Maternity services: what we are doing to improve

We want to provide the highest quality, safest care and best experience to every woman and baby in our care.

We have staff who are kind, caring and compassionate, and who want to deliver exceptional care together for every person who needs us - and that remains our aspiration.

We also recognise and understand our issues and so we know that, at this moment, we do not get that right for every person, every time.

We have acted with openness and honesty when we have got things wrong and proactively requested and welcomed reviews into our services - including from the Care Quality Commission (CQC) - which are now helping us to learn more quickly and make changes.

We have put a programme of work in place that will help us to:

  • be fully compliant against all national safety measures.

  • embed recommended changes from the recent reviews of our service.

  • make our communication with families better, so that you feel properly listened to and that we act on what you are saying.

  • do some focused work on the culture within our units, so that we create the best possible environment for our teams to do their job of caring for you.

  • strengthen our monitoring processes that track progress on the things we have said we will do, including how we make sure we have learned and made changes when something has not gone well.


A lot of work is underway already to help us get there. We will use this space to share publicly what we are doing and to provides updates on our progress.

 


Open letter to parents, parents-to-be, and families

Published 7 November 2025

Dear parents, parents-to-be, and families,

The Care Quality Commission (CQC), which regulates NHS services, conducted a full reinspection of Maternity services at Royal Derby Hospital and Queen's Hospital Burton in December 2024, and today (Friday 7 November 2025) has published its report of findings and improved the rating for both sites.

Maternity services at UHDB are now rated as 'requires improvement', with Caring at Queen's Hospital Burton rated as Good. When the services were inspected in August 2023, they were 'inadequate' which is one grade lower, so this rating shows that the hard work our teams have put into our improvements over the last two years is making an impact on the quality and safety of the care we provide to women, birthing people and babies.

'Requires improvement' is an encouraging step in the right direction but it is still not where we want to be. While the report compliments our kind and compassionate staff and shows our measurable progress, it also contains lots of challenges and areas where we did not consistently get it right for all families, and we want to change that.

We are two years into a focused Maternity and Neonatal Improvement Programme, which has been our structured approach to making improvements across maternity and neonatal care. Through this programme, we are already addressing the CQC's concerns, and responding to feedback from families to deliver improvements in areas that matter most to you, the people we care for.

Key safety improvements have been made through the ongoing improvement programme, and in the drop-down box below, you can read more information about how we are making maternity care safer, including some stories from families who have kindly shared their experiences. 

Some of the key areas where we have made positive improvements are: 

  • Our perinatal mortality rate (which includes stillborn babies and neonatal deaths) has been consistently better than the national average for over 18 months - meaning safer care for you and your baby.

  • Our maternity triage service, which is the equivalent of A&E in pregnancy, is now fully embedded and each month supports around 3,000 women over the phone providing instant access to support 24/7, with 1,600 women seen face-to-face by experienced midwives and doctors. Concerns are identified quicker, improving outcomes, and we have had no reported safety incidents relating to triage in the past 12 months.

  • Compliance against Saving Babies Lives, which are a set of national best-practice safety standards, has improved from 33% in September 2023 to 94% in September 2025.

  • We've brought in new equipment and an evidence-based approach to how we identify risks and support the management of major bleeds after birth (major obstetric haemorrhage). These are very rare (around five women in every 1,000 might experience one), but we have reduced our numbers by 55% when compared to September 2024.

  • More experts and training in fetal monitoring (to monitor babies' heartrates), with training compliance for midwives and doctors at 93.9%  - which is above the national standard of 90%. We also have hourly 'fresh eye' checks, where a second independent person reviews heart rate recordings, to provide an additional check for safety and accuracy for your baby.

  • We have fewer cases that meet the criteria for external review through the national Maternity and Newborn Safety Investigations (MNSI) framework, and of those that do, we have seen fewer safety recommendations which evidences our improved compliance with national guidance and best practice.

  • Compliance in seven of 10 measures (for 2024) set out in the national Maternity Incentive Scheme with further improvement expected this year. The scheme sets 10 safety standards for improving quality of care, and is assessed annually. This has improved from compliance of two of 10 in 2023.

