Chief Inspector of Hospitals rates Oxford University Hospitals NHS Trust as Good

14 May 2014 04:24 PM

England's Chief Inspector of Hospitals has published his first report on the quality of services provided by Oxford University Hospitals NHS Trust 

Overall, the trust has been rated as Good. Although the Churchill Hospital, the Nuffield Orthopaedic Centre and the Horton General Hospital in Banbury were all Good, the John Radcliffe Hospital has been given an overall rating of Requiring Improvement.

All four hospitals were inspected in February under the new inspection regime introduced by the Care Quality Commission to provide a much more detailed picture of care in hospitals than ever before. An inspection team of 51 people were involved in the inspection. Full copies of the reports can be found here.

At the John Radcliffe Hospital, many of the services were delivered to a good standard, although the inspectors found that both Accident & Emergency, and Surgery needed to improve.

While services were effective, shortages of staff within the maternity department and on surgical wards and in operating theatres meant that staff were not able to provide the best care at all times. Bed occupancy within the hospital was so high that it was having an impact on the quality of care, with A & E failing to meet national targets to admit, transfer or discharge patients within four hours.

Inspectors were told that operations were regularly cancelled due to lack of theatre capacity, shortage of staff or inefficient planning. In outpatients, there were not enough appointments to meet demand and clinics were overbooked, causing long waiting times and late cancellations.

At all four hospitals, the inspectors observed patients being treated with dignity, respect and compassion by all staff. The care provided by staff in the intensive and critical care services at the John Radcliffe, Horton and Churchill hospitals was considered to be good. Other areas of good practice included:

• The trust internal peer review process, in which over 100 clinical areas had been reviewed in a three month period.

• Staff worked well between teams. The value of an effective multidisciplinary approach in improving outcomes for patients was understood and encouraged.

The Care Quality Commission has identified six areas where the trust must improve, including:

• The trust must plan and deliver care safely and effectively to people requiring emergency, surgical and outpatient care.

• There must be enough qualified, skilled and experienced staff to safely meet people’s needs at all times.

• The trust must plan and deliver emergency care to people in a way that safeguards people's privacy and dignity.

• Staff must receive suitable induction in each area that they work.

• • The trust must ensure that newly qualified midwives are appropriately supported.
• • Patient records must accurately reflect the care and treatment for each patient in line with good practice.

  The Chief Inspector of Hospitals, Professor Sir Mike Richards, said:

  “Oxford University Hospitals NHS Trust is one of the largest acute teaching trusts in the country. It is clear from our inspection that the trust has its focus where it should be, on quality and safety, with the overall aim of improving patient outcomes and care and we have found a lot of good practice on our inspection.

  “While we have found that all four hospitals provide safe and effective services, we know that the trust has long-held problems in recruiting and retaining nurses and healthcare assistants. There are high vacancy rates in the surgical wards and theatres, leading to the cancellation of operations and long waiting times in places.

  At the same time, the trust is running at high capacity, at levels which can start to affect the quality of care and the orderly running of the hospital.

  “The trust is well aware of these issues. It has shown itself to be innovative in seeking solutions to longstanding problems - for instance in its efforts to improve the support for people leaving hospital. It will take the same sort of determination to resolve the staffing shortages, which is undoubtedly the biggest issue facing the trust and which does need to be addressed as a priority.”

  Ends

  For media enquiries, call the CQC press office on 020 7448 9401 during office hours or out of hours on 07917 232 143. For general enquiries, call 03000 61 61 61.

  Notes to editors

  The Chief Inspector of Hospitals, Professor Sir Mike Richards, is leading significantly larger inspection teams than before, headed up by clinical and other experts including trained members of the public. By the end of 2015, CQC will have inspected all acute NHS Trusts in the country with its new inspection model. Whenever CQC inspects it will always ask the following five questions of every service: Is it safe? Is it effective? Is it caring? Is it responsive to people’s needs? Is it well-led?

  This report describes our judgement of the overall quality of care provided by this trust. It is based on a combination of what we found when we inspected, information from our ‘Intelligent Monitoring’ system, and information given to us from patients, the public and other organisations

  The Care Quality Commission has already presented its findings to a local Quality Summit, including NHS commissioners, providers, regulators and other public bodies. The purpose of the Quality Summit is to develop a plan of action and recommendations based on the inspection team’s findings