Hospital staff shortages

The Care Quality Commission has told the Oxford Radcliffe Hospitals NHS Trust that it must take address shortages of staff at its three main hospitals.

A report published today by the CQC on the John Radcliffe Hospital, the Churchill Hospital and the Horton General Hospital showed four breaches in essential standards of care, covering staffing levels, care and welfare of patients, staff training and systems for assessing and monitoring the quality of it services.

The hospitals have been given until 25 February to respond with plans showing how they intend to fix these problems.

Inspectors will then monitor whether this plan is being followed by making unannounced visits to the hospitals, in coming months.

About the review

The review of the John Radcliffe Hospital, the Churchill Hospital and the Horton General Hospital as part of their routine schedule of planned reviews of all health and social care provision.

Inspectors visited all three hospitals in September, speaking to patients and staff, and reviewing a wide range of information on all 16 essential standards.

The trust’s own data showed there were shortages of staff in parts of the trust, including the maternity unit at the John Radcliffe Hospital, where there were vacancies for midwives and obstetricians.  While staff levels varied between wards, there were shortages of nurses, physiotherapists and pharmacists.

The reports say that the shortage of staff had affected attendance at training.  Staff said that the surgical emergency unit in particular had been under significant pressure, although there has been some recent progress to recruit more nursing staff.

CQC says that the trust’s performance on waiting times varied, with a significant number of patients waiting over 18 weeks after referral for treatment, and the trust was not meeting all waiting times for urgent cancer cases.

Roxy Boyce, Regional Director of CQC in the South East, met the chief executive of the Oxford Radcliffe Hospitals NHS Trust in December to discuss the concerns.

She said:

“Patients who we met were generally very positive about their experience at all three hospitals. The trust provides a vital service to a largely appreciative population.

“But the shortages of clinical staff on some wards are worrying. Staff on the surgical emergency unit in particular told us that staffing shortages were affecting their ability to attend to patients in the way they would like.

“Several staff commented that they felt they did not have enough time to talk to patients or enough time to give detailed explanations of care. Staffing pressures are also affecting some staff’s ability to attend training, fulfill specialist roles and support new starters.

“Some patients are also waiting too long for their treatment and this of particular concern for some cancer patients who need to be seen urgently by a specialist after referral by their GP.

“It may be that when the trust has addressed the staffing issues that these other matters, such as poor attendance at training, will also fall into place.

“In the short term the trust is using agency or bank staff to care for patients. But that is only a temporary solution.   We will be returning to the trust later in the year to look again at these issues.”

The Hospital's Response

Managers at the Oxford Radcliffe Hospitals Trust say they have already either demonstrated improvements in the areas highlighted or have action plans in place to address them.

Sir Jonathan Michael, Chief Executive of the Oxford Radcliffe Hospitals NHS Trust said:

“We welcome these reports from the CQC, which are important in helping the Trust  assess its performance against national standards and identify areas where further improvement is required. These reports cover almost every aspect of the services provided by the Trust – and  consolidate into a single report many of the difficult challenges that the Trust has been working to address.

"These reports also recognise those areas of good performance against these national quality standards  and particularly how much the Trust’s services and staff  are valued and praised by  patients. The Trust aims to deliver excellence and compassion in all aspects of its services, but recognises that it has more to do before that goal is achieved.

"The last year has seen many positive changes at the Oxford Radcliffe Hospitals and we are confident that we are making good progress  on  our journey of improvement.”

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