Councillors and NHS chiefs go head to head over Horton staffing

The audience at HOSC NNL-170708-175954001
The audience at HOSC NNL-170708-175954001

Elected councillors and health chiefs stood firmly on opposite sides as the issue of whether Banburyshire needs a full maternity service was discussed at Monday’s meeting.

Oxfordshire Joint Health Overview and Scrutiny committee (JHOSC) and Oxfordshire Clinical Commissioning Group (OCCG) clashed over expanding Banburyshire’s fundamental need for a consultant-led unit at an emergency meeting on Monday.

JHOSC member Cllr Alison Rooke said: “Given the IRP said it was absolutely necessary for north Oxfordshire to have a consultant-led obstetric unit, outside how difficult it is to provide the service, what has changed (so) women no longer need that safe provision of service?

“The biology of women and babies has not changed in those nine years so what has changed to make it safe not to have that unit?”

Oxford University Hospitals Trust medical director Tony Berendt said: “What has changed is, it’s not safe to have a unit we can’t staff. It is safe to have a midwife-led unit which is recognised as being safe by all the evidence and endorsed by the National Institute of Clinical Excellence (NICE).

“The IRP made its decision in 2008 based on the context of the time and a whole series of assumptions that I’m not privy to but their mindset would not have included the widespread vacancies within training grade posts, the inability to recruit middle grade doctors and the expectation of ever more consultant presence.”

JHOSC chairman Cllr Arash Fatemian argued: “Those are all reasons why it’s difficult but I’m struggling to find a material reason for not having an obstetric unit at the Horton.

“Given that seven of nine obstetric posts needed (to staff the Horton unit) have now been found, without any of the ‘golden hellos’ being offered by Cherwell District Council, and with a possibly ‘lukewarm’ approach to exploring all recruitment opportunities - which I think is fair given all the evidence - are you saying that is the only obstacle to preventing an obstetric unit at the Horton?

“Are you saying the views of the 86 GPs (involved in the 2008 review) and the IRP are no longer relevant?”

Mr Berendt said: “Our experience with that middle grade tier ever since (the Horton’s obstetric) training recognition was lost (in 2013) and the trust was able to get by with a different approach using trainees doing some research and some clinical service, is that those individuals don’t stay for ever. They are difficult to retain because doctors still developing their careers are looking to work in busy environments, not extremely quiet ones, even with rotation into larger centres i.e. in Oxford, it does not offset that work done in the Horton is low volume and complex and offers less training opportunity to doctors.

“Our concern is the sustainability of the recruitment. And we know from some hired that their intentions are absolutely to move on when they can.”

Mr Fatemian said: “I’ve worked in companies where we recruited graduates who have gone on to other things and have been difficult to retain but that in itself is not a reason not to go ahead and do something.”

Mr Berendt said there would be issues around reopening the Horton unit because of a lack of Special Care Baby Unit nurses. Horton SCBU staff last October either left or were compelled to move to Oxford where there was also a shortage of SCBU nurses.

Catherine Mountford, of the OCCG, said: “We’ve picked up the views of GPs all the way through this work.

“We have spoken to GPs and practices are being asked again to confirm their opinion and we have had visits to practices in south Northants and south Warwickshire because we are absolutely clear about the impact this has on their work and patients, but it is taken in the current context and how different the context of care is now than in 2007,” she said.

Mr Fatemian said: “While circumstances of recruiting have made it more difficult the fundamental (reasons) why there should be an obstetric unit in Banbury have not changed.”

Cherwell District Council’s Cllr Andrew McHugh said permanent loss of consultant obstetrics and gynaecology would be instrumental in the Horton losing the hospital’s capabiltiy in anaesthetics.

Read more on Monday’s meeting here; ‘United Banburyshire appeals for Horton to be saved.’

Horton maternity staffing no cause for permanent closure, says scrutiny committee.’ and ‘Cherwell District Council offers ‘golden hellos’ to incoming Horton doctors.’