Health and social care services are more joined up in Oxfordshire, according to latest watchdog report

Kate Terroni new

Significant work has been done to join up services across Oxfordshire that is already demonstrating improved outcomes for people, according to a follow-up review by the national regulator for health and social care published today (Wednesday, January 9).

The Care Quality Commission (CQC) found key improvements had been made eight months into an 18-month action plan that was agreed by Oxfordshire health and social care organisations after an initial review by the CQC in November 2017.

Following the first review, a key priority for system leaders has been to work more closely together to plan and deliver health and social care services, particularly for older people.

Senior managers have used their learning from Winter 2017/18, creating a system approach that has significantly improved joined-up working across NHS and Local Authority partners.

Health and care organisations have also been working together to improve patient flow through the system to reduce ‘delayed transfers of care’, so that patients who are physically well enough to leave hospital do so at the appropriate time.

The CQC report stated: “We saw some practical examples where the improved cross-system relationships had improved outcomes for people. For example, work had been undertaken to successfully reduce the numbers of people who remained in hospital unnecessarily.”

The Health and Wellbeing Board, which is responsible for overall health and care strategy in Oxfordshire, had also been expanded to include district councils and chief executives from the NHS Foundation Trusts and the Clinical Commissioning Group.

The follow-up review noted a sense of shared purpose between these organisations, and a willingness to take a system-based approach to resolving challenges and planning for the future. It also noted good involvement with older people in the Older People’s Strategy.

The health and social care partners in Oxfordshire acknowledge that improvements still required included a review of services commissioned to support pathways of care for older people, and better use of voluntary and community groups sector to support patients so they can go home from hospital.

Support and advice for people who pay for their own care – known as ‘self-funders’ –needs to be developed further, according to the CQC inspectors.

Enhanced relationships

Kate Terroni, Director of Adult Social Care for Oxfordshire County Council, said: “We really welcome this follow-up review and we’re delighted the Care Quality Commission has recognised the work we’ve done locally to improve outcomes for residents.

“The report notes that we are only eight months into an 18-month action plan. The report reflects the improvements in relationships between system leaders, the lessons learnt from last winter and how we’re working better together to support people to leave hospital when they are fit to do so.

“We recognise there is still more work to be done on our offer to self-funders, supporting carers and fully utilising our excellent voluntary sector. I look forward to continuing to work with our partners as we take this work forward.”

Hard work recognised

Dr Bruno Holthof, Chief Executive of Oxford University Hospitals NHS Foundation Trust, said: “I would like to thank all health and social care staff whose hard work has been recognised by the CQC in the report published today.

“We have made significant progress in helping more patients get home from hospital more quickly and in working together across organisational boundaries to prepare for the challenges which this winter will undoubtedly bring so that the people who rely on our services receive the high quality and timely care which they deserve.

“We know there is much more to be done but it is heartening that the progress made to date has been acknowledged by the CQC.”

Improved outcomes

Louise Patten, Chief Executive of Oxfordshire Clinical Commissioning Group, said: "We are really pleased to see that the CQC have recognised the significant improvements in our work as system leaders to reset the culture of our organisations that is now demonstrating improved outcomes for people in Oxfordshire.

“This has been a real learning journey for us; the CQC’s system assessment helped us understand the need for a more integrated approach across health and social care that focussed on working together to improve patient outcomes.

“I am hugely grateful to our staff, stakeholders and public for helping us to achieve so much in such a short time.

“This is, however, work in progress; we continue to develop the different parts of the health and social care system in Oxfordshire to work better together to improve patient care.”

Tangible impact

Stuart Bell CBE, Chief Executive of Oxford Health NHS Foundation Trust, said: “We welcome the findings of this follow-up review which demonstrates the real progress we have made as a health and social care system in such a short period of time.

“While there is still work to be done, we have developed stronger relationships with partner organisations and this joined-up approach is having a tangible impact on people’s lives.

“Most importantly, all the planning and preparatory work which the CQC recognised in its report has helped our teams across health and social care as they now face their toughest challenge in the heart of winter.”

Fully engaged

Penny Thewlis, Chief Executive of Age UK Oxfordshire, said: “We have welcomed CQC’s evaluation of progress and have seen very tangible evidence of this as the system has prepared for winter.

“The voluntary and community sector has a pivotal role to play in enabling people to return home safely and confidently from hospital, with the support they need in place, but also in enabling people to stay well.

“We can only fulfil our potential if we are fully engaged in planning and properly funded and real progress has been made on this since the last review. There’s still a way to go, but there is evidence that we are well and truly on the way.”

Working in partnership

Will Hancock, Chief Executive of South Central Ambulance Service, said: “We welcome the report from our regulator and are pleased the work that has been carried out has been recognised.

“In order to make further improvements in patient care for those in the area we will continue to work in partnership with all colleagues in the health and social care system.”

Areas of improvement

  • A Winter Director was appointed on October 1, 2018, leading a system Winter Team to reduce seasonal pressures across health and care services. The team has also worked to improve quality and performance of emergency and urgent care in the county.

  • A ‘Home for Christmas’ initiative involved the new Winter Team and all health and care organisations in Oxfordshire working together to ensure more than 80 patients a day were discharged from inpatient wards at the John Radcliffe Hospital during the last week before Christmas.

  • The table below illustrates improvements achieved in the reduction in the number of ‘delayed transfers of care’ in hospitals across Oxfordshire since April 2017. The actual number of patients delayed changes daily and the table provides the average number of patients delayed each month.


Average weekly delays per  month 2017-18

Average weekly delays per month 2018-19 
 April  167 104
 May 162 86
 June  170 77
 July 167 90
 August  132 97
 September  119 89
 October 120 72
 November 111 68
 December 99 69
 January 117  
 February 137  
 March 110