical decision-making and enabled the service to respond to women’s assessed needs in a timely and effective way.

During the assessment, we reviewed 11 care records. 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 updated care plans consistently and regularly where required. Staff completed newborn risk assessments using recognised tools such as the Newborn Early Warning Trigger & Track (NEWTT2) tool to record observations and feeding.

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 8 Meows charts and found 6 had been completed appropriately. The other 2 charts showed delays in completion of observations and missing blood pressure readings.

We were told a MEOWS records audit had been added to the schedule for the financial year commencing April 2026. The service provided no timeline of when a NEWTT2 audit would be completed. This meant the department had no assurance that they were consistently completing the records in line with guidance.

We scored the service as 2. The evidence showed some shortfalls. The service did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

The service did not consistently ensure that care and treatment were based on up-to-date evidence and guidance. Although a clinical effectiveness team worked to align maternity policies across the trust, a significant backlog of guideline reviews remained. At the previous assessment, leaders aimed to update out-of-date guidance by the end of 2025. However, at this inspection, 53% of guidelines were still out of date. This showed that the service had not maintained timely oversight of clinical guidance to ensure it reflected current best practice.

Although leaders told us that out-of-date guidelines remained compliant with National Institute for Health and Care Excellence (NICE) guidance, the delay in formal review and ratification meant staff could not be assured they were always working to the most current and locally approved standards. This limited the service’s ability to demonstrate consistent delivery of evidence-based care.

The service did not provide full assurance that key clinical risks were effectively monitored and reviewed. For example, whilst no themes relating to sepsis incidents had been identified during the previous 12 months, the service was unable to demonstrate ongoing oversight through a programme of sepsis audit. Whilst this was planned, it had not been implemented in a timely way. Without regular audit activity, leaders lacked assurance that patients at risk of sepsis were consistently identified and managed appropriately. They also lacked assurance that early deterioration was being effectively monitored.

However, the service had made changes and strengthened its approach to clinical audit and improvement. Leaders had implemented a 3-year maternity clinical audit strategy starting in April 2026. This strategy set out nine overarching principles aligned with national guidance and supported a more structured approach to audit and quality improvement. Leaders had planned an audit schedule for April 2026 to March 2027, which would include key audits such as MEOWS and sepsis. This showed improvement since the previous assessment and a clearer focus on monitoring high-risk areas. This had not been commenced at the time of our assessment.

Leaders used ward-based noticeboards to display best practice guidance and updated staff regularly. Staff accessed clinical guidelines through the trust’s intranet, and the service used multiple communication methods to share updates, including newsletters, departmental alerts, safety huddles and staff presentations. During the assessment, we saw these systems in use, which supported staff awareness of current guidance.

We scored the service as 3. The evidence showed a good standard. The service worked well across teams and services to support people. They 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. We observed effective safety huddles and handovers during the assessment.

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

Leaders continued to work with the local Maternity and Neonatal Voices Partnership (MNVP) to contribute to decisions about care in maternity services. The MNVP is a collaborative working group composed of women, birthing people, families, and healthcare staff. They work together to review and contribute to the development and improvement of local maternity and neonatal care. The MNVP ensure that service users’ voices are at the heart of decision-making.

We scored the service as 3. 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, reduced their future needs for care and support.

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

The trust provided a ‘pregnancy advice’ webpage, which included information on supplements in pregnancy, vaccinations and monitoring fetal movements. It also signposted women to external resources, including women’s health physiotherapy services. The website included contact details for each maternity site across the trust.

We saw ‘Swap to Stop’ posters displayed throughout the unit, the campaign promoted switching to an alternative as a step towards stopping smoking. The service monitored the impact of this initiative through a dashboard. This showed women followed the advice, with fewer women smoking at delivery compared to those who smoked at booking.

We scored the service as 2. The evidence showed some shortfalls. The service did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people.

The service did not consistently use benchmarking to support effective oversight of performance. Although the perinatal quality oversight model (PQOM) measured current performance and maternity indicators, leaders had not embedded benchmarking within clinical dashboards or set clear target indicators. This meant leaders could not consistently identify whether the service met national standards, improved over time or had become an outlier.

Following the previous inspection, leaders told us they intended to incorporate benchmarking into their performance dashboards. At the time of this assessment, they had added a benchmarking column to the clinical indicator dashboard, but it did not contain any data. As a result, leaders could not use the dashboard to compare performance against other trusts, identify outlying performance, or monitor improvement against peer organisations. Although leaders told us they benchmarked clinical indicators, including third and fourth degree tears and major obstetric haemorrhage, they also acknowledged that this work remained in progress.

The service did not always ensure that guidance reflected current risks. The guideline for postpartum haemorrhage (PPH) management was out of date and under review during the assessment. The service had also identified high rates of PPH but had not yet completed a thematic review. This meant leaders had not fully analysed a known risk area in a timely way. Variations in the prevention, recognition and management of PPH can increase the risk of harm to women and highlighted the need for strengthened clinical oversight, training and guidance.

However, the service showed some improvement in how it used data and audits to support care via their new audit strategy. They completed audits when performance fell below or above expected thresholds, and leaders produced quarterly reports to identify themes and trends across the service. We were unable to review any results for many of the audits as they were on-going. Leaders told us benchmarking remained a work in progress.

The service showed improvement in some clinical outcomes. Leaders told us that the number of babies born before arrival (BBA) had reduced following the introduction of dedicated telephone triage roles. Data showed BBAs accounted for less than 2% in December 2025 and January 2026 and reduced further to less than 1% in February 2026. This showed improved triage processes supported timely access to care.

Neonatal outcomes across the trust had also improved. Data showed neonatal mortality rates were below the national average, which demonstrated positive progress in clinical outcomes for babies.

We scored the service as 3. 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 had access to relevant policies, including the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS), and demonstrated a good understanding of their application in practice.

Staff made sure women were supported to give informed consent to treatment, based on comprehensive and appropriate information. Consent was clearly documented in the woman’s records. Verbal consent was routinely sought and recorded where appropriate, for example prior to procedures such as vaginal examinations. Written consent was obtained for more invasive procedures, including caesarean sections.

Staff understood the rights of women and birthing people related to consent. They told us they made sure they fully understood their rights and always respected informed choice.

We observed staff provide clear explanations of procedures, including the potential risks and benefits of both accepting and declining treatment, enabling women to make informed decisions about their care.

The trust’s consent policy outlined the duty to involve an Independent Mental Capacity Advocate (IMCA) when required, in line with relevant legislation and codes of practice. The policy also referenced the use of Gillick competence in relation to children, recognising that a child’s ability to consent increases with maturity and that parental consent cannot override the decision of a child deemed to be Gillick competent.