  • We have more staff to care for you across obstetrics, anaesthetics, maternity, neonatal, theatres and imaging. An additional 27 midwives joined us in September, and we have two additional consultants now than at the time of the 2024 inspection.

  • More staff trained in Obstetric Emergency Training (which is mandated training for all maternity staff). For Midwives, 97% are up to date with training, against a national target of 90%.

  • We have changed how inductions are managed and booked, to reduce delays, and upskilled our midwives through additional training so they can begin an induction more quickly if you need one.

  • We now use an electronic patient record system called BadgerNet for maternity and neonatal services >, which has an app that families can use to access pregnancy notes and support.

  • We are keeping families together by bringing critical care support and some neonatal care inside maternity spaces, and a state-of-the art special care baby unit has opened at Queen's Hospital Burton > meaning for the first time, Burton neonatal families can stay overnight with their babies.

  • Our homebirth service has been open for 12 months and has supported 49 families to birth in the community, including baby Kleo >.


We know from engaging with families, our improved compliance with safety measures (as detailed above), and the CQC improved rating, that our improvements are making a positive impact on how it feels to receive care here - but we are not complacent and we take concerns and feedback seriously.

If you want to talk to us about the CQC report - or any other aspect of your care - please do reach out. Our teams are here to answer any questions or worries; you can speak to any member of the team caring for you, your community midwife, or our Patient Advice and Liaison Service (PALS).

If you would prefer to speak to someone outside the Trust, our local Maternity & Neonatal Voice Partnerships (MNVPs) are a great source of help and advice (ddicb.derbyshirematernityvoices@nhs.net for Derbyshire, and or sasot.mnvp@nhs.net for Staffordshire).

To families who are accessing care now, or may be in the future: you have our absolute commitment that we will continue our work - our focus and energy firmly remains on delivering you high-quality, safe, and personalised care.

Guy Tuxford, Divisional Director for Women's and Children’s

Sarah Noble, Director of Midwifery

Chris Whale, Divisional Medical Director

Gwen Hatton, Divisional Nursing Director

 
Download 'The Maternity and Neonatal improvement programme journey so far' infographic [pdf] 202KB >

What we have done to make care safer for you

Using national best practice tools to provide exceptional care to you. We have made significant improvements to how we care for women, birthing people and babies by embedding national best practice care in areas including managing a heavy bleed, maternity triage and how we monitor babies' heart rates.  

  • Improved the way we triage women and birthing people: Women and birthing people who require urgent or emergency support during pregnancy will now be assessed and triaged using the Birmingham Symptom Specific Obstetric Triage System (BSOTS), that is nationally recognised as the best and safest way to triage and assess people within 15 minutes, by using a similar model to A&E that prioritises those who are seriously unwell >.

  • Changed how we monitor babies during labour: Maternity staff complete a training programme on an evidence-based, more personalised approach to fetal monitoring called physiological fetal heart monitoring. This means we have a single consistent approach to monitoring babies before they are born which helps our teams better track and respond to any changes to your baby's heart-rate during labour. Since this focused piece of work, we have seen fewer hypoxic-ischaemic encephalopathy (HIE) cases, a condition caused by a lack of oxygen to the brain before or shortly after the birth. We have a full-time fetal monitoring lead midwife in post and are in the process of recruiting a second fetal monitoring lead midwife to give dedicated attention to this work.

  • Changed how we measure any bleeding during and after birth: we are using a nationally developed process for reducing major bleeding after birth. It helps us to identify women at risk of bleeding after birth, and provides a more consistent measure of blood loss so we can quickly identify when someone is bleeding abnormally. This means we can take steps to stop any abnormal bleeding earlier and try and avoid someone needing a blood transfusion.

  • Embedded a new process to support clinical accuracy:  Since August 2023 we have embedded 'Fresh eyes', where a review happens by a second clinician every hour for women in labour. Over 90% of patients on labour ward across both sites now have fresh eyes assessments with independent checks.

 

Training and compliance - to ensure our dedicated colleagues are providing best practice and high-quality care, they attend regular training to refresh and test their skills and to improve our compliance with national safety measures. 

  • For Saving Babies Lives, which sets standards for reducing perinatal mortality, we have improved compliance from 33% in September 2023 to 94% in September 2025.

