protests at parliament and People's Park

Our hospital provides vital services to Banbury's growing population.

Consultant-led Maternity, SCBU, 24/7 Children's Ward, A&E, orthopaedics and Critical Care Unit are under threat.

Here's what we know.

Banbury's Horton General Hospital is facing a double assault -

- management determined to centralise as many services as possible in Oxford, no matter the cost to Banburyshire residents
- and the government's Sustainability and Transformation Plans, which are about to decimate the NHS across the country.

The Sustainability and Transformation Plans (known as STP) deserve a page all to themselves - please read it, get angry and do something about it - quickly. You'll find instructions on our dedicated STP page here.

As for the onslaught the trust continues to deliver - we can barely keep up with the news, but here's what we know.

County Councillors reject Oxfordshire transformation plan

On 21 February 2017, members of Oxfordshire County Council's cabinet accepted recommendations to reject the Oxfordshire Transformation Plan - which feeds into the controversial regional Sustainability and Transformation Plan (STP) - in its current form.

They said it was impossible to consider proposals to permanently end consultant-led maternity and close scores of hospital beds because the splitting of the consultation meant the knock-on effects would not be highlighted until the second phase in the autumn. This information would be necessary for the county council to gauge what the impact would be on council services.

HOSC refers CLU decision upwards

On 2 February 2017, the influential Health Overview & Scrutiny Committee voted to refer the temporary closure of Consultant Led Maternity at the Horton to the Secretary of State for Health, Jeremy Hunt.

Hunt has previously confirmed on BBC South Today that he would pass the case to the Independent Reconfiguration Panel (IRP) if HOSC referred it to him. HOSC's decision should therefore ensure that the case is reviewed the same body of independent experts who saved services at the Horton General Hospital back in 2008.

In 2008, the Independent Reconfiguration Panel ruled that the journey from Banbury to Oxford was too far for a woman in labour, and extremely unwell adults and children to undertake.

Consultation begins

Originally expected to begin in May, public consultation on the loss of the Horton's consultant-led maternity unit, medical beds, trauma, paediatrics and A&E will now begin on Monday 16th January. A Banbury public meeting is to be held on Thursday, January 26 but the Oxfordshire Clinical Commissioning Group has not yet confirmed a venue. Sign up to our mailing list to receive details when we know more, by emailing keepthehortongeneral@hotmail.co.uk

OUHT announces maternity-led unit will continue until at least March

This is because they continue to fail to recruit enough doctors.

Oak Ward closes

Oak Ward closed on 7 October 2016. Oak Ward delivered acute general medicine services to mainly elderly patients. The Health Overview & Scrutiny Committee was highly critical of the decision which the trust had sought to slip through claiming it wasn't a big enough change to warrant consultation. HOSC disagreed, and a consultation will now be started by January 2017.

Consultant-led maternity closes

Consultant-led maternity closed its doors on 3 October 2016, replaced by a midwife-led unit staffed by just one midwife, one care assistant and an ambulance stationed outside. The trust say the closure is temporary, although the resignations of staff, removal of equipment and conversion of rooms into offices suggest otherwise, as does the trust's continued lacklustre attempts at recruitment. HOSC and KTHG are watching closely.

Maternity - board decision

At a board meeting on 31 August 2016, the board of the Oxford University Hospitals NHS Foundation Trust (OUHFT) decided to temporarily suspend Consultant led Maternity Services at Horton General Hospital in Banbury from 3 October 2016. A midwife-led service will operate instead. Campaigners have vowed to keep up the fight.

Maternity - prior to board decision

A meeting was held at the Horton General Hospital on the morning of Friday 3rd June 2016 to inform staff about the Trust's future plans for Banbury's consultant-led maternity unit.

The Trust claims the existing situation is unviable, and is proposing alternative solutions that would reduce the service to a midwife-led unit (i.e. no consultant support available on-site), with the loss of the Special Care Baby Unit and in all probability loss of the 24/7 Children's Ward.

It's only eight years since the Independent Reconfiguration Panel decreed that 28 miles / 1.5 hours in traffic was too far to travel, and that all these services must stay in Banbury in order to provide 150,000 people (and growing) with a safe, fair and accessible service.

Subsequently, the news worsened

On 20 July, Trust representatives informed a meeting that due to 'three clinical fellows resigning' the Horton General Hospital's obstetric service (doctor-led maternity) would not be safe from the first week of September onwards. They are now drawing up a contingency plan. Allegedly a recruitment drive has been unsuccessful, although the Trust representative when questioned, could not remember where the posts had been advertised.

Desperate interim measures include converting offices to maternity wards at the JR.

