Oaklands Hospital

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

We looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

Leaders promoted a positive culture amongst staff and patients. They were capable and worked to enable the long-term sustainability of the organisation. They valued and empowered all staff and encouraged colleagues to speak up if they had concerns. Leaders worked closely with other services and local communities to build relationships and improve people’s care. They encouraged innovation within the service to enhance staff and peoples’ experience.

Leaders contributed positively to experiences and high-quality care for those using the service through clear vision and values. They had the skills, knowledge, and credibility to implement this vision while managing risks effectively.

We have not awarded this service a score for Well-led.

Find out about when we will not publish a key question score and what we look at when we assess Well-led.

We scored the service as 3. The evidence showed a good standard. The service had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.

The hospital’s values and clinical priorities were clearly displayed on notice boards within the outpatient department (OPD). The service had a strategy that was fully aligned with both the corporate mission and the corporate strategy. There was a strong commitment to system-wide collaboration and leadership. The Ramsay Way was to deliver high-quality healthcare through 3 key values: strong relationships, continuous improvement and sustainable growth. They had been cascaded to staff across the services and the staff we spoke with had a good understanding of these. Objectives were also incorporated into individual staff appraisals.

The outpatient and physiotherapy departments told us they had a local strategy in place that fed into the hospital wide strategy. These were based on patient safety, engagement, development and retention of staff, improvement to clinical service delivery and financial performance.

The services had a clear leadership structure. There was an outpatient manager for the department. They oversaw the day to day running of the service. Physiotherapy was run by a physiotherapy manager who was supported by a physiotherapy team leader. Staff told us that they felt well-supported by the departmental manager and had opportunities to learn and progress.

Leaders monitored and reviewed progress against the strategy through structured processes, including midyear and end of year staff reviews, to assess how well the service and individuals upheld the organisation’s mission and values. They told us there was strong oversight of this and high levels of compliance. Heads of department also worked with staff to develop training needs analyses to support ongoing development. 

Leaders told us they regularly observed staff demonstrating the organisation’s strategy and values in their daily practice, and they were able to share examples that were consistent with what we saw throughout our assessment.  

The service had grievance and disciplinary procedures in place to provide guidance to staff on how to raise concerns about their employment and to ensure that any issues of conduct were managed fairly, consistently and in line with organisational policy.

We scored the service as 3. The evidence showed a good standard. The service had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.

The service was led by capable, compassionate and inclusive leaders with clearly defined responsibilities. They demonstrated the high levels of experience and capacity needed to deliver excellent care and ensure effective management of risk.

The director of clinical services had overall responsibility for the services provided at the hospital and also held the role of registered manager.

The leadership structure included direct reports from the head of governance, senior nursing and surgical leads, with additional oversight of doctors, pharmacy, allied health professionals and physiotherapists.

Leaders told us they had strong access to support and development within their roles. They described feeling well supported through regular one‑to‑one meetings, mentoring and peer support from senior colleagues. They told us that they received ongoing guidance through established corporate networks and regular contact with senior corporate executives.

Leaders gave examples of internal progression, including staff who had moved from department based roles into senior managerial positions through structured career development. They explained that defined career pathways were now in place, with development opportunities extending from all roles through to senior leadership. 

All staff told us they felt well supported and valued by both managers and senior leaders. They consistently spoke positively about senior leaders and managers being compassionate, highly visible and approachable within the service. Staff we spoke with in the OPD described a positive and supportive culture where they felt genuinely valued by colleagues and leaders. They told us they were encouraged to contribute ideas, felt listened to, and professional development was supported. Staff consistently spoke with pride about their work, demonstrating a strong commitment to delivering high quality, compassionate care and achieving the best possible outcomes for patients

Staff told us that the OPD management team recognised individual contributions for example ‘we are recognised for the work we do, we are always focused on the patient and our manager supports us to do this…’.

Many staff also described a strong sense of psychological safety and said leaders were supportive of wellbeing initiatives and encouraged staff to identify improvements. They often described the culture as being open and honest and that this had strengthened over recent years, with increased commitment from the senior leadership team to maintaining a safe and supportive environment. 

Managers and leaders were regularly present in clinical areas, enabling them to address issues quickly and maintain close engagement with staff and patients. Staff we spoke with confirmed this. Staff told us there was a genuine “open door” culture and gave examples of when they had raised concerns or shared ideas with senior managers and leaders and that feedback had been acted upon. 

The service had a robust fit and proper persons (FPPR) process in place to carry out comprehensive checks to assure that all leaders were suitable, safe and fit to hold their roles.

We looked at the recruitment files for 3 consultants (who worked across both the medical and outpatient services), 4 nurses and a healthcare assistant from the outpatient services. We found evidence that suitable checks had been carried out prior to commencement of employment in the files we looked at. This included identification checks, proof of qualifications, at least two employment references, Disclosure and Barring Service (DBS) checks and professional body registrations and revalidations.

The hospital reported there were no outstanding queries relating to practising privileges. The 3 consultants’ files we looked at showed up to date appraisals and indemnity certificates and the consultants were listed on the GMC specialist register relevant to their specialty area. 