  • For the Maternity Incentive Scheme, which sets 10 safety standards for improving quality of care, we were compliant with 2/10 measures in 2023 which has improved to 8/10 in 2025, with clear plans to continue improving.

  • Our perinatal mortality rates have consistently been below the national average for over 12 months. For May 2025, the rolling yearly stillbirth rate has decreased to 2.45 per 1000 births against a national average of 3.54 per 1000 births. The rolling neonatal death rate has remained at 0.98 per 1000 births compared to national average of 1.65 per 1000 births.

  • We have changed how we track our staff training. We support staff to refresh and test skills regularly, like how they monitor your baby during labour, with annual training to make sure all staff caring for you are experienced, knowledgeable and confident. As an example, for fetal heart monitoring training, our compliance for midwives is 93.8%, above the national target - so you can be assured everyone looking after you is trained in what they are doing for you and your baby.

 

Recruitment and culture - as well as improving the experience for our families, we want to improve the experience of our teams too.

  • Recruited more staff - we have boosted staff numbers across obstetrics, anaesthetics, maternity, neonatal, theatres and imaging (where you go for scans) and are actively recruiting more experienced midwives too. We have one of the lowest vacancy rates in the Midlands with kind, caring and compassionate staff who are committed to making a difference to your pregnancy journey and birth experience.  

  • A good safety culture - We know that a good safety culture is one that involves value, respect and civility. Our frontline colleagues, including midwives, support workers and consultants, have worked together to develop a shared set of behaviours and values for everyone to sign up to.

  • Looking at who does it best: We remain the only Trust in the country who proactively asked to join the Maternity Safety Support Programme, a national improvement programme led by NHS England through which we can learn from other maternity units and bring the best back to UHDB. 
     

Improving our facilities, systems and software - we have invested in new equipment to support our experienced teams when caring for women, birthing people and babies: 

  • We have invested £1.6m in a dedicated electronic patient record for maternity services called BadgerNet, with a patient portal so that women can access their records, advice and support through an app. This system also means that wherever you access care at UHDB, our clinical teams will have instant access to your notes. To find out more about this, visit our Badger Notes page >.

  • We have invested £250k in ultrasound software that automates and maps the scan measurements for babies who require regular growth monitoring during pregnancy.

  • We have introduced wireless telemetry, which means you can have continuous monitoring via a cardiotocograph (CTG) machine but without the need for wires which can sometimes restrict movement. A CTG is a medical device used to monitor a baby's heart rate and a mother's contractions during pregnancy and labour. Telemetry can be utilised in the birthing pool and encourages movement in labour for those that are recommended or request continuous fetal monitoring. You can find out more about telemetry >, which is now available in the labour wards at Queen's Hospital Burton and Royal Derby Hospital.

  • Improving our induction pathway - at Royal Derby Hospital, we now have dedicated induction side rooms and at Queen's Hospital Burton we have a private examination room that is used during intimate examinations. We are also reviewing how our inductions are booked and managed to reduce the time you wait before an intervention.

  • Neonatal transitional care - after birth, some babies require more frequent observations, this is called neonatal transitional care, and some babies require antibiotics. We have created transitional care spaces within our postnatal wards, which means at set times babies requiring neonatal care can now be administered their antibiotics in wards beside their parents, minimising the separation between infants and families. 

  • Supporting research trials which can support better outcomes: Research can help improve quality of care not just here at UHDB, but for women and babies everywhere. We have already been involved in research trials for things like routine testing for Group B Streptococcus; a Smoking Nicotine and Pregnancy 2 trial, which looks at interventions on smoking cessation in late pregnancy, and an investigation into the role of previous in-labour caesarean section in future pre-term birth risk and protection against invasive Group B Streptococcus disease.

 

Listening to women, birthing people and their families and supporting you to have a personalised birthing experience: if you have accessed our services we value your feedback in helping to shape further improvements within maternity. 

If you are interested in joining us as a Patient Safety Partner, we would love to hear from you > We are committed to continuing on this journey at pace, to listen, to improve, and to make positive changes.

Check back for regular updates on our progress and improvements.

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