HORTON UPDATE: Trust explains maternity service downgrade

Horton General Hospital, Banbury NNL-150115-235124001
Horton General Hospital, Banbury NNL-150115-235124001

The NHS Trust that runs Banbury’s Horton General Hospital has today (Friday) issued a statement giving the reasons why maternity services there are set to be downgraded in September.

As reported elsewhere on this website the obstetric service at the hospital is likely to be suspended because of a shortage of doctors meaning it will be only able to offer a midwife-led unit from then on, unless the posts are filled.

The decision has been met with fierce criticism from the Keep The Horton General campaign group which fears a consultant-led service will never return and could trigger the loss of other.

A spokesperson for Oxford University Hospitals NHS Foundation Trust (OUHT) says it is struggling to fill five middle grade obstetric doctor posts at the hospital, a situation brought about by the recent resignation of three doctors.

The Trust says unless the staffing problems are resolved by then, the obstetric service will be suspended from the end of September, and will be provided at the John Radcliffe Hospital in Oxford instead.

The OUHT statement said: “The Trust has been experiencing problems recruiting these middle grade doctors for some time. This is a national problem and the Trust currently has unfilled vacancies at both the John Radcliffe Hospital in Oxford and at the Horton. The middle grade rota consists of eight posts but currently the Trust has only been able to fill six of these and of these, three of the current post holders leaving at the end of September and early October, leaving just three doctors in post.

“Despite advertising these posts on a number of occasions, so far the Trust has been unable to fill them.

Paul Brennan, Director of Clinical Services at OUHT, said: “We are trying very hard to fill these posts, but we are also making contingency arrangements in case recruitment continues to prove unsuccessful.

“We want to keep the service as it is now. Difficulty in recruitment is unfortunately a risk we have identified for some time, and we have been working hard to manage it. However, this reflects national difficulties in recruiting to obstetrics. Discussions are being held with staff at the Horton and maternity staff at the John Radcliffe Hospital to explore how we are going to manage the situation.”

The Trusts’s statement said that the contingency arrangements will involve the unit at the Horton becoming a midwifery-led unit from the end of September until such time as the vacant posts can be filled. Women who choose not to give birth at a midwifery-led unit, or for whom it would not be appropriate, will be offered alternatives at the John Radcliffe Hospital and possibly local hospitals in Northamptonshire and south Warwickshire.

A decision will be made in late August. From next week, work is starting at the John Radcliffe Hospital to prepare for the possibility of additional beds being required at the hospital’s Women’s Centre and further rooms for maternity are being converted over the summer.

The trust’s statement said there have been long-standing problems in maintaining a consultant-led maternity unit at the Horton General Hospital due to recruitment and retention issues and part of that problem has been that doctors want to work in an environment that provides them with the opportunity to develop their skills and learn from a variety of experience.

The statement continues: “In the past it was possible to attract middle grade doctors to the Horton maternity unit by offering training recognition as part of the approved training programme of what was then the Oxford deanery. “Unfortunately, obstetric training was withdrawn at the Horton a few years ago by Health Education England Thames Valley (the local body responsible for post graduate medical training) because of the low number of births at the Horton, which is one of the smallest obstetric units still operating in the NHS. They decided that doctors were not experiencing enough births at the Horton for the training to be useful and training posts were allocated to support units delivering much larger numbers of births.

“Following the withdrawal of training recognition, the Trust worked with the University of Oxford to find a different way of making middle grade obstetric posts attractive at the Horton. Clinical Research Fellow posts were established to attract doctors who would welcome some time to do research as well as their clinical practice.

“Wherever possible, posts are appointed across hospital sites. This is in part so that clinicians at the Horton are exposed to more cases in order to keep their practice current but also to make jobs more attractive and to allow for staff to be deployed where they are needed. For obstetrics, the opportunities to work across the Horton and John Radcliffe sites have been limited. The difficulties are to do with the complications of running two on call rotas and also with the Horton proving a less attractive option for would be employees. With a national shortage of obstetricians, jobs need to be as attractive as possible for prospective candidates. To that end, the Trust is currently offering a premium pay rate in order to further encourage applicants and also exploring the opportunities for post holders to spend time at the unit in Oxford.”