The Care Quality Commission has published its findings following a local system review of Oxfordshire. This report is one of 20 targeted reviews of local authority areas looking specifically at how people move through the health and social care system, with a focus on how services work together.
The reviews look at how hospitals, community health services, GP practices, care homes and homecare agencies work together to provide seamless care for older people living in a local area.
The review in Oxfordshire found that there was a strong ambition for partner agencies to work together and provide excellent services to the people of Oxfordshire but there was a lack of strategic planning. Despite this, health and social care professionals were highly dedicated to supporting people using services, their families and carers.
While Oxfordshire has a history of public engagement, feedback has sometimes indicated that this has not always been effective. This has been recognised by engagement leads and a dedicated team has been set up to progress on the work required. The Social Care Institute of Excellence has reviewed the work of this team and confirmed that there is positive work taking place.
Some of the key findings of the review were:
- The Adult Social Care Outcomes Framework measures how well care and support services achieve the outcomes that matter most to people. The framework for 2016/17 showed that the percentage of older people who were satisfied with their care and support was slightly above average, but there was mixed feedback from people and carers about the quality of their experiences when we spoke with them.
- Plans were in place to build and adapt properties that could remain a person’s home for life and support longer term independence.
- System leaders and frontline workers reported widespread issues in respect of recruitment and retention of staff across the system. In response there were plans to build affordable housing that would attract health and social care workers into the area, with a view to providing a more sustainable workforce. However these plans would take some time to come to fruition and we found that shorter term solutions were also being sought.
- There was a focus on job and career prospects, to manage and support the acute care system, and to provide seven day care preventative services.
Despite this support, staff in the hospital setting continued to report heavy workloads with additional pressures in relation to meeting performance targets.
Professor Steve Field, Chief Inspector of Primary Care Services, said:
“Our review of Oxfordshire’s services - and how they work together - found some encouraging examples of shared approaches, but not all services are fitting together effectively."
“System leaders need to improve how they work together more effectively to plan and deliver health and social care services for older people in Oxfordshire."
“There needs to be a review of how people move more effectively through the health and social care system. Care pathways, the process of setting best practice for a patient, should be well-defined and understood throughout the system without any chance for confusion."
“It is important that system leaders continue to develop their approach to integration and also improve their working relationships beyond local partners and across the wider sustainability and transformation partnership.”
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...some encouraging examples of shared approaches, but not all services are fitting together effectively.
Professor Steve Field, Chief Inspector of Primary Care Services