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Oxfordshire health and social care: Good relationships being forged but more development is required says CQC review
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.”
For further information, please contact John Scott, Regional Engagement Manager on 077898 75809.
Journalists wishing to speak to the press office outside of office hours can find out how to contact the team here.
Please note: the press office is unable to advise members of the public on health or social care matters. For general enquiries, please call 03000 61 61 61.
- Last updated:
- 22 February 2018
Notes to editors
The Oxfordshire local system review looked principally at how people move between services provided by Oxfordshire County Council (local authority), Oxford Health NHS Foundation Trust (OHFT), NHS Oxfordshire Clinical Commissioning Group (OCCG) and Oxford University Hospitals NHS Foundation Trust (OUHT), intermediate care facilities, care homes, a domiciliary care agency, a GP practice, an extra care housing scheme, out-of-hours services and the urgent care centre.
This review was carried out following a request from the Secretaries of State for Health and Communities and Local Government to undertake a programme of 20 targeted reviews of local authority areas. The purpose of the reviews is to understand how people move through the health and social care system with a focus on the interfaces between services, and identify any areas for improvement.
This review makes a number of suggestions of areas for the local system in Oxfordshire to focus on to secure improvement including:
- System leaders must continue to engage with people who use services, families and carers when reviewing strategies and integrated systems and structures to ensure these are coproduced.
- System leaders must review how people flow through the health and social care system including a review of care pathways so that there are not multiple and confusing points of access. Pathways should be well defined, communicated and understood across the system.
- System leaders should ensure that housing support services are included especially in relation to admission and discharge from hospital, to enable early identification of need and referrals.
- There should be a review of commissioned services to consider outcomes, design and delivery to improve the effectiveness of social care assessments and reduce and avoid duplication. On completion, the criteria for each service should be circulated to system partners and social care providers to ensure resources are used effectively.
- There must be improvement regarding all parties working together to plan and deliver health and social care services for older people in Oxfordshire. Whilst doing so a review of people’s experiences must take place to target improvements needed to the delivery of health and social care services, bringing people back to the forefront of service delivery.
- The Older Person’s strategy must be reviewed and the results implemented into an updated Joint Strategic Needs Assessment. As part of the Older Person’s strategy, the draft frailty pathway should be implemented and evaluated to include those underrepresented in society.
- System leaders must implement the Sustainability and Transformation Plan’s joint workforce strategy and work with the full range of care providers to support a competent , capable and sustainable workforce active