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Oxford University Hospitals NHS Foundation Trust

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Recruitment situation for Horton Obstetric Service

Current situation

Given the current suitation in relation to recruitment (see below), the decision made on safety grounds to run maternity services at the Horton as a midwifery-led unit remains in place. To reopen an obstetric-led service, without sufficient doctors in place to staff it, would be unsafe, and so Oxford University Hospitals will not endanger the patients in its care by doing this.

Referral to Secretary of State

Oxfordshire's Health Overview and Scrutiny Committee (HOSC) at a meeting on 2 February 2017 decided to refer the decision to temporarily suspend obstetric-led services at the Horton to the Secretary of State, on the basis that the temporary suspension extends beyond March 2017.

The rationale for suspension of obstetric-led services at the Horton has remained unchanged since HOSC itself considered and accepted the decision to temporarily suspend obstetrics in October 2016. We look forward to working with HOSC on next steps.

Recruitment

Recruitment to the new rota originally commenced in April 2016 and advertisements ran nationally in April, May, July, August, September, October, November and December 2016, and January, February, March, May and June 2017. The jobs have been advertised on NHS Jobs, the main source of recruitment for this type of role, and in addition, at the request of key stakeholders, the Trust tried advertising these roles in the British Medical Journal. This did not result in any increase in the number of applications.

The detailed outcomes are set out in the table below, which is updated regularly.

Following the decision to temporarily cease to deliver an obstetric-led service at the Horton, the Trust renewed its focused recruitment efforts - including clarification of the salary (which includes significant financial incentives), and the possibility of extension to the standard duration of contracts.

Despite these efforts, the rota currently has seven doctors in post, five of whom who were recruited as part of the continual recruitment since April 2016. Unfortunately, two of these doctors have now resigned which means that only five doctors will be in post by the end of October. The Trust requires nine doctors in post to fill the rota in order to provide a safe obstetric led service for mothers and babies delivering at the Horton.

As per the table below, since July 2016 five doctors' applications led to appointments.

Updated 11 September 2017

Date of advert
Applications
Shortlisted Attended for interview Offered position Accepted offer
20/04/16 5 4 1 0 N/A
20/05/16 7 3 3 3 0
13/07/16 4 3 2 2 1
12/08/16 8 3 3 3 3
12/09/16 8 4 2 1 1
07/10/16 7 3 1 1 1
27/10/16 9 2 0 0 0
03/01/17 13 6 4 2 2
16/03/17 31 3 1 0 0
06/08/17 13 In process      

 

Note: delays in start dates or failure to progress an application after offer can occur for a number of reasons including other job offers elsewhere, failing to meet the clinical standards required in terms of GMC registration or English language tests, visa and work permit requirements or candidate withdrawal from the process.

Oxfordshire Clinical Commissioning Group has looked at the processes that OUH has taken to recruit and is satisfied that every reasonable step has been taken, but that the local, regional and national shortage of suitable candidates and a small obstetrics unit makes these posts very difficult to recruit into.

Births at the midwifery-led unit at the Horton

Births and transfer numbers at the Horton Midwifery Led Unit are regularly reported to the Oxfordshire Clinical Commissioning Group and are in line with national and local expectations. Staff in the midwife led unit are happy to show women around and are proud of the excellent service they are able to offer women with low risk pregnancies.

From 3 October 2016 to 31 July 2017

Total number of women who attended the Horton MLU to give birth: 204

Total Births: 161; Transfers in labour 55*; Postnatal transfers 22; Total Transfers 77

*12 of these transfers were after the baby had been born but the placenta had yet to be delivered. Transfer was for assistance with this. This is classed as a transfer in labour as the birth process is not considered to be completed until the placenta is delivered.

No babies were born in transit.

Pregnant women can get more information via their midwives or GPs, or on the Trust website: www.ouh.nhs.uk/hospitals/horton/news/article.aspx?id=552

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