Window to the Womb

Updated 9 September 2019

Window to the Womb is operated by D I Harries Limited and is located in central Chester-le-Street, a town in County Durham. The service operates under a franchise agreement with Window to the Womb (Franchise) Ltd. The service is an independent healthcare provider offering antenatal ultrasound imaging and diagnostic services to self-funding or private patients aged over 16 years of age. The service primarily serves the communities of Washington, Durham, Sunderland, Newcastle, and outlying areas.

As part of the agreement, the franchisor (Window to the Womb Ltd) provides the Chester-le-Street service with regular on-site support, access to their guidelines and policies, training, and the use of their business model and brand.

The service has had a registered manager in post since it began operating in 2016. The service is registered for the following regulated activities:

• Diagnostic and screening procedures

We conducted a short-announced inspection of the service on 27 June 2019. We had not previously inspected this service.

Updated 9 September 2019

Window to the Womb is operated by D I Harries Limited, and is located in central Chester-le-Street, a town in County Durham. The service operates under a franchise agreement with Window to the Womb (Franchise) Ltd. The service is an independent healthcare provider offering antenatal ultrasound imaging and diagnostic services to self-funding or private patients over 16 years of age.

Window to the Womb has separated its services into two clinics. These are comprised of a ‘Firstscan’ clinic, which specialises in early pregnancy scans (from six to 15 weeks of pregnancy), and a ‘Window to the Womb’ clinic, which offers later pregnancy scans (from 16 weeks of pregnancy).

We inspected the service using our comprehensive inspection methodology. We carried out a short-announced inspection on 27 June 2019; giving staff two working days’ notice. We had to conduct a short-announced inspection because the service was only open if patient demand required it.

To get to the heart of patients’ experiences of care and treatment, we ask the same five questions of all services: are they safe, effective, caring, responsive to people's needs, and well-led? Where we have a legal duty to do so we rate services’ performance against each key question as outstanding, good, requires improvement or inadequate.

Throughout the inspection, we took account of what people told us and how the provider understood and complied with fundamental standards.

Services we rate

We had not previously inspected this service. We rated it as Outstanding overall.

We found the following areas of good practice:

• The service made sure staff were competent for their roles. Staff had the right qualifications, skills, training and experience to keep people safe from harm and deliver effective care and treatment. There were established referral pathways to NHS antenatal care providers.

• Staff understood how to protect patients from abuse and the service had systems to do so.

• There were clear processes for staff to raise concerns and report incidents; and staff understood their roles and responsibilities. The service treated concerns and complaints seriously, and had systems to investigate them. Lessons learned were shared with the whole team and the wider service.

• The service operated an open and honest culture, and there was a national freedom to speak up guardian, and an alternative (independent) dispute resolution service; if needed.

• The environment was appropriate for the service being delivered, was patient centred, and was accessible to all women.

• We saw extensive evidence of positive feedback from women who had used the service; including from women who had received difficult news, and those who had experienced pregnancy loss.

• Staff understood the importance of obtaining informed consent, and involved patients and those close to them in decisions about their care and treatment.

• The service had a vision for what it wanted to achieve, and consistently engaged well with patients and staff to plan and manage services.

We found the following areas of outstanding practice:

• We saw all staff at the service (including scan assistants) had received safeguarding children and young people, and safeguarding adults’ level three training. In addition to this, we saw that staff mandatory training at the location included documented six-monthly review and understanding checks of Window to the Womb safeguarding policies.

• There were high levels of emotional support available to women and their companions. Scan assistants acted as chaperones, to ensure women felt comfortable and received optimum emotional support. All staff received communication training to offer emotional support. We also saw scan assistants periodically assessed sonographers for their quality of customer care and communication skills, and findings were fed-back to them. The service purposely ran early pregnancy and later pregnancy clinics at different times to ensure that women who had experienced pregnancy loss or were anxious about their pregnancy did not share the same area with women who were much later in their pregnancy. Staff had received enhanced bereavement and communication training. The service also benefited from a dedicated ‘quiet room’, which could be used if women and their companions had received difficult news.

• The service systematically improved service quality and safeguarded high standards of care by creating an environment for excellent care to flourish. The registered manager was a registered bereavement midwife of ten years standing with extensive of practice in large NHS teaching hospitals; they brought this breadth of experience to leadership of the service. Leaders strived to deliver and motivated staff to succeed; personal and professional staff development was positively encouraged and there was a deeply embedded system of leadership development and succession planning. The service was committed to promoting training, research and innovation. For example, the service had formed a collaboration with a local (Russel group) university and assisted them with performing research scans for fetal research. They had participated in a study exploring auditory simulation in the womb, and another study exploring the effects of hyperemesis and smoking on the fetus. At inspection, we saw that the service was currently involved in a study exploring fetal taste preferences. They were also due to assist with an upcoming study exploring the effects of maternal anxiety and depression on fetal neural development.

Ann Ford

Deputy Chief Inspector of Hospitals (North)

Updated 9 September 2019

Window to the Womb (Chester-le-Street) is an independent healthcare provider offering antenatal ultrasound imaging and diagnostic services to self-funding or private patients over 16 years of age. The service offers an early pregnancy clinic (from six to 15 weeks of pregnancy), and a later pregnancy clinic (from 16 weeks of pregnancy). Depending on the type of scan performed, these might involve checking the location of the pregnancy, dating of the pregnancy, determination of sex, and fetal presentation at the time of appointment. Patients are provided with ultrasound video or scan images, and an accompanying verbal explanation and written report.