We scored the service as 3. The evidence showed a good standard. The service fostered a positive culture where people felt they could speak up and their voice would be heard.

The service fostered a positive culture where staff felt they could speak up and their voice would be heard.

The service had a Freedom to Speak Up Guardian (FTSUG) on site and followed the FTSUG process. The service had a Safety to Speak Up lead in each department. This was a policy that encouraged and enabled individuals to voice concerns about safety issues without fear of reprisal. It emphasised a culture were speaking up was seen as a positive action that contributed to patient and worker safety and improved care.

There was a process for staff to follow if they wanted to use the Safety to Speak Up code and we saw posters within the ODP to provide information about the freedom to speak up process.

During our assessment, we spoke to staff to ask about who they would speak to if they had a concern. Staff were able to tell us who they would escalate concerns to.

The service had grievance and disciplinary procedures in place to provide guidance to staff on how to raise concerns about their employment and to ensure that any issues of conduct were managed fairly, consistently and in line with organisational policy.

We scored the service as 3. The evidence showed a good standard. The service valued diversity in their workforce. They work towards an inclusive and fair culture by improving equality and equity for people who work for them.

The service valued diversity in their workforce. Staff worked towards an inclusive and fair culture by improving equality and equity for people who work for them.

Staff in the OPD told us they were treated with respect and equity. Staff told us managers engaged with them regularly and they felt confident their concerns were listened to. All the staff we spoke told us they had not experienced any instances of unfair treatment, discrimination or harassment.

The service had an equality and human rights policy which was incorporated in the recruitment policies and processes. There were support mechanisms available for staff with protected characteristics, including flexibility around working arrangements and shift patterns.

The hospital, as part of Ramsay Health Care UK, actively monitored and supported the Workforce Race Equality Standard (WRES) and the wider Workforce Disability Equality Standard (WDES) principles through its equality, diversity and inclusion policies.

The policy took into account 9 protected characteristics: age, disability, gender reassignment, pregnancy and maternity, race, religion and belief, sex, sexual orientation, and marriage and civil partnership.

The Equality and Human Rights Policy was in date at the time of our assessment and was scheduled for review in July 2026. However, the Equal Opportunities and Diversity Policy was not in date and had expired in December 2025.

We scored the service as 2. The evidence showed some shortfalls. The service did not always have clear responsibilities, roles, systems of accountability or good governance.

Staff working in the OPD told us they felt supported and were able to develop to improve their practice. There was evidence of an open and supportive culture.

The service had clear responsibilities, roles and systems of accountability. Staff used these to manage and deliver good quality, sustainable care, treatment and support. Staff acted on information concerning risk, performance and outcomes, and shared information securely with other professionals as appropriate.

Leaders operated effective governance processes throughout the service and with partner organisations, however we found gaps within the OPD mandatory training records and the system used did not allow staff to maintain them effectively or easily. The provider took immediate corrective action during the assessment. We received assurance that additional processes were put in place to strengthen operational and governance oversight and maintain a safe service.

The service had a risk register which showed that key risks were identified and control measures and mitigations were put in place. Where relevant, reports were shared for to the clinical governance committee and medical advisory committee (MAC). MAC meeting minutes demonstrated that key governance areas were discussed including incidents, complaints and practising privileges.

There was a structured programme of audits covering key topics such as infection control, patient records and medicines management. Information relating to performance against key quality, safety and performance objectives was monitored and cascaded to staff through routine team meetings, safety huddles, performance dashboards and newsletters.

Electronic systems (such as to store records and manage patient appointments) required password access. Diagnostic scan results, reports and images were stored electronically and could be accessed by staff in other parts of the hospital, such as during routine outpatient consultations.

We scored the service as 3. The evidence showed a good standard. The service understood their duty to collaborate and work in partnership, so services work seamlessly for people. They share information and learning with partners and collaborate for improvement.

Staff and leaders engaged with patients, staff, partners, and national networks to share learning and were focused on continuous improvements to the service. For example, the physiotherapy department were developing a patient user group and were leading on a sustainability initiative for a crutch recycling scheme, which had been taken up by other hospital sites in the network.

The service worked with local health care partners to ensure there was a good understanding of local needs and improve the care they provided. These included both local GPs and local hospitals. Patients we spoke with told us care and treatment was well co-ordinated before, during and after their surgery.

The service had transfer protocols in place with the local NHS hospital.

The service operated as part of a network of Ramsay hospitals. There were regular meetings between the different hospitals across the country. These meetings were utilised to share information and learning as a result of serious incidents and or complaints.

We scored the service as 3. The evidence showed a good standard. The service focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people.

We saw evidence of learning and improvement resulting from findings from audit results and incidents and shared learning was cascaded to staff to aid learning. Due to the type of service, these developments were predominantly driven by organisational initiatives, structures and directives. Staff and leaders had a good understanding of how to make improvement happen and the service promoted a strong culture of continuous quality improvement.