Concerns over JR maternity could influence decisions over Banbury’s Horton

Oxford's John Radcliffe Hospital NNL-150710-123011001
Oxford's John Radcliffe Hospital NNL-150710-123011001

Hospital inspectors have published a list of criticisms after an unannounced visit to the John Radcliffe Hospital’s maternity unit.

The Care Quality Commission this week published a report on its inspection in November.

Spokesman John Scott said the ‘focussed’ inspection was mounted following concerns expressed to the CQC.

He said such issues could have been reported by a whistleblower, a patient or someone working within the hospital. Anyone may report concerns to the CQC.

“We inspected the maternity services reviewing the ‘safe’ and ‘well led’ domains. This inspection was in response to concerns about the effectiveness of the governance processes and the management of risk,” he said.

The key findings were:

> Not all staff had completed safeguarding children’s training to the expected level

> The service did not manage the control of the risk of infection consistently

> Staff did not ensure ward areas and equipment were kept clean to prevent the spread of infection. Neither did staff always follow good infection control practices

> To maintain safe staffing levels the trust relied on staff working flexibly and moving between wards and the delivery suite. They also relied on on-call staff out of hours

> Systems to monitor quality to ensure risks were managed were not robust

> Although morale was generally good... multi-disciplinary working was not always effective.

The CQC report said the JR service provided mandatory training in relevant key skills and made sure everyone completed it. Staff completed and updated risk assessments for each patient which informed individual plans of care.

They kept clear records and asked for support when necessary. Staff were positive about management support.

There was a local vision to reconfigure the delivery of maternity to segregate ante-natal and post-natal patients to enable a review of the staffing and skills mix.

And it said the service has links with local academic organisations and collaborates to provide accredited courses providing development opportunities for staff at many levels.

The CQC gave the OUH a list of improvements to be made in areas including infection control, some buildings condition, medical staff recruitment, clinical waste procedures, monitoring for risk and management of medicines. It was told it should review staffing to ensure on-call staff are not routinely called in at night.

The hospital trust is rated ‘good’ overall. However the JR was inspected in 2014 and rated ‘requires improvement’.

Checks will continue.

A spokesman for OUH said two other inspections took place at the same time as the one for maternity, looking at the Oxford Centre for Enablement and on the leadership of the trust.

He said the head of inspection Mary Cridge found the trust was led, ‘by an experienced leadership team with the skills, abilities and commitment to provide high-quality services’.

And he added that since the CQC inspectors fed back their initial findings at the end of their visit in November, the trust had been working on key actions to tackle the areas for improvement which they identified, including those in maternity.