CQC upgrades Worthing hospital maternity services rating

An inspection – in February last year – was carried out in response to ‘ongoing concerns about the service’. It was also to ‘follow up on improvements’ the University Hospitals Sussex NHS Foundation Trust was told to make at previous inspections. 

The report read: “CQC found that there had been improvements since the previous visits; however, some breaches of regulations were identified relating to safe care and treatment and the effectiveness of departmental management, which has negatively impacted on other key question ratings.

“Following this latest inspection, CQC has upgraded how well-led the service is from requires improvement to good. Safe is re-rated as requires improvement. Caring is re-rated as good. Responsive and effective were not rated at the previous inspection and are rated as good.

“The overall rating for Worthing Hospital remains rated as requires improvement.”

Positive changes highlighted

Amanda Williams, CQC deputy director of hospitals, secondary and specialist care in Sussex, praised the improvements.

She said: "When we inspected Worthing Hospital’s maternity services, we saw staff working hard to support women throughout their pregnancy journey. The service offered specialist midwives for mental health, bereavement and safeguarding, and provided 24/7 access to emergency mental health support.

"Leaders have worked to create a more positive culture where staff feel confident to speak up and share ideas. The trust appointed an independent freedom to speak up guardian, and staff told us they now feel safe raising concerns with managers. This open approach helped the service learn and improve continuously, making care more effective and responsive.

"The service worked closely with the local maternity and Neonatal Voices Partnership to make sure women's voices shaped how care was delivered. Women told us they felt involved in decisions about their care and didn't feel anxious about raising concerns. Feedback surveys consistently showed above 90 per cent positive feedback."

Trust responds to findings

Dr Tim Taylor is the chief of service for the women and children’s division at the University Hospitals Sussex NHS Foundation Trust.

In response to the CQC, he said: “We welcome the CQC’s recognition of the improvements made to maternity services at Worthing Hospital. We know we have made great strides to improve maternity services in recent years, but it is really encouraging to have that improvement recognised by the CQC as well.

“Our teams work extremely hard to give people safe, compassionate care – I hope that they welcome this new rating as a recognition of the huge amount of the commitment and compassion they offer every day. And I hope that local families feel encouraged that the service they rely on is working to such a high level.

“We never lose sight of the utter devastation that families face if a baby is lost, and so the work to improve is never over – we must keep trying to be better.

“We are committed to building on the progress made at Worthing, and to listening to families, including through our work with the Sussex National Maternity Voices Partnership. We need to ensure future improvements are shaped around the needs of the people who use our services.”

Key achievements

Inspectors found a number of improvements in practice:

– Adequate staffing levels, with the introduction of maternity nurses easing pressure caused by midwifery vacancies;

– Daily huddles and structured handovers to maintain continuity of care, ensuring patients only needed to tell their story once;

- Initiatives to improve women’s overall health, including posters encouraging smokers to switch to vaping and wellbeing clinics providing healthy eating advice;

– A dedicated bereavement suite with specialist equipment such as cold cots, allowing families to spend time with their baby after a death;

– Thoughtful initiatives like ‘hope boxes’ for women who would be legally separated from their babies after birth, containing items from both mother and baby.

Areas still requiring improvement

However, the inspection also identified ongoing concerns.

Amanda Williams said: "We found some areas where improvements are still needed, including more work required to improve policies and the trust’s audit programme.

"There was also only one dedicated obstetric theatre for planned and emergency caesarean sections where national guidance requires two. This meant if two women needed an emergency caesarean at the same time, one of them would have to be transferred elsewhere and their emergency treatment could be delayed.

“We have asked the trust for an action plan to address some of the concerns we found during our inspection and we’ll continue to monitor the service to ensure ongoing improvements continue and women are safe while this happens.”

Specific concerns included:

– Staff did not always have access to up-to-date guidance; many policies, including the labour induction policy, were overdue for review;

– Ligature risks in some areas were not adequately addressed, potentially leaving people at risk of self-harm or suicide;

– The department lacked a routine audit programme, meaning issues such as sepsis cases were not regularly reviewed or acted upon;

– While recognising significant progress, the CQC also highlighted areas for further improvement, including ensuring clinical guidance and policies are up to date, strengthening risk management and audit processes, and expanding obstetric theatre capacity – all areas currently being addressed by the trust.