Councillors wave through maternity downgrade proposal at Horton

The Horton General Hospital, Maternity Unit, in Banbury. NNL-160706-143707009
The Horton General Hospital, Maternity Unit, in Banbury. NNL-160706-143707009
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Oxfordshire county councillors have given hospital bosses the green light to take consultant-led maternity away from the Horton General Hospital.

At a meeting this morning (Friday) the Oxfordshire Health Overview and Scrutiny Committee accepted assurances from the Oxford University Hospitals Trust (OUHT) that mothers transferred from the midwife-only unit remaining in Banbury would not take longer than 30–45 minutes to be ambulanced to the JR, Oxford.

The trust will have an ambulance parked outside the Horton 24 hours-a-day from Monday to ensure any mother suffering unforeseen complications will not have to wait for an ambulance.

Some councillors did not accept the statistics given by OUH clinical manager Paul Brennan were realistic. Some felt the times – for on-the-road journeys, offered by South Central Ambulance Service – were optimistic given traffic congestion and did not include ‘loading and unloading’ of the patient from Horton delivery room to JR operating theatre.

Speeches asking for the matter to be referred to the Secretary of State for Health were given by Val Ingram, the Save Our Horton Facebook page administrator, Keith Strangwood, chairman of Keep the Horton General, Dr Peter Fisher, a retired Horton consultant and Sarah Ayre, a senior midwife, formerly of the Horton.

Mrs Ingram said the Independent Reconfiguration Panel in 2008 had deemed Oxford ‘too far’ to take labouring women. She said she had received information that the JR had diverted expectant mothers to the Horton on two days last week because it was too busy – a claim the OUH managers denied.

She asked why locum doctors could not be employed to keep the Horton unit open. Mr Brennan said agencies had been approached but no suitable doctors were available.

Mr Strangwood claimed recruitment efforts were ‘bound to fail’ as advertising had run concurrently with a declaration of plans for a major downgrade of the Horton, deterring potential applicants.

He said: “The trust deliberately lowered the birth numbers at the Horton. In 2013 it was 1,123 but last year it was 1,466. Why were births transferred to the JR…, to make it unviable for the Horton to be a full consultant led service. If the JR (cared) about the Horton it would be transferring births from the north side of Oxford to the Horton to relieve pressure on the JR.”

Mr Strangwood said the trust’s ambulance ‘would have to have wings’ to get to the JR in time to save a life.

“The whole thing has been engineered by the trust,” he said.

Mrs Ayre told councillors that Horton midwives believe the downgrade will not be temporary. She described the move as a ‘short-sighted and clinically unsound plan’.

National guidelines for time limits between a birth emergency arising and reaching consultant help are 30 minutes, if the life of the mother and baby is at risk.

Mrs Ayre said: “The clock does not start until a doctor says.”

That could mean when the mother in danger reached the JR, which would lose up to an hour, she warned.

Mr Brennan told the committee the Horton unit would be reopened as a consultant-led service ‘regardless of whether consultation (on a further transformation proposal) has started’.

Obstetrician Catherine Goddard said the beds and medical equipment being taken from Banbury to the JR would all be returned. She said work had been done to JR offices so they could be used for deliveries and as admission rooms.

“This is an emergency. We aren’t pretending this is the best thing we could have done. We’re doing the best in the circumstances and we’re doing it because of staff shortages. This is the best service we can offer in the circumstances.”

Mr Brennan said four doctors have been successfully recruited and four more were to be interviewed soon. But red tape and inductions meant the earliest the unit could reopen is January.

“The most risky element is Special Care Baby Unit (SCBU) nurses but there is an advertisement to recruit these and when there is a full complement for SCBU nurses and doctors we will reopen,” he said.

Cllr Ian Hawking expressed concern about a need for 15 minute ‘loading and unloading’ time at each end of an emergency transfer and said he felt the trust’s risk assessment was ‘very flawed’.

Clinical director Veronica Miller said: “There hasn’t been a policy to take deliveries to the JR. We are following guidelines.”

Campaigners are now concerned that the attendance of the Post Graduate Dean at next month’s Community Partnership Network meeting (of Banburyshire health service stakeholders) could mean further restrictions for staff training in Banbury – which could replicate the maternity crisis in other departments.

Those who voted against the trust’s contingency plan were Cllr Surinder Dhesi, Cllr Alison Rooke and Cllr Moira Logie.