- NHS hospital
John Radcliffe Hospital
Assessment report published 9 September 2026
Contents
Ratings - Neonatal services
Our view of the service
We inspected the neonatal service at John Radcliffe Hospital on 19 and 20 January 2026. The reason for assessment was to ensure full oversight of maternity and neonatal services at the trust. This was a fully comprehensive assessment and was the first time neonatal services had been inspected as a sole unit and not part of either maternity or children and young people’s services.
The neonatal unit at the John Radcliffe Hospital, is part of Oxford University Hospitals NHS Foundation Trust. The unit covers a wide geographical area. It is a level 3 tertiary neonatal intensive care unit with surgical provision, which means it provides specialised advanced care for babies across the Thames Valley who have complex or rare conditions that could not be managed by local secondary or primary services. In the 12 months preceding the inspection, the service supported 804 admissions, of which approximately 83% were babies born within the trust’s maternity services.
We inspected the neonatal intensive care unit (NICU), high dependency unit (HDU) and low dependency unit (LDU). We spoke with staff across all professional groups and grades, engaged with five families, and observed care and treatment.
Since an external independent review of leadership and governance, staff advised us there had been notable improvements in the learning culture, moving away from a blame culture to one where incidents were used to make improvement. Staff advised us they believed the reason for this was the introduction of the new leadership appointments, including a deputy matron and a matron. However, some pockets of staff dissatisfaction remained.
The service had identified constraints relating to the physical environment and had developed action plans to address these. However, progress was slow and risk register ratings did not fully reflect the length of time the environmental constraints had been known, nor did they reflect the concerns raised by families during the inspection.
The neonatal unit was the only service within the trust not using a fully integrated electronic baby record system. Instead, staff relied on three separate record systems. We found leaders may have had an overestimation of the effectiveness of mitigating actions as we found ward clerks spent considerable time reconciling records across systems, and incidents of missing or incomplete records were not always reported through formal processes. As a result, leaders may not have had full oversight of the scale of risk associated with record management.
We will request an action plan from the trust on meeting these concerns upon publication of the final report.
People's experience of this service
Families told us they were generally positive about the service and felt well supported during their time on the neonatal unit. They consistently described staff as caring, compassionate and attentive to both their own and their baby’s needs.
However, families highlighted concerns regarding the physical environment. They noted a clear contrast between the modern, spacious NICU and the older, more cramped HDU and LDU areas. Families also raised concerns about limited access to toileting facilities. While this did not detract from the quality of care provided, it impacted on the overall experience of the service.