Breaking: Horton Hospital Public Meeting full report

Keep the Horton General (KTHG) campaigners said they were “optimistic they are now being listened to” after last night’s (Wednesday’s) public meeting organised by Oxford University Hospitals NHS Trust (OUHT) and the Oxfordshire Clinical Commissioning Group (OCCG) at Rye Hill Golf Club.

Despite growing anger over the rural location of the meeting last week, the club was packed with hundreds of campaigners concerned about the hospital’s future after the withdrawal of emergency surgery from the Horton in January last year.

The public meeting at Rye Hill Golf Club

The public meeting at Rye Hill Golf Club

OUHT and OCCG bosses confirmed emergency surgery would not return to the Horton and outlined their strategy for an expanded surgical unit at the JR to provide a greater range of surgical specialisms and sub specialisms.

However bosses reassured campaigners, outlining a five-year-plan for the future of the Horton including expansion of assessment facilities to avoid “needless” transfers of patients to Oxford.

Key outcomes:

- NHS bosses rule out return of emergency surgery to Horton, but pledge greater assessment of patients to avoid unnecessary transfers

- Centralised emergency surgery hub planned for John Radcliffe Hospital

- Increased numbers of specialist surgeons will travel from JR to operate in Banbury

- No plans to cut elective surgery at the Horton

- Pledge for £2 million investment in Horton buildings

- Removal of emergency surgery about strategy not funding cuts say bosses

- Clinical Commissioning Group needs to save £20 million this year

- Campaigners optimistic they are being listened to

Bosses also pledged specialist JR surgeons would increasingly also operate in Banbury with 80 per cent of surgeons already doing so when the need arises.

OUHT’s Clinical Director for Surgery Nick Maynard said the Trust had been investigating removing emergency surgery from the Horton six months prior to January 2013 but had to implement the change more quickly than expected when three surgeons suddenly became unavailable, reducing the number of surgeons from five to two. Bosses strongly denied suggestions from one campaigner this was a deliberate move to “engineer” the removal of emergency surgery. They said one surgeon left the Trust for non clinical reasons, one had withdrawn from clinical practice and another had decided to focus on elective rather than emergency surgery.

Mr Maynard said the Trust’s strategy was to build “centralised surgical units” such as that at the JR Hospital because extensive research showed patient outcomes improved with the volume of operations completed and the Trust needs to provide units open 24 hours, with surgeons trained in the widest possible range of specialisms.

He said an alternative to create such a centre at the Horton would require eight surgeons and was not workable because only 3.25 patients were referred from Banbury to the JR for emergency surgery each day.

But he added patients being sent to the JR then not being admitted and returned to Banbury was “unreasonable” and “shouldn’t happen”, and pledged to expand assessment by consultants at the Horton from one to a minimum of four hours each day, so “only those patients that need to be admitted will be transferred to Oxford”.

He also pledged an increase in the availability of ultrasound and CT scans at the Horton.

The amount and type of elective surgery at the Horton was said to be on the increase and £2 million was pledged for the improvement of buildings on the site in the coming year.

Bosses said the school of surgeons had decided to no longer send trainees to the Horton due to the reduced amount of emergency surgery limiting their training experience, but insisted strategy rather than funding cuts was the driving force behind the decision.

Ian Wilson, OCCG’s Chief Executive, offered reassurance that the GP led group which buys health services for patients had no intention of seeing the removal of emergency surgery from the Horton as the start of a decline in services at the site.

He said: “I intend to give some context and reassurance that this isn’t the thin end of the wedge for the Horton.

“We do face some significant challenges over the next period. Maintaining the quality and safety of services is paramount but we also need to make sure services change and develop in line with technological and other developments.”

Mr Wilson admitted however OCCG needs to save £20 million from it’s £650 million annual budget next year.

He said the group’s strategy was to support initiatives to help patients manage their own health in their own homes as he said “most people would prefer to be in their own homes rather than in hospitals” but added the Horton Hospital has a “bright future” as part of the group’s vision.

Concerned patients feared the closure of the cardiac gym at the Horton but were told it is to remain open but will focus on the increasing demand in current cardiac patients. Former cardiac patients will no longer be able to attend the gym.

After the meeting, campaigner and retired surgeon Peter Fisher said he was disappointed KTHG hadn’t been allowed ten minutes to speak as requested but added: “I think we’re pleased that they are going to offer more assessment locally but we’re probably not going to get emergency surgery restored.”

Of the proposal to send more surgeons from Oxford to operate in Banbury he said: “Unless you have people whose primary responsibility is here, they don’t have the loyalty to the place and the relationships with the GPs.

“We’ve got to push them hard on the details of how we’re going to have the assessments done up here. It’s a question of trust and I’m afraid we don’t trust them at the moment.”

KTHG campaigner Keith Strangwood added: “We’re not happy but we’re optimistic that they might be starting to listen to us.”

A full report of the meeting will now go before Oxfordshire County Council’s Health Overview and Scrutiny Committee on February 27.