How staff commitment led to an ‘outstanding’ CQC rating for maternity services

Our maternity service has been rated ‘outstanding’ by the Care Quality Commission (CQC), the independent regulator of health services. Miss Mandish Dhanjal, clinical director of maternity and a consultant obstetrician and gynaecologist, explains what the CQC report found and what our services offer for women who choose to have their babies at our hospitals.

The Care Quality Commission (CQC) inspected our maternity service in February 2019 and rated our service as ‘outstanding’. We are the first maternity unit of any NHS trust in London to receive this rating, which recognises the excellence of our service and the expertise and commitment of our staff.

All our maternity services were rated outstanding: our NHS services at both Queen Charlotte’s & Chelsea and St Mary’s hospitals, and our private services at Queen Charlotte’s & Chelsea and the Lindo Wing at St Mary’s Hospital.

CQC maternity rating for Imperial College Healthcare

Inspectors found many examples of outstanding practice across our maternity service and, as the Trust’s clinical director of maternity, I feel immensely proud of this achievement by our staff and would like to highlight a few findings from the CQC report.

The report said our level of caring and responsiveness to the needs of women having their babies with us was ‘outstanding’ and that our maternity service was ‘safe, effective and well led’.

It said we provided ‘compassionate individualised care’ and that our staff provided ‘extensive support to patients and their relatives and worked hard to meet the holistic needs of their patients through emotional and practical measures’.

The report also noted that there was ‘a strong culture of multidisciplinary working with specialists to enable woman and baby-centred care’, the maternity service ‘was especially caring and responsive to parents who had suffered a loss’ and it was ‘involved in a wide range of research, innovation and quality improvement projects’.

Our vision for maternity care

When I became clinical director of maternity in 2013, our vision was to provide the highest quality compassionate care to women and their families. We looked at our processes and staffing and identified areas that could be improved, and this has helped us achieve our rating of outstanding. Here are some examples of what we did:

  • We improved continuity of care so that women are looked after by the same small team of four to six midwives throughout their pregnancy, delivery and postnatally. We also further invested in one-to-one midwifery care, known as ‘case-loading’, for vulnerable women, such as those with mental health problems, where the woman sees the same midwife throughout her pregnancy. Continuity of care leads to better patient experience and outcomes, with reduced chances of having a premature baby.
  • We introduced obstetric high dependency areas on our labour wards so that women who require specialist care can remain on the labour ward rather than be transferred to a medical ward or intensive care unit and separated from their baby.
  • We placed emphasis on training and worked hard to get our staffing right with the right number of staff and mix of skills and expertise.
  • We improved the pathway for our women who need to be induced (when drugs are given to start labour), introducing a new drug to speed up the process which resulted in better patient experience.
  • We invested in our bereavement team, which supports women who miscarry or lose their baby, with dedicated bereavement midwives as well as obstetric consultants and counsellors with appropriate training.

The CQC report highlighted many of these improvements as well as the fact that we combine a high-level of multidisciplinary expertise with being caring and responsive to the needs of individual women having their babies with us. For example, women can see their midwife in community clinics rather than come to hospital. We also give women the choice of delivering where they would like to, provided it is safe for them and their baby. We have birth centres and labour wards at both St Mary’s and Queen Charlotte’s & Chelsea, and we also support women who choose a home birth.

Individualised maternity care and expertise

We are able to offer this individualised care because we provide all forms of maternity care – low risk, high risk and specialist care – at a highly-experienced level. We have an obstetric medicine team for women with complex medical problems, a fetal medicine team who look after women with multiple pregnancies, babies who are not growing well or those where we are concerned about birth defects or genetic conditions, and extra support services such as a perinatal mental health team for support with mental problems in pregnancy and postnatal depression, diabetes team, bereavement team and specialist midwives for our vulnerable women.

In addition to our NHS services, our private services at Queen Charlotte’s & Chelsea and the Lindo Wing were rated outstanding. Women choose our hospitals for private maternity because we are a large trust with highly specialist neonatal intensive care units. Nationally and internationally, we have one of the best neonatal units and unrivalled obstetric, midwifery and anaesthetic expertise, while any money generated by our services is invested back into our NHS services.

Essentially, our outstanding rating is due to our record of providing the highest quality compassionate, responsive and safe care. It is a credit to our committed staff who all strive to provide the best possible care to women who choose to have their babies with us, and I am delighted that their hard work has been recognised in this way.

Our maternity and obstetrics services are the first in London to receive an ‘outstanding’ rating from the CQC. Our birth centre, labour ward and home birthing teams support growing families every day, from those with straightforward pregnancies to those with more complex needs. Find out more about what our maternity services have to offer, and self-refer quickly online.

Imperial Private Healthcare offers outstanding consultant-led maternity care at the Lindo Wing at St Mary’s Hospital, and both midwife-led and consultant-led maternity care at the Sir Stanley Clayton ward at Queen Charlotte’s & Chelsea Hospital. Visit Imperial Private Healthcare’s website to enquire about bespoke maternity packages.