The Robert Jones & Agnes Hunt Hospital

The on-site assessment took place on the 23 May 2025. The assessment took place due to overdue inspection and out of date ratings. We have rated the service asGood overall.

The high dependency unit at The Robert Jones and Agnus Hunt Orthopaedic Hospital NHS Trust provides a service to patients who need high dependency care (described as level two). Care is provided to patients who have undergone extensive or complicated orthopaedic surgery, or who have been identified at their pre-operative assessment clinic as maybe requiring closer post-operative nursing care. The high dependency unit also provides care to patients who are being nursed on the general wards and whose condition is deteriorating clinically or are causing concern. Patients are also admitted in the event of surgical emergencies.

An outreach service is provided within the trust, which operates 24 hours a day, 7 days a week. The team follows up all patients upon discharge from the high dependency unit to one of the wards, during service hours, to ensure good clinical progress continues. They attend to deteriorating patients on the general and surgical wards. The outreach role is a dual one as they also provide nursing cover to the whole hospital at night.

As of 30 March 2025, there were 4 adult critical care beds, of which 1 was occupied. Between 25 November 2024 and 30 March 2025, the trust has had between four to six open beds with an average monthly bed occupancy rate of 58%. The trust has had a comparable number of open critical beds and bed occupancy, over the past three years. Between January 2024 and January 2025, the High Dependency Unit (HDU) Hospital had an average of 21.96 care hours per patient day.

April 2025 figures:

Weekday bed occupancy at 2pm 48.51% against target 87.00%

Weekend bed occupancy at 2pm 40.63% against target 87.00%

Weekday bed occupancy at midnight 66.67% against target 87.00%

Weekend bed occupancy at midnight 38.71% against target 87.00%.

The on-site assessment took place on the 23 May 2025. The assessment took place due to overdue inspection and out of date ratings. We have rated the service asGood overall.

The high dependency unit at The Robert Jones and Agnus Hunt Orthopaedic Hospital NHS Trust provides a service to patients who need high dependency care (described as level two). Care is provided to patients who have undergone extensive or complicated orthopaedic surgery, or who have been identified at their pre-operative assessment clinic as maybe requiring closer post-operative nursing care. The high dependency unit also provides care to patients who are being nursed on the general wards and whose condition is deteriorating clinically or are causing concern. Patients are also admitted in the event of surgical emergencies.

An outreach service is provided within the trust, which operates 24 hours a day, 7 days a week. The team follows up all patients upon discharge from the high dependency unit to one of the wards, during service hours, to ensure good clinical progress continues. They attend to deteriorating patients on the general and surgical wards. The outreach role is a dual one as they also provide nursing cover to the whole hospital at night.

As of 30 March 2025, there were 4 adult critical care beds, of which 1 was occupied. Between 25 November 2024 and 30 March 2025, the trust has had between four to six open beds with an average monthly bed occupancy rate of 58%. The trust has had a comparable number of open critical beds and bed occupancy, over the past three years. Between January 2024 and January 2025, the High Dependency Unit (HDU) Hospital had an average of 21.96 care hours per patient day.

April 2025 figures:

Weekday bed occupancy at 2pm 48.51% against target 87.00%

Weekend bed occupancy at 2pm 40.63% against target 87.00%

Weekday bed occupancy at midnight 66.67% against target 87.00%

Weekend bed occupancy at midnight 38.71% against target 87.00%.

The Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust has approximately 200 inpatient and critical care beds across 9 wards.

The hospital is a single site hospital based in Oswestry, Shropshire. It provides specialist and routine orthopaedic care to its local catchment area, and specialist services both regionally and nationally. The hospital is a specialist centre for the treatment of spinal injuries and disorders and provides specialist treatment for children with musculoskeletal disorders. Additionally, the trust works with partner organisations to provide specialist treatment for bone tumours and community based rheumatology services. The trust is part of the National Orthopaedic Alliance (NOA), an acute care collaboration vanguard designed to improve orthopaedic care quality across England.

The surgical services at The Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust are comprised of 5 inpatient wards:

Kenyon ward – 22 beds

Powys ward – 22 beds

Clwyd ward – 22 beds

Ludlow ward – 16 beds (private patients) NOT assessed

Oswald ward - oncology ward, 10 beds en-suite. NOT assessed.

The trust’s theatre suite comprises of 12 operating theatres, including 2 day-surgery theatres located in the Menzies unit.

