A LACK of joined-up thinking in Oxfordshire’s health and social care system is holding back improvements to patient care, according to a new report by the health watchdog.

A review by the Care Quality Commission (CQC) found there was little collaboration and “no shared vision” between the five organisations responsible for providing care in the area.

According to the CQC, the problem is also contributing to Oxfordshire’s on going battle with bed-blocking with the system’s complex discharge pathway in need of streamlining.

The report, released today (Monday), did however praise the “highly dedicated” workforce and recognised an “increased ambition” for agencies to work together.

One of 20 conducted across the country by the CQC, the local system review report aimed to gain a better understanding of how people move through the health and social care system in Oxfordshire.

As part of the review inspectors visited services provided by Oxfordshire County Council, Oxford Health NHS Foundation Trust, Oxfordshire Clinical Commissioning Group, Oxford University Hospitals NHS Foundation Trust (OUHFT), and South Central Ambulance Service NHS Foundation Trust (SCAS) last autumn.

And while a greater than average proportion of Oxfordshire’s health and social care services achieve a good or outstanding CQC rating, the report said there remained significant challenges to join up services across organisations in the county.

The review, conducted in November and December 2017, highlights the lack of an overall strategic plan while inspectors found there was no shared vision between the five agencies – something the CQC said was a “fundamental building block to providing joined up care”.

Inspectors also identified difficulties in staff recruitment, largely owing to the cost of living in Oxfordshire, and said heavy workloads for staff had impacted upon care delivery and integration of services.

Earlier this month it was reported that nursing vacancies at OUH had almost doubled between 2016 and 2017.

A list of actions recommended by the CQC have already been agreed by the five organisations involved.

Director for adult social care at Oxfordshire County Council, Kate Terroni, said the service was just “partway through” its journey to improvement. She added: “Individual parts of our system work very well. They need to work far better in co-ordination so that we can tackle all of the issues raised in the report and provide seamless services for people in Oxfordshire.”

However, MP for North Oxfordshire Victoria Prentis said the report was the “reality check the system needed”.

“We have suffered for too long with a system where providers are reactive not proactive in their decisions, are difficult to communicate with and are unable to articulate a truly innovative plan for the future of healthcare in Oxfordshire,” she added.

Patient feedback, however, was largely positive with inspectors noting in the report: “People, their family and carers told us that they felt well cared for and involved in making decisions about their care, support and treatment when moving through the health and social care system.”

The CQC’s recommendations include making services more local, improving information available to people who fund their own care, and investing more in recruitment and retention of care staff.