Row over surgery at the Horton continues
Hospital bosses admitted this week they do not want to reinstate emergency surgery at Banbury’s Horton General Hospital.
Chief executive of the Oxford Radcliffe Hospitals Trust, Sir Jonathan Michael, and senior managers listened to campaigners’ reports of ‘nightmare’ transfers by patients suffering abdominal problems, ranging from appendicitis and obstructed hernias to gall bladder problems and obstructions of the bowel.
The managers told Tuesday’s Community Partnership Network that protocols for referring patients to the John Radcliffe hospital had already been changed five times and were continuing to be reviewed to iron out deficiencies.
However Dr Peter Fisher, retired Horton consultant physician, said the trust should opt for the ‘humane’ solution and arrange for investigations to be carried out at the Horton.
“It might be a lot more sensible, humane and cost effective if assessment is done at this end of the county and not in Oxford,” he said.
Dr Fisher said loss of emergency abdominal surgery at the Horton General Hospital could affect medicine and other services. He said a junior duty surgeon would not be sufficiently experienced to give essential advice to colleagues handling medical emergencies out of hours.
“Guidelines by the Association of Surgeons of Great Britain and Ireland in 2007 says hospitals should not be taking undifferentianted medical patients without surgical capability,” he said.
Dr Fisher cited the example of gastro-intestinal haemorrhage such as a bleeding ulcer as one in which expert surgical opinion was critical to a joint decision on treatment.
He said: “On-site consultant opinion can be obtained round the clock in medicine, obs and gynae, paediatrics, orthopaedics and anaesthetics but it seems surgery is different.”
Nick Maynard, OUH clinical director for surgery, said: “It is felt the safest way is for patients to be admitted to the place where the specialist surgeons are based.”
Charlotte Bird, acting chair of the Keep the Horton General Campaign, said the group had received horrific stories of patients left to find their own way to Oxford and then left in pain on trolleys and waiting for hours to be seen by consultants at the JR.
But Mr Maynard said in a recent audit, 90 per cent of patients were taken by ambulance, 60 per cent saw a trainee surgeon within four hours and all were seen the same day by a consultant surgeon.
Banbury GP Dr Gwyneth Rogers said GPs were worried about a knock-on effect on other Horton services.
“It’s not just emergency abdominal surgery. It appears anything vaguely surgical is being bounced to the JR.”
Among unacceptable transfers she cited were men with agonising urinary retention or women with a gynaecological problem accompanied by abdominal pain.
“It is not good patient care to my mind,” she said.
Mr Maynard agreed that acute retention should be dealt with in Banbury and said the trust is considering setting up an urgent surgical clinic at the Horton as a way of preventing any unsatisfactory situations.
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Monday 20 May 2013
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