During the inspection we visited 3 wards, the surgical admissions and day case unit, the operating theatres and the recovery unit.

We spoke with 29 patients and visitors and 40 members of staff. These included senior managers, all grades of nursing staff, healthcare assistants, domestic staff, consultant surgeons, anaesthetists, and other grades of doctors.

We last inspected the hospital in November and December 2019. Where it was rated good overall.

We carried out this announced inspection on the 22 and 23 May 2025.

We inspected this service using our single assessment framework and looked at all the key questions and 33 quality statements. The main service provided by the hospital was surgery for adult patients.

There were effective systems to ensure that standards of cleanliness and hygiene were maintained.

The service had enough staff with the right qualifications, skills, training and experience to keep people safe from avoidable harm and to provide the right care and treatment.

The service managed patient safety incidents well. Staff recognised incidents and reported them appropriately.

The service made sure staff were competent for their roles.

All staff worked together as a team to benefit patients. Doctors, nurses and other healthcare professionals supported each other to provide good care.

Patients told us they felt involved in their own care and treatment as staff took time to explain what was happening and why.

We saw examples where staff had gone above and beyond what was expected to support patients.

The trust planned and provided services in a way that met the needs of local people.

The service treated concerns and complaints seriously, investigated them and learned lessons from the results, and shared these with all staff.

Managers and senior leaders had the right skills to perform their roles effectively.

The trust had a vision for what it wanted to achieve and workable plans to turn it into action developed with involvement from staff, patients, and key groups representing the local community.

There was evidence of improved culture across the service and there was strong leadership. Staff told us they felt supported, respected, valued and were proud to work at the trust.

The service was committed to improving services by learning from when things went well and when they went wrong, promoting training, research, and innovation.

The Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust has approximately 200 inpatient and critical care beds across 9 wards.

The hospital is a single site hospital based in Oswestry, Shropshire. It provides specialist and routine orthopaedic care to its local catchment area, and specialist services both regionally and nationally. The hospital is a specialist centre for the treatment of spinal injuries and disorders and provides specialist treatment for children with musculoskeletal disorders. Additionally, the trust works with partner organisations to provide specialist treatment for bone tumours and community based rheumatology services. The trust is part of the National Orthopaedic Alliance (NOA), an acute care collaboration vanguard designed to improve orthopaedic care quality across England.

The surgical services at The Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust are comprised of 5 inpatient wards:

Kenyon ward – 22 beds

Powys ward – 22 beds

Clwyd ward – 22 beds

Ludlow ward – 16 beds (private patients) NOT assessed

Oswald ward - oncology ward, 10 beds en-suite. NOT assessed.

The trust’s theatre suite comprises of 12 operating theatres, including 2 day-surgery theatres located in the Menzies unit.

During the inspection we visited 3 wards, the surgical admissions and day case unit, the operating theatres and the recovery unit.

We spoke with 29 patients and visitors and 40 members of staff. These included senior managers, all grades of nursing staff, healthcare assistants, domestic staff, consultant surgeons, anaesthetists, and other grades of doctors.

We last inspected the hospital in November and December 2019. Where it was rated good overall.

We carried out this announced inspection on the 22 and 23 May 2025.

We inspected this service using our single assessment framework and looked at all the key questions and 33 quality statements. The main service provided by the hospital was surgery for adult patients.

There were effective systems to ensure that standards of cleanliness and hygiene were maintained.

The service had enough staff with the right qualifications, skills, training and experience to keep people safe from avoidable harm and to provide the right care and treatment.

The service managed patient safety incidents well. Staff recognised incidents and reported them appropriately.

The service made sure staff were competent for their roles.

All staff worked together as a team to benefit patients. Doctors, nurses and other healthcare professionals supported each other to provide good care.

Patients told us they felt involved in their own care and treatment as staff took time to explain what was happening and why.

We saw examples where staff had gone above and beyond what was expected to support patients.

The trust planned and provided services in a way that met the needs of local people.

The service treated concerns and complaints seriously, investigated them and learned lessons from the results, and shared these with all staff.

Managers and senior leaders had the right skills to perform their roles effectively.

The trust had a vision for what it wanted to achieve and workable plans to turn it into action developed with involvement from staff, patients, and key groups representing the local community.

There was evidence of improved culture across the service and there was strong leadership. Staff told us they felt supported, respected, valued and were proud to work at the trust.

The service was committed to improving services by learning from when things went well and when they went wrong, promoting training, research, and innovation.

