CQC report on the Adult Critical Care Unit at the John Radcliffe Hospital published

The Care Quality Commission (CQC) carried out an inspection of Oxford Critical Care – the Adult Critical Care Unit on the John Radcliffe Hospital site in Oxford – in November 2022. The Unit is run by Oxford University Hospitals NHS Foundation Trust.

The report, published on Thursday 6 April, based on the inspection is published on the CQC website.

The CQC report identifies several positive areas of good practice which are highlighted:

• The service met national standards
• Many aspects of the care provided to patients were safe and effective
• Staff were focused on the needs of people receiving care on the unit
• The unit was clean, the risk of infection was controlled, and the provision to support increased infection control measures, if needed, was in place
• Medicines were also well managed
• This management of infection risks and medicines supported safe care
• Staff assessed risks to people and kept comprehensive care records
• Safety incidents were reviewed to help make improvements
• There was a flexible approach to managing staffing to ensure there were enough staff to care for patients
• Staff received annual appraisals, and nursing staff were up to date with their mandatory training
• There was a vision and plans for the service’s development
• Staff felt respected, supported and valued by leaders

However, the CQC report also highlights areas for further improvement including:

• The service did not always have the right staff skill mix, and it did not meet the recommended national guidelines on nursing skill mix in intensive care units
• Staff fatigue was high, and morale was low - strained relationships, staff turnover and the fast pace of change on the unit all impacted its working environment
• Medical staff had not completed mandatory training to a level required by the Trust
• Processes for identifying and escalating risk appeared to be inconsistently used, which created a disconnect between the unit and senior leaders – leaders of various levels of seniority were unaware of local risks, or interpreted risk differently to frontline staff
• Audits were not always completed which meant some information was not being used to measure the quality and safety of the unit, or help it meet challenges

Professor Meghana Pandit, Chief Executive Officer of Oxford University Hospitals, said: "On behalf of the Trust Board, I would like to thank all staff working in Oxford Critical Care for their positive approach to the CQC inspection in November and for everything that they do every day to look after the patients in their care.

"I am pleased that the CQC inspectors have publicly recognised, in the report published today, that our Oxford Critical Care staff are focused on the needs of patients, and have identified a number of other positive areas.

"However, it is important to acknowledge that the CQC inspectors also found some areas for improvement which we need to address together. 

"The Trust Board is working with the management team and all staff to make improvements. This improvement will be monitored through the Trust's governance processes and recruitment to a dedicated role to lead the improvement is underway."