John Radcliffe Hospital trust told it 'requires improvement' by CQC

Issues over the poor condition of operating theatres, patient privacy and staff shortages were all raised in a Care Quality Commission report published today.

Inspectors from the CQC visited Oxford University Hospital NHS Foundation Trust in November, December and January to assess the quality of five core services – emergency care, medical care, surgery, maternity, and gynaecology. They also looked at management and leadership.

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The health watchdog has now announced it has downgraded the rating of the trust, which also runs the Churchill and Nuffield Orthopaedic Centre in Headington as well as Banbury's Horton General, from 'Good' to ‘Requires Improvement’.

The trust's chief executive Dr Bruno Holthof said immediate changes had been made following the inspection but admitted the trust was only 'partway through a journey to improvement'.

Earlier this year it was revealed the trust had decided to delay refurbishing the John Radcliffe's operating theatres until April in an effort to minimise the impact on surgery waiting lists.

However the CQC told the trust to take immediate action after an inspection team discovered dilapidated conditions and the risk of infection in November.

Areas in some of the theatres and wards were described as 'damaged' and inspectors said they 'posed potential risks' to patient and staff safety.

Bruno Holthof.

It added: "Staff in the main theatre department had become disheartened that the refurbishment had not happened and had accepted the environment they worked in was substandard."

The report went on to say: "Staff we spoke with in main theatres had become tired of reporting the poor state of the theatre department."

The hospital, which carries out a range of surgeries including heart operations, vascular surgery and trauma surgery, must now submit a weekly update to the CQC until further notice.

Concerns over the privacy of patients and the risk of infection were also raised during the same inspections, with one operating theatre window found to be unobscured so the inspector was able to look directly onto a patient undergoing surgery.

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Ongoing staff shortages were highlighted several times within the report, with surgery, gynaecology and midwifery noted as not always having enough nurses or midwives with the right mix of qualification and skills.

The watchdog's deputy chief inspector of hospitals Dr Nigel Acheson said that since its last inspection in 2014, the trust had not 'sustained the momentum' and 'embedded the improvements that were necessary'.

He added: “We have made it clear to the trust where it must take action to improve and have placed urgent conditions on the trust’s registration to ensure these improvements do take place.

"We will remove those conditions when we are satisfied that the trust has made sufficient progress to provide the quality of services that its patients are entitled to expect."

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Dr Acheson did praise the trust's 'strong and engaged' workforce who 'worked together for the benefit of patients', however, he went on: "It is concerning to find that some staff, particularly those with protected characteristics under the Equality Act, did not always feel they were treated equitably.”

Dr Holthof thanked staff whose 'compassion and kindness has quite rightly been recognised by the Care Quality Commission'.

He added: "Thanks to their dedication and hard work, the CQC has rated our services as ‘Good’ for being caring, responsive and effective.

“However, we recognise that we are only partway through a journey to improvement and this is reflected in our overall rating by the CQC as ‘Requires Improvement’.

“We look forward to working together with our staff, patients, foundation trust governors, and partners in the local health and social care system to continue to address those areas identified by the CQC where we know we need to do better.”

Rosalind Pearce, executive director of Healthwatch Oxfordshire, said the watchdog had 'quite rightly' highlighted areas where the trust was doing well, especially its caring and compassionate staff.

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She added: "This is very much in line what patients tell us about the excellent care and commitment of the frontline staff who treat them. However, there are a number of negative aspects which must be addressed."

She said the complaint resolution process needed to be 'quicker and clearer' for patients and added: "Possibly of more concern is the criticism of the level of take-up of safeguarding training, which should be addressed as a matter of urgency.

"This is essential to provide a safe environment for the care of the patient as a person, not just a procedure. Issues of safety and privacy are clearly very concerning for patients, so it is important these are addressed urgently.

“We welcome the urgent action being taken but it is important that the impetus is sustained and standards are maintained over time.”