North Oxfordshire MP Victoria Prentis has said she is “furious” with today’s decision by the Oxfordshire Clinical Commissioning Group Board to approve proposals set out in their Phase One Transformation Programme.
The first phase of the consultation, which ran from January to April this year, put forward proposals for the future of health services in Oxfordshire. It was met with widespread opposition, particularly in the north of the county, with many people concerned about the future of the Horton General Hospital and patient safety.
During the meeting, the CCG Board Members voted to support the following proposals from the consultation:
- Transfer of Level 3 Critical Care from the Horton to the John Radcliffe (JR) in Oxford.
- A complete transfer of immediate care for suspected Strokes to the JR.
- To make permanent the temporary downgrade of the Horton maternity unit from an obstetric to a midwife led unit (MLU).
- The permanent closure of 110 acute beds, followed by a further 36 bed closures dependent on approval by the Clinical Senate.
- An increase in Planned Care Services at the Horton, including plans for a new Diagnostic and Outpatient facility.
Before the Board made the decision, a number of stakeholders including Victoria Prentis, Witney MP Robert Courts, Joint Oxfordshire Health Overview and Scrutiny Committee (HOSC) Chair, Councillor Arash Fatemian, Professor George Smith, Chair of Healthwatch Oxfordshire, and Keith Strangwood of the Keep the Horton General campaign group, were given the opportunity to make brief statements. In her own contribution, Victoria made clear her frustrations and focused on areas of patient safety which have not been addressed properly throughout the consultation process.
After the meeting, Victoria said: “The Board’s decision to approve proposals in the Transformation Programme consultation comes as no surprise.
“I am furious. Public consultation has been meaningless. The Board heard five clear addresses from myself, my colleague Robert Courts, HOSC Chair, Councillor Arash Fatemian, Professor George Smith, Chair of Healthwatch Oxfordshire, and Keith Strangwood, Chair of the Keep the Horton General campaign group. We were united in our views, yet there was no further mention of many of the points we raised when the Board examined the proposals. For example, we have no idea whether the static ambulance will remain at the Horton. Blue light transfer times were looked at without addressing the fact that no transfer can take place until another midwife has come into the unit to enable the duty midwife to travel with the mother giving birth. While patient safety is top priority for all of us, there was no proper discussion about how people, particularly those in the north of the county who do not own a car, are supposed to access services at the John Radcliffe.
“No discussion was had about the impact on the families of patients, and there was no consideration of future arrangements for the hardworking Horton staff, and those whose job is now in Oxford, who have had to adapt to changes made in the last year.
“My requests to pause the decision-making process until we have a clearer vision of health services and more evidence to understand the proposals have been ignored over and over again. Before today there were two referrals to the Secretary of State. There are now three, as the Oxfordshire Joint Health Overview and Scrutiny Committee (HOSC) will now refer the decision to permanently downgrade the maternity unit. I support them in their calls for no action to be taken until the referral process has run its course. We will also have to see how the judicial review brought by five councils progresses.
“I urge my constituents not to give up hope. I remain absolutely committed in the fight to retain acute services at the Horton General Hospital.”
Please see below a video of Victoria’s address and her speaking notes.
The consequences of your decision today are significant.
Significant for the low-risk mothers who choose the Horton MLU who become high risk during labour and need transferring, but must wait for a midwife and wait for an ambulance before they are able to. Can you be sure that you have enough information concerning what will replace the static ambulance? There is nothing in the papers before you and we were given inconsistent information during the consultation. We know there have been cases where difficulties have arisen.
Significant for the many thousands of women – the 85 per cent who give birth in an obstetric unit – who will now be forced to spend up to one and a half hours in their car – if they are lucky enough to have one – in the latter stages of labour and then wait while their partner parks. Your impact assessment observes that there is poor connectivity and congestion for people in the north of the county trying to get to Oxford. Yet the CCG’s proposals rely on models applied to metropolitan and largely urban areas, overlooking the rural nature of much of the county. Can you be sure that all travel options have been explored and considered?
Significant for all other services at the Horton. The Horton General Hospital provides almost a third of the county’s A&E. The decision you make take today may inadvertently put the ability to do this at risk. Training accreditation for anaesthetists has been removed this month. Please ensure you are fully sighted on the knock-on effects before making your decision.
I accept that recruitment is a national problem but can you be sure that the Trust has not explored all options when it has neither taken up our offers of help with recruitment, including discounted housing and school fees, nor has it engaged with the District Council’s offer of golden handshakes.
Can you be sure that there has been robust critical analysis of the workforce modelling on which you can base a decision? Has there been sufficient exploration of the suggestion for a Banbury Health Campus worked up by the District Council?
Can you be sure that local clinicians have been properly consulted? I have heard from local GPs who tell me they are worried their voices are not being heard. They are tired of the process. It has not felt like a consultation to them.
In 2008, the Independent Reconfiguration Panel was left with a sense that the Horton was viewed as a problem to be solved rather than a development opportunity, and encouraged the Trust to recognise the Horton’s positive future as an integral part of its future vision.
Can you be sure that this has happened? The Trust have told me that they are ready with their options for Phase 2, and have been for the past year. The CCG has told me that it is only just starting work on Phase 2 and consultation is unlikely until May 2018. A new Chief Executive and Clinical Lead also need to be appointed. We have three referrals to the Secretary of State from various HOSCs, and a judicial review, which is very much still live, brought by five councils.
In these circumstances, I ask you to make the decision on stroke care (Proposal 2) but to park decisions on Proposals 1 and 5 – bed closures and maternity – until the full picture is assessed and we have the answers we need.