Watchdog committee sets out its opposition to NHS proposals

Members of a key watchdog committee have resolved to refer several aspects of proposals to make big changes to NHS services in Oxfordshire to the Government.

Oxfordshire’s Joint Health Overview Scrutiny Committee, made up of county councillors, district councillors and members of the public heard from 20 public speakers at a special meeting on August 7 including MPs Robert Courts and Victoria Prentis and former MP Tony Baldry.

Councillor Arash Fatemian, the Chairman of the Committee, said: “We heard from people from all walks of life and all political persuasions during our deliberations about these NHS proposals.

“Two MPs, Victoria Prentis and Robert Courts, the leader of Cherwell District Council Cllr Barry Wood and people representing various different local bodies came together to present a united front to express their opposition to several aspects of the proposals that have been made.

“If the NHS subsequently agree the proposals we will then refer the aspects that we are unhappy about to central government. Our central role is to apply scrutiny and oversight to the local health service and that is what we have done and it is what we will continue to do in the future.”

The committee’s resolutions were as follows:

1. Critical Care

The committee is supportive of the proposal to move to a single Level 3 Critical Care Unit for Oxfordshire, subject to assurances from the CCG and OUHT that there will be no long term detrimental effects on Accident and Emergency and anaesthetic services at the Horton General Hospital.

2. Acute Stroke Services

The committee supports the CCG’s drive to improve outcomes for stroke patients by conveying them directly to the Hyper Acute Stroke Unit at the JR. However, this is subject to clarification being given about the impact of recent changes to guidance on ambulance response times (namely the extension of response times from eight minutes to forty minutes for stroke victims) and assurances that stroke rehabilitation will continue to be carried out at relevant local sites around the County such as the Horton General Hospital and Witney and Abingdon Community Hospitals.

3. Changes to Acute Bed Numbers

The committee supports the current closure of 110 beds, but cannot support further bed closures without a more comprehensive understanding of the impact this will have on the wider health and social care system, in particular community based services.

4. Planned Care Services at the Horton General Hospital

Whilst the committee agrees with the principle of developing planned care services at the Horton General Hospital, we are unable to give full support to the proposal without being provided with a more detailed and fully-costed plan in which the local community has been fully engaged. The committee urges the CCG and OUHT to bring forward their detailed plans to increase footfall at the Hospital and ensure its sustainability, but we are unclear why these proposals need to be considered as a matter of urgency under part of Phase 1 of the Transformation Plan.

5. Maternity services

The committee strongly opposes the proposal to create a single specialist obstetric unit at the JR and establish a permanent midwife-led service at the Horton General Hospital. If the CCG Board agrees this proposal on 10th August, the committee resolved to refer the decision to the Secretary of State on the grounds that it is not in the best interests of local residents and the health service because:

  1. The arguments set out in the 2008 IRP judgement still apply;

  2. The fundamental needs of mothers in North Oxfordshire and surrounding areas have not changed since 2008;

  3. The population of North Oxfordshire has grown since 2008 and is set to grow substantially in the coming years, further justifying the need for a consultant-led maternity service in the north of the county; and

  4. There are ongoing issues with travel and access from the Horton to the JR for expectant mothers.

Whilst the committee accepts that there are difficulties recruiting and retaining suitably qualified staff to maintain an obstetric unit at the Horton, we do not consider this just cause for removing a service when the needs of local people have not fundamentally changed, particularly as seven of the nine consultant posts advertised by the Trust are now filled. Moreover, the committee is disappointed to hear that the CCG has not fully engaged with local partners who put forward alternative options for maintaining an obstetric service at the Horton.

The committee is also disappointed by the lack of a clear picture for countywide maternity services as a result of the two-phased consultation. The impact of permanently removing the obstetric unit at the Horton on maternity services as a whole, including the Chipping Norton, Wallingford and Wantage midwifery-led units, was not clear in the Phase 1 consultation. The committee does not believe it has seen a robust enough case for meeting the needs of expectant mothers in the absence of consultant-led services in the north of the county.