Meanwhile, local GPs from Bloxham Surgery and Hook Norton Surgery, Chipping Norton Surgery, Cropredy Surgery, Deddington Surgery, Fenny Compton & Shenington Surgery, Hightown Surgery, Horsefair and Middleton Cheney Surgery, Shipston Medical Centre, Sibford Surgery, West Bar Surgery, Windrush Surgery, Woodlands Surgery and Wychwood Surgery joined together in writing a letter of strong opposition to the trust's proposals. In their letter they state that they are "opposed to the proposals on the grounds of safety, sustainability and the reduction in access to basic health care and choice for our patients, which will affect especially the most vulnerable."

Further condemnation came from Banbury MP Victoria Prentis and in a joint statement by all the political parties in the Banbury constituency. This is of course in addition to the widespread anger within the local community that has seen membership of our facebook group grow from 4,000 to 14,000 supporters, and was evidenced at Banbury's biggest ever public protest, 2016's "Hands Around the Horton" in which 5,000 people joined hands in a symbolic circle of protection around the Horton General Hospital.

A&E, medicine, orthopaedics, CCU at risk as well as SCBU, maternity and Children's Ward

Shortly after the maternity meeting on 3 June 2016, the OUHFT presented their "emerging options" for the Horton General Hospital at the public session of the Community Partnership Network (CPN).The OUHFT said all options will need to be assessed for activity, workforce, finance and estates and there will be a full consultation in October 2016.

The options were as follows:

Option 1

Option 1 is what we currently have at the Horton General Hospital. It was initially presented to the CPN, and to the midwives on 3 June, as the "status quo" but more recently (perhaps as a result of unwanted publicity?) it has been honoured as an Option. Option 1, the status quo, is what the experts in the form of the IRP decreed we must have, at the end of the last campaign in 2007/8.

Andrew Stevens, OUHFT Director of Planning & Information, said "Option 1 is the status quo but if we thought that was adequate..... we would not be doing this exercise".

So let's look at Options 2 and 3, which the OUHFT believe to be the only real options.

Option 2

Under Option 2, Banbury's Horton General Hospital would:
Lose A&E - downgraded to GP urgent care and Minor Injuries Unit
Lose Acute Stroke and Rehab - downgraded to Rehab and Early Supported Discharge
Surgery (elective day cases) - would be limited to 8am to 3pm
Lose Surgery - elective inpatients
Lose elective orthopaedic inpatients
Medicine - elective day cases - would be limited to 8am - 3pm
Lose Medicine - elective inpatients
Medicine - non-elective inpatients - inpatient ward would be downgraded to frail assessment unit
Lose Critical adult care (Critical Care Unit)
Lose consultant-led Maternity - downgraded to Midwife Led Unit (ie no consultants or anaesthetists allocated to maternity)
Lose Special Care Baby Unit
Paediatric inpatients downgraded to paediatric observation and assessment unit (8-10)
(We think this means open 8am to 10pm, ie no overnight patients)

Option 3

Under Option 3, Banbury's Horton General Hospital would see:
A&E retained as "integrated urgent care centre with ED function + out of hours + minor injury unit + walk in centre"
Lose Acute Stroke and Rehab - downgraded to Rehab and Early Supported Discharge
Adult Critical Care - retained but in the form of a High Dependency Unit on-site + "e-ICU"
Lose consultant-led Maternity - downgraded to Midwife Led Unit (ie no consultants or anaesthetists allocated to maternity)
Lose Special Care Baby Unit
Paediatric inpatients downgraded to "paediatric observation and assessment unit, assessment and clinical decision unit (24/7)"

Keep the Horton General campaigners, midwives, SCBU staff and members of the public mounted a spirited and angry attack on the safety aspects of the options presented, the failure to communicate properly with staff, and the OUHFT's failure to ensure that the so-called midwife staff representatives were indeed representative of the staff, their opinions and commitment to the Horton General Hospital.

We were delighted to hear from Andrew McHugh (former practice manager, Horsefair Surgery) that, although he had supported previous OUHFT proposals, he was very concerned about the Midwife Led Unit (MLU) proposal. He had undertaken a survey of GPs in the area and they were "overwhelmingly against the MLU on the grounds of safety".

Andrew Stevens (OUHFT) stressed that they are still "evaluating and refining options" and that there will be a full public consultation beginning October 2016. He repeatedly attributed the options to various Clinical Groups, and said the OUHFT would consider other options if put forward by the CPN. As KTHG is aware of other smaller hospitals running Consultant Led Units with middle-grade staff (something the OUHFT Post Graduate Dean maintains is not possible, thereby creating the very problem that the OUHFT seek to "solve"), this offers some hope .

