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Inspection report

Date of Inspection: 14 September 2010 and 11 July 2011
Date of Publication: 3 February 2011
Inspection Report published 3 February 2011 PDF

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People should be treated with respect, involved in discussions about their care and treatment and able to influence how the service is run (outcome 1)

Meeting this standard

We checked that people who use this service

  • Understand the care, treatment and support choices available to them.
  • Can express their views, so far as they are able to do so, and are involved in making decisions about their care, treatment and support.
  • Have their privacy, dignity and independence respected.
  • Have their views and experiences taken into account in the way the service is provided and delivered.

How this check was done

Our judgement

Many patients are very positive about their experiences of care and treatment at the Churchill Hospital. There is evidence, however, that some patients have received poor care, that patients and their relatives are not always treated with respect and that communication could be improved in relation to delayed or cancelled procedures.

Overall, we found that the Churchill Hospital was meeting this essential standard, but there are areas of concern where improvements need to be made.

User experience

In assessing this outcome we used information provided by patients via NHS Choices website, complaints that we have been sent and patient survey results. We also spoke to patients during our visit to the hospital on 14 September 2010.

Patients we spoke to were, on the whole, very positive about their experiences of care and treatment. Patients reported that staff were respectful and focused on meeting their personal care needs. Patients also stated that they felt they were treated with dignity and respect. They also stated that they were given information about procedures including reasons for needing to reschedule or cancel them. Patient’s outlined that the risks and benefits of different care and treatment options had been explained to them.

There were 11 comments sent by patients via the NHS Choices website referring to care across all hospitals that make up the Oxford Radcliffe Hospitals NHS Trust. Eight of these were positive. These outlined that patients were happy with their treatment, felt that their care was good and that staff treated them with dignity and respect. There were, however, examples where patients identified that some staff had been rude, disorganised, lacking compassion and that they had not been treated with dignity or respect.

Complaints from patients and relatives received by the Care Quality Commission (CQC) have also highlighted a range of negative experiences. Although the CQC does not deal with individual complaints, when complaints are received, they are used to inform our assessment of providers of care. These complaints related to care across all hospitals that are part of the trust and in some cases, related to care in wards or departments at more than one hospital. The complaints highlighted some serious concerns about the involvement of patients and their families in decision making. Some patients and relatives also reported poor care and the impact of long waiting times for diagnostic and screening procedures, such as radiology. Others outlined that there was a lack of communication regarding their own or their relative’s treatment, including when operations were cancelled or delayed.

The inpatient survey (2009) was returned by 429 patients. This survey gathered patient feedback across the whole trust and results are benchmarked against other trusts. Results show that the trust scored ‘about the same’ when compared to other trusts. All responses from patients are scored out of 10. The trust scored:

• 7.4 out of 10 for how involved patients felt in decision making about their treatment.

• 8.1 out of 10 for whether they had been given enough information about their treatment and care and

• 9.3 out of 10 for whether they had enough privacy when being examined or treated.

• 6.3 out of 10 for whether family or someone else close to them having enough opportunity to talk to a doctor if they wanted.

Results of the outpatient’s survey (2009) were, on the whole, positive. The trust scored highly in relation to patients being given enough privacy when being examined. It also scored well in relation to patients being provided with information about treatments, including the risks and benefits. Patients also responded well to whether they had been treated with respect and dignity. However, the trust scored poorly (below the 20% threshold for all trusts) in relation to patients being told how long they would have to wait and why. This was also identified as a key area of concern more widely within the trust. Patient experience audits, conducted by the Picker Institute, found that some patients had concerns with communication, particularly in relation to delayed or cancelled procedures.

Other evidence

During our visit, staff were observed treating patients with respect and patients’ privacy and dignity was maintained. During the visit, patients were observed to be cared for in single sex accommodation on most of the wards visited. Staff stressed that they would always try and ensure that bays are single sex. One breach was identified during the visit where a gentleman had been in a mixed sex bay and this had been addressed as soon as it was possible. Staff commented that all breaches are reported as incidents. Toilet and bathroom facilities are dedicated as male or female. In the inpatient survey, the trust scored 8.2 out of 10 for patients not having to share a sleeping area, such as a room or bay, with patients of the opposite sex.

Written information for patients and their families and carers was seen to be available. The trust also provided some examples of patient information that is given to patients.

The trust has a range of methods in place to collect patients’ views. This includes patient questionnaires, the use of patient held devices to get immediate feedback, the NHS Choices website and the Patient Advice and Liaison Service (PALS).