Worthing Hospital

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

We looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

We looked for evidence that there was an inclusive and positive culture of continuous learning and improvement that was based on meeting the needs of people who used services and wider communities. We checked that leaders proactively supported staff and collaborated with partners to deliver care that was safe, integrated, person-centred and sustainable, and to reduce inequalities.

We assessed all quality statements in this key question.

At our last assessment we rated this key question good. At this assessment has changed to requires improvement.

The service was still in breach of legal regulation in relation to the governance of the service. The breach was in relation to delays in commencing audits programmes, slow progress in updating policies, lack of implementation of benchmarking, the lack of oversight of risks and medicines management systems.

This meant the service was not consistently managed and well-led. Progress in addressing known issues was slow, including updating policies and introducing audits to provide assurance of care quality and safety. Medicines management systems were not consistently embedded in practice, and leaders were unable to demonstrate effective assurance that medicines were managed safely. Risks identified at the previous assessment had not been fully mitigated, and action to address them was not always timely or effective.

In addition, leaders did not consistently review maternity outcomes or undertake comprehensive analysis of performance data. This limited their ability to identify trends, assess the effectiveness of improvement actions, and recognise all areas requiring improvement.

However, leaders continued to promote a positive and person-centred culture. Leaders and staff shared a vision based on listening, learning and trust. Leaders were visible, knowledgeable and supportive, and staff felt empowered to raise concerns and provide feedback. Staff told us they were treated fairly and with respect and were free from bullying and harassment. Women with protected characteristics felt supported by the service. Staff understood their roles and responsibilities, and managers worked collaboratively with the local community to improve care. Leaders remained open to innovation and demonstrated a commitment to continuous improvement across the service and wider system.

We have not awarded this service a score for Well-led.

Find out about when we will not publish a key question score and what we look at when we assess Well-led.

We scored the service as 3. The evidence showed a good standard. The service had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.

The service’s vision was to “be a leading provider of maternity care, where supportive, compassionate care and kind communication create a safe empowering and personalised experience for all families.”

The divisional goals were aligned with the NHS 3 Year Delivery Plan for Maternity and Neonatal Services (2023) and the trust Maternity Improvement Plan. The goals included delivering the highest standards of safety and quality of care, reducing health inequalities, workforce development, enhancing service user experience, increasing innovation, technology, community and partnership.

We observed key service values, including ‘compassion’, ‘teamwork’ and ‘kindness’, displayed throughout the department. Staff consistently described how these values guided their day-to-day practice, demonstrating a positive and inclusive culture.

Leaders promoted staff wellbeing through visible and accessible support initiatives. A health and wellbeing board provided practical advice, including grounding techniques for managing stress and guidance on self-care during night shifts. The service also displayed thank you cards from women and families, which reflected positive experiences and demonstrated that staff felt valued and recognised for their work.

Leaders supported staff to maintain their wellbeing through access to a dedicated well-being application. Staff used the application on their personal devices to record how they were feeling, enabling matrons to identify when support was needed and respond in a timely way. Staff had access to another application that provided a platform for staff to share ideas about improving the service. Staff spoke positively about this initiative and the support it offered.

During the assessment, staff welcomed us into the unit and engaged openly with the inspection process. They were candid about their experiences and demonstrated a willingness to reflect and improve. This indicated an open, supportive culture where staff felt confident to contribute and engage with service development.

We scored the service as 3. The evidence showed a good standard. The service had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.

Leaders showed genuine concern for the staff. Leaders were mindful of recent media attention and the stress this could cause for the staff. They provided regular listening events for staff that had a high uptake. These events provided staff with a safe place to discuss concerns with the support of senior leaders as well as keep informed on current matters.

The service operated with a clear reporting structure. Leaders described a stable and well‑trusted site‑based leadership structure, with strong relationships between clinical leaders, divisional leadership and the executive team.

Staff told us that ward managers, matrons and the head of midwifery were visible and approachable within the maternity unit. Some leaders worked clinically alongside staff, which staff said improved communication and strengthened trust in the leadership team.

The Director of Midwifery maintained direct and regular access to the trust board through established governance meetings. This allowed oversight of quality and safety information and supported timely action to drive improvements.

A team of Professional Midwifery Advocates (PMAs) provided pastoral support and restorative clinical supervision to midwives and maternity support workers. Pastoral support is the provision of emotional, social, and practical care to individuals to ensure their wellbeing and personal development. All midwives were allocated a PMA, and the team also offered support to maternity support workers.

Trained Trauma Risk Management (TRiM) practitioners from both medical and midwifery backgrounds supported staff following incidents. They facilitated structured debriefs and provided access to individual support, including counselling services. TRiM practitioners delivered psychologically informed responses to help staff process and recover from traumatic events.

The service implemented a Restorative Culture Programme to support staff in adopting a compassionate and open approach when engaging with families and colleagues following incidents. The programme focused on improving how staff recognised and responded to the needs of those affected by harm. Feedback showed the training had a positive impact on staff understanding and influenced more empathetic and reflective practice. At the time of our assessment, more than 40 senior staff had completed the training. This showed a commitment from leadership to embed a restorative and learning-focused culture.