A special CPN maternity workshop will be set up, including actual working midwives, and attempts were made to secure similar promises for A&E, paediatrics and inpatient orthopaedics.

KTHG chairman Keith Strangwood proposed a motion to remove the worst option, Option 2, from consideration, it being totally contrary to the statement in the same paper that "almost all the patients currently being cared for at the Horton will continue to be cared for locally". A vote was taken after KTHG forced the issue, but unfortunately the motion did not pass, with 3 votes for striking out the option, and 9 for keeping the worst option in the process.

The documents presented in the meeting are publicly available from Cherwell District Council's website (Permanent link here.) The slide illustrated below, presented to the meeting, is on page 11 of the downloadable pdf.

Options for the Horton General Hospital presented by the OUHFT to the CPN 14 June 2016

Oak Ward and F Ward were next

On 13 July 2016, the OUHFT announced the closure of Oak Ward and downsizing of F Ward. They intend that this will happen by 3 October.

36 beds will be lost and 60 staff will be "re-deployed" as a result.

Oak Ward houses acute general medicine patients while F Ward takes trauma and orthopaedic patients.

Staff and campaigners were left stunned by the announcement, which (contrary to the "rules of engagement" in place since our 2008 victory over the OUHFT's downgrading plans) had neither been discussed at the Community Partnership Forum, or opened up to any form of consultation.



So what can we do about it?

KTHG is working hard on our response. We'll let you know via this website, our facebook group and via our email service if you have signed up to receive updates, but in the meantime, here's WHAT YOU CAN DO.



What's the reason for the proposed cuts?

The NHS has suffered swingeing cuts to its budget in real terms over recent years.

The Oxford University Hospital Foundation Trust is not immune to these budgetary restraints.

However their current proposals for the Horton General Hopital are going over exactly the same ground that was covered, and secured, only eight years ago. Here's a link to the report by the Independent Reconfiguration Panel that secured our services in 2008.

Absolutely nothing has changed in the intervening time except that there are now MORE vehicles on the routes to Oxford from Banbury, ongoing roadworks in and around North Oxford and a housing explosion that will provide homes for MANY MORE potential Horton users.

Members of KTHG attended a meeting organised by Victoria Prentis in November 2015 when David Smith, Chief Executive, Oxfordshire Clinical Commission Group (OCCG) said that there is resentment amongst the GPs in South Oxfordshire about the cost of funding the services that are now under threat. The OCCG now controls the budget which funds all medical services in the county including hospitals.

Our viewpoint is that when the cuts were referred to the Secretary of State for Health (Alan Johnson) in 2007/8, a large group of esteemed professionals from various walks of life painstakingly evaluated all of the evidence. Their judgement was crystal clear. "The IRP does not consider that (the proposals) would provide an acceptable or improved service for the people of North Oxfordshire and the surrounding area".

Whether the GPs in the south resent the amount spent in the north of the county, or not, does not alter the adjudication of 2008.

KTHG member, Charlotte Bird, met the former Secretary of State for Health two years ago. She told him he was a hero locally for the decision he took in 2008. He replied, "I didn't make the decision; I left it in the hands of the experts".

The OUHT want everything to be Oxford-centric which is simply not viable. There is a cast iron case for retaining full services at the Horton. Simply put, lives will be lost if women in labour have to be transferred from Banbury to Oxford for emergency caesareans. Young lives will be lost if seriously ill children have to be transferred to Oxford because we don't have a 24/7 paediatric service. And we all know how quickly children can go downhill when they are poorly.

So the question at stake is - money or lives?

Please let your GP (who is a member of OCCG) know how strongly you feel.

Wherever you live, copy your email/letter to Victoria Prentis, MP for Banbury: her email address is victoria.prentis.mp@parliament.uk

If you are based in South Northants also copy it to Andrea Leadsom, if you are based in South Warks, also copy it to Nadhim Zahawi, and if you are based near Southam, copy it to Jeremy Wright (emails below).

And don't forget to copy KTHG so we can log the number of messages sent. Our email address is keepthehortongeneral@hotmail.co.uk

THANK YOU.

Email addresses for reference:

Victoria Prentis: victoria.prentis.mp@parliament.uk
Andrea Leadsom - andrea.leadsom.mp@parliament.uk
Nadhim Zahawi - nadhim.zahawi.mp@parliament.uk
Jeremy Wright - jeremy@jeremywright.org.uk
Keep The Horton General - keepthehortongeneral@hotmail.co.uk