The on-site assessment took place on the 23 May 2025. The assessment took place due to overdue inspection and out of date ratings. We have rated the service as Good overall.

The high dependency unit at The Robert Jones and Agnus Hunt Orthopaedic Hospital NHS Trust provides a service to patients who need high dependency care (described as level two). Care is provided to patients who have undergone extensive or complicated orthopaedic surgery, or who have been identified at their pre-operative assessment clinic as maybe requiring closer post-operative nursing care. The high dependency unit also provides care to patients who are being nursed on the general wards and whose condition is deteriorating clinically or are causing concern. Patients are also admitted in the event of surgical emergencies.

An outreach service is provided within the trust, which operates 24 hours a day, 7 days a week. The team follows up all patients upon discharge from the high dependency unit to one of the wards, during service hours, to ensure good clinical progress continues. They attend to deteriorating patients on the general and surgical wards. The outreach role is a dual one as they also provide nursing cover to the whole hospital at night.

As of 30 March 2025, there were 4 adult critical care beds, of which 1 was occupied. Between 25 November 2024 and 30 March 2025, the trust has had between four to six open beds with an average monthly bed occupancy rate of 58%. The trust has had a comparable number of open critical beds and bed occupancy, over the past three years. Between January 2024 and January 2025, the High Dependency Unit (HDU) Hospital had an average of 21.96 care hours per patient day.

April 2025 figures:

Weekday bed occupancy at 2pm 48.51% against target 87.00%

Weekend bed occupancy at 2pm 40.63% against target 87.00%

Weekday bed occupancy at midnight 66.67% against target 87.00%

Weekend bed occupancy at midnight 38.71% against target 87.00%.

The Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust has approximately 200 inpatient and critical care beds across 9 wards.

The hospital is a single site hospital based in Oswestry, Shropshire. It provides specialist and routine orthopaedic care to its local catchment area, and specialist services both regionally and nationally. The hospital is a specialist centre for the treatment of spinal injuries and disorders and provides specialist treatment for children with musculoskeletal disorders. Additionally, the trust works with partner organisations to provide specialist treatment for bone tumours and community based rheumatology services. The trust is part of the National Orthopaedic Alliance (NOA), an acute care collaboration vanguard designed to improve orthopaedic care quality across England.

The surgical services at The Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust are comprised of 5 inpatient wards:

Kenyon ward – 22 beds

Powys ward – 22 beds

Clwyd ward – 22 beds

Ludlow ward – 16 beds (private patients) NOT assessed

Oswald ward - oncology ward, 10 beds en-suite. NOT assessed.

The trust’s theatre suite comprises of 12 operating theatres, including 2 day-surgery theatres located in the Menzies unit.

During the inspection we visited 3 wards, the surgical admissions and day case unit, the operating theatres and the recovery unit.

We spoke with 29 patients and visitors and 40 members of staff. These included senior managers, all grades of nursing staff, healthcare assistants, domestic staff, consultant surgeons, anaesthetists, and other grades of doctors.

We last inspected the hospital in November and December 2019. Where it was rated good overall.

We carried out this announced inspection on the 22 and 23 May 2025.

We inspected this service using our single assessment framework and looked at all the key questions and 33 quality statements. The main service provided by the hospital was surgery for adult patients.

There were effective systems to ensure that standards of cleanliness and hygiene were maintained.

The service had enough staff with the right qualifications, skills, training and experience to keep people safe from avoidable harm and to provide the right care and treatment.

The service managed patient safety incidents well. Staff recognised incidents and reported them appropriately.

The service made sure staff were competent for their roles.

All staff worked together as a team to benefit patients. Doctors, nurses and other healthcare professionals supported each other to provide good care.

Patients told us they felt involved in their own care and treatment as staff took time to explain what was happening and why.

We saw examples where staff had gone above and beyond what was expected to support patients.

The trust planned and provided services in a way that met the needs of local people.

The service treated concerns and complaints seriously, investigated them and learned lessons from the results, and shared these with all staff.

Managers and senior leaders had the right skills to perform their roles effectively.

The trust had a vision for what it wanted to achieve and workable plans to turn it into action developed with involvement from staff, patients, and key groups representing the local community.

There was evidence of improved culture across the service and there was strong leadership. Staff told us they felt supported, respected, valued and were proud to work at the trust.

The service was committed to improving services by learning from when things went well and when they went wrong, promoting training, research, and innovation.