Transforming Oxfordshire's healthCare
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Developing healthcare services for the future
The NHS in Oxfordshire has started discussions with the public and those using our services on how to deliver care and treatment in ever-more innovative ways, using resources more efficiently, and providing quality services within the budgets we have. We are talking to our patients and the public about the opportunities we have for doing things differently.
We face increasing demands on our services. While the amount of money we receive for the NHS in Oxfordshire is increasing year on year, the cost of delivering services is growing at a faster rate. If we don't change anything, we face a potential funding gap of
£200m by 2020/21.
At Oxford University Hospitals NHS Foundation Trust we are working with our health partners:
to develop healthcare fit for the future in Oxfordshire.
We have jointly set up a Transformation Board to drive forward change in health and social care in Oxfordshire. The vision is that a joint plan for Oxfordshire will strengthen the range of services available in community-based centres supported by specialist skills from our hospital clinicians.
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Transforming healthcare at Oxford University Hospitals
The OUH story
As part of the new vision, we have begun a review of our Trust strategy. Our clinicians have been mapping and reviewing care pathways to design better and more efficient services and patient care across all our hospital sites. Our focus is on how quality improvements can be made to drive up performance and use resources more effectively which in turn will help to secure financial sustainability.
We want to use technology to shift resources towards preventing disease, early diagnosis and earlier intervention to keep people well. Using new technologies and digital health applications, many being developed in Oxford, we can begin to revolutionise the delivery of healthcare for our populations. This will reduce the reliance on hospital-based care and support more home-based care.
Our five key themes
- Good Quality Costs Less
We believe that improving the quality of care and getting it right first time allows investment in our services
- Home Sweet Home
Providing care as close to home as possible to improve patient care
- Go Digital
Technology is transforming healthcare, including our ability to manage our own healthcare
- Focus on Excellence
Prioritising the work we do in specialist care and focusing on fewer areas
- The Masterplan
Our work on developing our estates strategy to ensure our hospitals are fit for the 21st Century
Vision for the Horton General Hospital, Banbury
At the Horton General Hospital we want to develop an innovative health campus with the objective of becoming a centre of excellence for selected services. Plans are being considered for redevelopment of the site to make it 'a general hospital fit for the 21st century,' said OUH Chief Executive Dr Bruno Holthof.
The Horton is one of the smallest district general hospitals in England and the Trust has focused for some years on developing plans for its sustainability. The vision includes:
- expanding outpatient facilities to increase the number of outpatient appointments available at the Horton, reducing the number of patients who need to travel to Oxford to be seen;
- increasing day case surgery and improving outpatient diagnostic services like radiology to reduce the need for patients to travel to Oxford's hospital departments for tests and scans.
Recent developments at the Horton include a refurbished radiology department and work is now starting on a
£3.6 million investment to replace the CT scanner. Work is also nearly complete on a
£2.6 million refurbishment of the Endoscopy Unit at the Horton.
'There are wider questions about the role of the Horton', said Dr Holthof. 'But we have invested in the Horton in the past and will continue to invest it it in the future.'
Emerging options for the Horton follow discussions with clinicians about the current models of care for specialist care, diagnostics, urgent and emergency care, maternity and children's services.
Horton maternity unit and recruitment of obstetric doctors
In the short term, the Trust has struggled to recruit enough obstetric doctors for the maternity unit at the Horton, to the point that there will be just two doctors in post by early October. The Trust’s contingency arrangements are for the maternity unit to become midwife-led while efforts continue to fill the vacant posts.
Dr Holthof said: 'We understand there will be concerns about the possibility of the maternity unit becoming midwife-led. However, our first priority is to manage births safely at the unit. If you do not have enough doctors, it is not safe to run an obstetrics unit.'
Midwives will continue to provide home births and low-risk births at the Horton maternity unit. Antenatal and postnatal clinics will also continue. But high risk women, for example women with multiple pregnancies, high BMIs, or expected complications will give birth at the John Radcliffe Hospital where obstetric care is available. The Trust will continue to advertise the posts with the intention to staff these posts at the Horton.
How should we prioritise services at the Horton? Please do take time to fill in the survey below.
Public consultation and the OxfordshireTransformation Plan
A public consultation on proposals for the future delivery of health and care services in Oxfordshire is going ahead in two phases.
The Oxfordshire Clinical Commissioning Group is leading the formal consultation on the proposals which have been developed as part of the Oxfordshire Transformation Programme.
The first phase of the consultation starts on 16 January and runs for three months, focusing on proposed changes to:
- the use of our hospital beds and moving more care out of hospital and closer to home;
- planned care at the Horton General Hospital including tests and outpatient care;
- acute stroke services in Oxfordshire;
- critical care at the Horton;
- maternity services for women in north Oxfordshire and options for the future delivery of maternity services at the Horton General Hospital, including obstetrics, and the Special Care Baby Unit.
Over the past year, OUH clinical teams have worked with our NHS and social care colleagues on the options for the future delivery of services at the Horton. The opportunities for doing things differently have been discussed with staff, stakeholders, patients and the public at a number of engagement events across Oxfordshire.
Our vision for the Horton is to expand outpatient facilities and significantly increase the number of outpatient appointments available at the hospital. We want to increase day case surgery and outpatient diagnostic services reducing the need for patients to travel to Oxford’s departments for tests and scans. Our joint ambition is to better integrate health and care services and to shift resources to enable more services to be delivered locally and to treat people closer to where they live.
It was decided that a two-stage consultation process was necessary to allow for additional work to develop the options for Emergency Departments and emergency care services, children’s services, and community hospitals, and maternity services and midwifery-led units in Oxfordshire. These proposals will be consulted on in phase 2.
This consultation and the work of the Oxfordshire Transformation Programme forms a substantial part of Oxfordshire’s contribution to the wider Sustainability and Transformation Plan (STP) for Buckinghamshire, Oxfordshire and West Berkshire (known as BOB STP), one of 44 STPs being developed across the country to support the delivery of the NHS Five Year Forward View.
How to have your say
A number of events are being held in towns across the county where the public can hear more about the proposals and share their views. Further information on all of these of events, their locations and venues can be found on the website: www.oxonhealthcaretransformation.nhs.uk.
The public can also provide feedback by completing an online survey via the Talking Health public involvement service. Register and complete the online survey at: https://consult.oxfordshireccg.nhs.uk. Or Email: firstname.lastname@example.org
Oxfordshire Transformation Programme
The Transformation Board agrees that more should be done to:
- Keep more people healthy, prevent ill health and manage long term conditions
- Provide convenient and accessible care to patients as close to their homes as possible – by grouping together services in neighbourhoods or localities. This includes providing health professionals, working with patients and carers, with access to diagnostic tests and expert advice quickly so that the right decision about treatment and care can be made for patients while avoiding sending patients to hospital unnecessarily
- Ensure the system of hospital based care keeps pace with developments in modern healthcare so they are able to provide high quality services to meet changing demands – with doctors on site 24 hours a day to deliver the quality of care patients need where required
- Prevent people from being unnecessarily admitted to hospital or using A&E services because there isn’t a better, quicker or more local alternative
- Make the best possible use of taxpayers’ money (including staff, equipment and buildings)
- Meet the rising demand for services and, wherever possible, reduce that demand by improving people’s health.
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