We scored the service as 3. The evidence showed a good standard. The service fostered a positive culture where people felt they could speak up and their voice would be heard.

Women and birthing people had opportunities to provide feedback in ways that reflected their individual preferences and needs. Data from the Friends and Family Test (FFT) for maternity services in March 2026 showed that Worthing received 30 responses, of which 26 were positive and 4 were mixed.

The trust reviewed results from the NHS Staff Survey 2025 against the seven People Promise elements and two additional themes: Staff Engagement and Morale. Scores across all areas were in line with the average for comparable trusts. All areas showed a statistically significant improvement compared to 2024, except for ‘we each have a voice that counts’, which showed no significant change. However, these results reflected trust-wide data and were not specific to maternity services.

The trust monitored freedom to speak up activity through the maternity dashboard. In the 12 months prior to the assessment, no cases had been recorded within maternity services.

We scored the service as 2. The evidence showed some shortfalls. The service did not always value diversity in their workforce. They did not always work towards an inclusive and fair culture by improving equality and equity for people who work for them.

Workforce Disability Equality Standard (WDES) data showed variation in the experiences of staff with long-term conditions or illness compared to those without. The Workforce Disability Equality Standard (WDES) is a set of measures which enables NHS organisations to compare the workplace and career experiences of disabled and non-disabled staff. Several metrics showed staff with long-term conditions or illnesses reported poorer workplace and career experiences. This highlighted an area where the trust needed to improve equality and inclusion.

However, 75.06% of staff with long-term conditions or illness reported that the trust had made reasonable adjustments to support them in their role. This was higher than the national average of 73.65% and was based on 1,251 responses. This showed some positive progress in supporting staff with additional needs.

Workforce Race Equality Standard (WRES) data showed improvement since our previous assessment. However, differences remained between the experiences of staff from ethnic minority groups and white staff. Staff from ethnic minority backgrounds continued to report poorer experiences across several metrics, indicating that further work was required to improve equity and inclusion within the workforce. The Workforce Race Equality Standard is a set of measures which enable NHS organisations to compare the workplace and career experiences of staff from ethnic minority groups with their white colleagues.

We scored the service as 1. The evidence showed significant shortfalls. The service did not have clear responsibilities, roles, systems of accountability and good governance. They did not act on the best information about risk, performance and outcomes, or share this securely with others when appropriate.

The service did not operate effective governance systems to provide assurance that the service delivered safe, high-quality care. Leaders maintained a maternity dashboard with workforce, clinical and organisational data. However, they did not consistently use benchmarking information to understand how the service performed compared with national standards and similar organisations. At our previous assessment, we identified the absence of benchmarking data. At the time of this assessment, leaders told us this remained a work in progress. Although the dashboard contained a designated section for comparative data, leaders had not populated it. As a result, leaders could not fully demonstrate how the service performed against national expectations or identify areas where outcomes differed from similar services.

Leaders did not establish effective systems to monitor quality and drive improvement. At our previous assessment, the service did not have a formal audit programme. Although leaders had appointed audit midwives and developed an audit schedule based on national and local priorities, most audits remained scheduled or ongoing and had not yet been completed. As a result, leaders could not demonstrate that audit findings had been used consistently to improve practice or provide assurance that care was delivered in line with expected standards.

The service did not maintain effective oversight of medicines management. Although policies and processes were in place, staff did not consistently follow them. Staff did not reliably monitor medicines storage, maintain controlled drug records or ensure accurate documentation of medicines administration. The service had also not addressed all concerns identified at the previous inspection, including weaknesses in the governance of emergency medicines. Delays in implementing improvements meant known risks remained. Leaders could not provide assurance that medicines management systems were effective or embedded across all clinical areas.

Although the service had appointed a pharmacist and introduced measures to strengthen medicines governance, these improvements were not yet embedded into practice. As a result, governance arrangements remained insufficient to ensure the safe and effective management of medicines.

The service did not consistently use data to understand variation in clinical outcomes. The service identified that Worthing Hospital had the highest proportion of category 1 caesarean sections compared with other trust sites. Although leaders had planned an audit for 2026, they had not yet completed a review to understand the reasons for the variation or whether further action was needed.

The service could not provide assurance that key safety processes were effectively monitored. At our previous assessment, we identified a lack of auditing relating to Modified Early Obstetric Warning Scores (MEOWS) and the Newborn and Infant Physical Examination (NEWTT2). At this assessment, a MEOWS audit had been included in the 2026 to 2027 programme but had not yet been completed. We did not see evidence that NEWTT2 had been included within the audit schedule. As a result, leaders could not demonstrate that observations were consistently recorded accurately or that deterioration was identified and escalated in a timely manner.

The service did not manage risks effectively. Some risks had remained on the risk register for more than 3 years without sufficient mitigation or evidence of meaningful progress. This demonstrated that leaders did not always take timely or effective action to reduce known risks.

