MP JOINS COLLEAGUES TO SPEAK IN OXFORDSHIRE NHS STAFF RECRUITMENT & RETENTION DEBATE
On Tuesday 20 February, Banbury MP Victoria Prentis spoke in a debate on the recruitment and retention of NHS staff in Oxfordshire. During the course of the debate, which was secured by Oxford West and Abingdon MP Layla Moran, Victoria emphasised the need to be creative with recruitment ideas, have greater clarity when considering the domino effect of staffing shortages, and communicate more openly and transparently.
Speaking after the debate, Victoria said: “I was delighted to have the opportunity to contribute to this important debate. Recruiting and retaining NHS staff in Oxfordshire has been an ongoing issue for many years now. The current situation at the Horton’s maternity unit is a daily reminder for us all. We need to think outside the box and tackle the problems together, particularly in light of the Care Quality Commission’s recent full system review of the local health system. We are in urgent need of a vision for our health service and must keep up the pressure.”
Full text of Victoria’s speech:
Thank you, Mr Hollobone, and it is a pleasure to take part in the debate. I thank the hon. Member for Oxford West and Abingdon (Layla Moran) for securing it.
It is great to see all my fellow Oxfordshire colleagues present today. If I may say so, they have all been great allies in my fight to save acute services at the Horton General Hospital. Talking about recruitment in some detail is particularly useful, because that is our greatest local challenge with regard to good healthcare.
It is also good to see the Minister in his place. Since he took up his role, he and I have spoken many times about the issues faced at the Horton. We in Banbury are waiting patiently to hear the outcome of the Independent Reconfiguration Panel’s initial assessment of the permanent downgrade of our maternity services. Our hopes are pinned on a full review, and we were due to find out 10 days ago whether that would take place. We have heard nothing yet, but I am watching the post with interest.
The Independent Reconfiguration Panel is familiar with our situation, having looked at similar proposals to downgrade maternity at the Horton back in 2008. Just as recruitment was the contributing factor almost 10 years ago, the failure to fill middle-grade vacancies at the Horton’s obstetric unit was the straw that broke the camel’s back in 2016. However, failures in recruitment are not, as we have heard, unique to maternity services at the Horton. We have spoken briefly about chemotherapy services at the Churchill, and at a meeting in January with local GPs, many expressed concerns about the sustainability of their practices in the current recruitment climate. Last week, the Care Quality Commission observed the following in its full and, if I may say so, quite critical review of the local system, which the hon. Member for Oxford West and Abingdon has quoted and which I will carry on a little:
“The system in Oxfordshire was particularly challenged by the issues of workforce retention and recruitment across all professions and staff grades, especially acute hospital staff…and in the domiciliary…market. This resulted in staff shortages, heavy workloads and impacted upon seamless care delivery and integration of services.”
I am reassured that the Department takes recruitment seriously and has invested significant time and resources in addressing current workforce challenges across the nation. Attracting more people to the profession and training them takes many years. The cost of living in our area is high and London weighting is a significant pull factor out of our area, particularly given our very reliable transport links to the capital. We may be a wealthy county but we must think creatively to overcome the current challenges. The future of our services depends on that.
When I called for help, I was overwhelmed by the generosity of local schools and businesses in my area, which offered discounted school fees, free shirts from Charles Tyrwhitt, and free beer from Hook Norton—that made the headlines—to any prospective obstetricians who wanted to apply for a job at the Horton General. As a leading house building authority, Cherwell District Council has been exemplary in its support for the Horton, exploring the possibility of golden handshakes and providing key worker housing. A local developer came forward to offer one of its new build properties to any obstetrician looking to relocate to our area. Yet all of these offers remain completely unexplored by the local hospital trust, which has refused repeatedly to engage with me on this issue.
Last September, the Secretary of State announced plans to offer salary supplements to GPs in rural and coastal regions, which was a really welcome development. Market towns such as Banbury, Bicester, Abingdon and the many others represented in this Chamber desperately need similar incentives to attract newly trained professionals, whether through an Oxfordshire weighting or a ring-fenced housing allowance. I have no particular view about which would be the more effective incentive—I am happy to explore both. More money is always welcome, but it does not have to be the only answer. Just yesterday, I heard from a Banbury GP who has not been able to recruit a fully qualified international GP who is a resident outside the EU, because of problems with the tier 2 visa requirements. The person is an Australian who trained in Banbury and is very familiar with the local system, and we would really value having her back.
It is important that we consider specialties such as general practice and obstetrics when looking at the shortage occupation list that needs to be filled, because there are gaps in those areas too. We must think outside the box and talk across Departments to find the solutions that we desperately need. We must also have some clarity. When obstetric services at the Horton were suspended in August 2016, we were told that the rota needed six obstetricians to operate safely. But the goalposts were moved; the trust now tells us that nine are needed before the unit can reopen. Those decisions have real consequences. We must know the potential domino effect that shortages can have on other medical rotas. Since maternity services at the Horton were downgraded, the hospital has, in turn, lost one of its anaesthetic rotas. Difficulties attracting professionals to CT1 and CT2 posts pose a very real risk to the future sustainability of the one remaining rota. Until that can be full resolved, the threat to all acute services at the Horton cannot be fully ruled out.
Finally, we must learn, as I say repeatedly, to communicate openly and transparently. Extracting recruitment information from the trust is painfully slow. Rather than offer updates, it leaves us to ask for meetings. We are still waiting for the meeting that my hon. Friend the Member for Witney (Robert Courts) requested for us to discuss recruitment at the Churchill. Yet when I made remarks on local radio about a perceived culture of secrecy, the trust chairman was very quick to summon me to meet her. I was told by the trust that all Oxfordshire MPs would be sent a detailed briefing on recruitment and retention challenges by 1 February. I have not had such a briefing and I do not know whether other hon. Members have.
Time and again I have offered assistance with tackling recruitment. Schools and businesses made generous offers to attract obstetricians, and I am furious that the trust continues to fail to engage. I am hopeful that the CQC report provides a long overdue reality check and that we start to see a real step change in its approach. I have made clear numerous times that we MPs are ready and waiting to help. I am really hopeful that under the new excellent interim head of the clinical commissioning group, we will start to develop a vision for our future healthcare, which we have so desperately lacked for so long.
This year we mark 70 years of the NHS. I am hopeful that many of the hard-working staff in Oxfordshire will be recognised at the upcoming parliamentary awards. I am particularly grateful to the dedicated Horton midwives who now face an almost three-hour round commute to and from the John Radcliffe, following the downgrade of our unit. Experience has taught us that we need to keep up the pressure.