Anaesthetics cover to be changed at the Banbury's Horton General Hospital

The Oxford University Hospitals NHS Trust (OUH) has planned and introduced the changes during the coronavirus crisis.

It is also planning to change contracts for some theatre staff so they work 11-hour shifts rather than eight hour days. The trust says this will allow far more day-case surgery.

In the case of anaesthetics the change will mean middle-grade doctors will be responsible for overnight and weekend cover with help if needed from consultants who would be called from home.

Campaigners have for years warned that downgrading maternity - which happened in 2016 - would cause a domino effect, rendering anaesthetics unviable (as there would be no caesarean sections) and threatening the future of the children's ward and ultimately, A&E.

The OUH told the Banbury Guardian that 'round-the-clock consultant anaesthetic cover is not ending at the Horton'.

Cover will be there in a 'non-resident on-call model' which is in line with the JR Hospital, Oxford and the national clinical model, it says.

Consultants would be within a 30-minute drive from the Horton, which would have a middle-grade anaesthetist - a 'speciality doctor' - at night. These middle grades would be able to intubate an infant, the spokesman said.

The OUH said changes were being made as part of 'new ways of working with Covid-19'.

"Services, including anaesthetics, worked differently during the height of the pandemic and now, as we prepare for a new normal, the Trust is aligning the way that the Horton anaesthetics work to be on the same model as that provided at the John Radcliffe Hospital. This is an established clinical model that is used nationally.

"In both hospitals, there will be 24/7 anaesthetic cover with resident speciality doctors present at night, and additional cover available with consultants on-call. This will free up more anaesthetic time to enable more surgery to take place at both the Horton and the JR. These changes will go live at the Horton in July.

"We have ensured it will not negatively impact quality of care or service delivery, including paediatric services and our Emergency Department. They will continue to have 24/7 anaesthetic support as is the case with the Children’s Hospital and the ED at the John Radcliffe."

With reference to changes in theatre staffing, the OUH says it held a consultation but it is understood that this was held in May at the height of the coronavirus crisis and the Banbury Guardian has heard staff felt the timing was difficult and unfair.

"We held a consultation on theatre staff shifts to ultimately increase operating capability and capacity at the Horton. If implemented, the changed pattern of working would allow staff to have time off during the week and also align the working days of theatres across the Trust. This consultation was for all non-medical theatre staff at the Horton.

"Initial conversations were had in December 2019. The consultation formally started in May this year, supported by drop-in sessions at the Horton and with email support. The consultation lasted four weeks, which is in line with Trust policy. We are currently in the process of finalising the consultation and will be contacting the staff involved directly."

With reference to staff members' unhappiness with the management of theatres, the OUH said: "We have dedicated Freedom to Speak Up guardians at our Trust, who are there to support staff in raising issues in a safe and confidential way. We encourage all of our staff to make the most of the support offered by them and publicise this to our staff several times a week."

* The OUH says planning is underway across the Trust for a second wave of COVID-19.

"During the COVID-19 response, the clinical teams at the Horton have been able to provide high quality care for North Oxfordshire patients close to home. Where it has been clinically appropriate, patients have been transferred to the John Radcliffe, but these cases have been in the minority," said a spokesman.