The service did not ensure staff consistently had access to current guidance. A significant number of policies and guidelines remained beyond their review dates. Leaders told us that, despite being out of date, the guidance remained aligned with current national standards, which was confirmed by the documents we reviewed. The service had aimed to complete all policy reviews by the end of 2025. However, more than half remained outstanding at the time of our assessment. Leaders explained that progress had been affected by the complexity of aligning and merging guidance across multiple sites

The service did not demonstrate a proactive approach to learning from incidents and emerging risks. The service identified post-partum haemorrhage as one of the most frequently reported incidents. However, leaders had not completed a thematic review and had not prioritised the ratification of relevant guidance. Third and fourth-degree tears were also among the three most reported incidents, yet leaders had not developed a clear plan to undertake further analysis or identify opportunities for improvement. This limited assurance that leaders effectively used incident data to drive learning and improve patient outcomes.

However, the service met all 10 safety actions required under year 7 of the Clinical Negligence Scheme for Trusts (CNST) Maternity Incentive Scheme. This programme aimed to improve the safety and quality of maternity and neonatal care through a financial incentive framework. Meeting these requirements demonstrated that the service had implemented nationally recognised safety standards to support improved outcomes for women, babies and families.

The service achieved 94% compliance with the Saving Babies’ Lives Care Bundle in quarter 3 of 2025 to 2026. While this showed staff had implemented most elements of this national safety programme, the service had not achieved full compliance, but they had previously. Leaders had developed action plans to address areas where performance did not meet expected standards, which showed that they had recognised gaps and had taken steps to improve.

Leaders told us they had identified an increase in the number of babies born with an APGAR score below 7 and had taken action to review this trend. This showed leaders were monitoring outcomes and using available data to identify potential areas of concern. The APGAR score is a recognised assessment tool used to evaluate a newborn's condition shortly after birth and can indicate the need for additional support or intervention.

Leaders showed a proactive approach to understanding factors that may be affecting neonatal outcomes by recognising the increase.

We scored the service as 3. The evidence showed a good standard. The service understood their duty to collaborate and work in partnership, so services work seamlessly for people. They share information and learning with partners and collaborate for improvement.

Leaders worked collaboratively with the local Maternity and Neonatal Voices Partnership (MNVP) to inform service development and decision-making. The MNVP brought together parents, service users, providers, commissioners and system partners to review and improve local maternity and neonatal care. This partnership approach ensured that the experiences and views of women and families remained central to service design and delivery.

The maternity safety board champions visited the maternity unit and liaised with outside representatives such as the Maternity and Neonatal Voices Partnership (MNVP) to review services, monitor risk and provide the board with a report of maternity services. They used their feedback to triangulate what they heard and saw on walk-abouts.

We scored the service as 2. The evidence showed some shortfalls. The service did not always focus on continuous learning, innovation and improvement across the organisation and local system. They did not always encourage creative ways of delivering equality of experience, outcome and quality of life for people. They did not always actively contribute to safe, effective practice and research.

The service did not always implement improvements in a timely way. Although leaders introduced a range of initiatives to support quality improvement, progress was sometimes slow and affected by contributing factors such as workforce pressures. This meant some improvements were not embedded as quickly as required to consistently enhance care. An example of this was commencing audits. A lack of clinical audits around sepsis and observations meant the service could not identify any themes or trends to identify where learning is needed by maternity or obstetric teams.

The service had not achieved UNICEF Baby Friendly Initiative (BFI) accreditation. Leaders had identified this as a risk in September 2022; however, they had not yet implemented all required changes. This meant the service could not demonstrate full alignment with nationally recognised, evidence-based standards for infant feeding and parent-infant relationships. Data showed leaders planned to achieve BFI level 2 accreditation following an assessment scheduled for June 2026, which indicated ongoing progress but highlighted delays in implementation. This was not achieved at the time of the assessment.

However, the service demonstrated a proactive approach to improving systems, communication and patient experience in several areas. The maternity assessment unit used a live electronic board that was visible to staff on the delivery suite. This enabled staff and leaders to maintain real-time oversight of activity and workload and coordinate support across clinical areas when needed. This supported effective communication and operational management and enabled teams to respond promptly to changes in demand.

The service introduced charity-funded ‘Bili blankets’ to support the treatment of newborn jaundice. These portable phototherapy devices allowed babies to receive treatment while remaining close to their parents. This approach enabled parents to continue holding and feeding their babies during treatment, which promoted bonding and supported the emotional wellbeing of families alongside clinical care.

Leaders also introduced the ‘ImproveWell’ application, which enabled staff to contribute ideas for service improvement and track progress. Staff used the application to provide real-time feedback on their experience. This included reporting on how their day was going and completing short surveys. Leaders used this information to identify areas for improvement and inform service development. At the time of the assessment, data from the application had supported a business case to extend its use across additional areas of the trust. This demonstrated a developing culture of staff engagement and continuous improvement.