Horton sources continue to claim Banbury children's ward will be reduced to day-time only

The Oxford University Hospitals NHS Trust (OUH) has denied again that it has any plan to downgrade the service but says the trust must work 'flexibly' in the face of Covid-19.

Accusations had been made that the trust will use coronavirus staffing changes as justification for making the children's ward an 'ambulatory' service - meaning children needing care or treatment outside daytime hours would have to travel to Oxford.

The trust unsuccessfully tried to downgrade the service to this model in 2006 - a bid that was vetoed by the then Health Secretary as unsafe because of distance.

Paediatrics was then put into the second part of a two-phase consultation in the Oxfordshire Transformation Plan after the Horton's full maternity and special care ward had been reduced to a midwife-only unit, 46 beds closed and intensive care downgraded.

Following High Court action by campaigners and local councils, this second stage review was cancelled and assurances given that the children's ward and A&E would be safe into the future.

This week sources close to the children's ward reported on a winter planning meeting that heard:

* Open Access (where children with ongoing problems can visit the ward freely without a GP referral) is ending as this is not possible for an ambulatory unit

* A number of experienced nurses has left recently and two are on long-term sick leave

* There are concerns about the level of experience of new recruits

* Some older consultants would prefer not to work night shifts and the OUH is not willing to employ younger consultants to provide night cover

* Because of a new directive that there should be two nurses in full personal protective equipment (PPE) for each of the three oxygen units (not tube ventilation) the ward would need twice as many nurses. Staff consider this 'artificial inflation of staff requirements' and do not believe all units at Oxford obey this order

* Consultants have been told there are not enough nurses so the unit needs to become ambulatory on a 'temporary' basis for six months over winter, with their pay levels protected

* Staff believe a six-month downgrade will not be restored in summer, when the ward is quieter. They say next autumn after the unit has been closed for a year there will be no staff or equipment and it will be considered too costly to pay for more consultant paediatricians with the ward remaining ambulatory. This will be a threat to A&E, they say.

The OUH said in a statement: "We would reiterate our statement that we are not downgrading the service offered at the Horton.

"In relation to COVID-19, we have learned that we must work flexibly in terms of how we deliver our services and how we deploy our staff. This approach will continue to be important as we prepare for the possibility of future surges and also as we move towards winter. We are therefore working across the Trust to ensure that our services are able to run safely, with the right staffing, social distancing, PPE and processes in place to protect both staff and patients – our number one priority."

Charlotte Bird, press officer for Keep the Horton General campaign group said: "I am afraid it does not give us any reassurance whatsoever.

"...'priorities remain the safety and quality of care for all of our patients and the safety and well-being of our staff'. This is exactly the same criteria that were applied to obstetrics in 2016 as justification for taking that service to Oxford, leaving us with a midwife only facility.

"The children’s ward should be treated as a priority. If they are short of staff then staff should be seconded from other departments to ensure the children’s ward is able to run 24/7.

With the exception of intensive care, what other service is as vital?

"It is too easy for people to read the OUH denial of intention to downgrade and rest back thinking nothing will happen. The statement also allows for any strategy they want to employ in the coronavirus situation and that spells danger for small but vital services that they may want, ultimately, to change."

Banbury MP Victoria Prentis said: "While it does seem reasonable for the Trust to plan for the winter months ahead, it is important that they maintain an open line of communication.

"We need to understand what is going on at the Horton and any challenges they may be facing. Ensuring the Horton remains a fully-functioning local General Hospital is a priority for us all.”