Trust Board temporarily suspends obstetric service at the Horton General Hospital

 Edited 15 September 2016

At an Extraordinary Board Meeting held on 31 August 2016, the Board of Directors of Oxford University Hospitals NHS Foundation Trust has determined that for immediate and real patient safety reasons contingency plans must be put in place to temporarily suspend obstetric services at Horton General Hospital in Banbury from 3 October 2016.

A video of the Extraordinary Board Meeting is now online: https://youtu.be/jtVIMWoSbaY

The decision was based on there being insufficient numbers of middle grade obstetric doctors to safely staff the obstetric service from that date. The contingency plan will mean that maternity services will be offered temporarily by a Midwifery-led Unit (MLU), while efforts continue to fill vacant obstetric posts. Women requiring an obstetric-led birth will deliver their baby at the John Radcliffe Hospital. Other aspects of their care will continue to be provided at the Horton.

Oxford University Hospitals NHS Foundation Trust, which runs the Horton General Hospital in Banbury, has been struggling to fill middle grade obstetric doctor posts at the hospital for several months. This shortage is a national problem and the Trust currently has unfilled vacancies at both the John Radcliffe Hospital in Oxford and the Horton General Hospital in Banbury.

The problem was compounded at the Horton due to the withdrawal in 2013 of recognised obstetric training programme status by the Royal College of Obstetricians and Gynaecologists, because of the low number of births there annually.

Despite advertising these posts on a number of occasions, so far the Trust has been unable to fill them, with just two of the required posts being filled from October 2016. The Trust is committed to continuing its efforts to recruit to fill the vacant posts and to review what more it can do to make the posts attractive.

The Trust will be in contact directly with expectant mothers about how this decision affects their individual options for giving birth. The Banbury Midwifery-led Unit (MLU) will provide the same environment of safety for mothers and babies as all MLUs across the country, including those operated by the Trust. MLUs are fully supported by national maternity policy. In addition, the Trust is enhancing arrangements for those  occasions when a mother may need to be transferred to obstetric services.

Expectant mothers in the north of Oxfordshire, south Warwickshire and south Northamptonshire may still choose to give birth to their babies at the Horton General Hospital MLU, provided their pregnancy is deemed to be low-risk. Those assessed as high-risk and in need of an obstetric service will be directed instead to hospitals in Warwick, Northampton or the John Radcliffe Hospital in Oxford.

The implementation of  the contingency plan will result in the following.

• The temporary establishment of a midwifery-led birth unit at the Horton General Hospital 
• The temporary cessation of obstetric care at the Horton General and its transfer to the John Radcliffe Hospital 
• The temporary cessation of the Special Care Baby Unit at the Horton General and its transfer to the John Radcliffe Hospital 
• The temporary cessation of the inpatient emergency gynaecology service and the establishment of a seven day ambulatory emergency gynaecology unit at the Horton General Hospital

The Trust alerted the public about potential problems in recruitment in July 2016, and from 25 July work started at the John Radcliffe Hospital to prepare for the possibility of additional beds being required at the hospital's Women’s Centre. Further work on rooms for maternity and additional cots for the Special Care Baby Unit and work on theatres is ongoing. 

Dr Bruno Holthof, Chief Executive of Oxford University Hospitals, said: "We are extremely disappointed to be in this position today and have taken into consideration the views of many groups of people who are affected by this decision. Having tried exceptionally hard to recruit to these posts, using every incentive available to us, we would prefer to be maintaining the obstetric service at the Horton and will keep on with our recruitment drives. However, we clearly cannot run a service without doctors to provide it. This outcome reflects national difficulties in recruiting to obstetrics. We will continue with our ambition to reinstate the obstetric service at the Horton as well as the Special Care Baby Unit that goes alongside it, as soon as we have the staff to operate safely."

Dr Veronica Miller, Clinical Director of Women's Services at Oxford University Hospitals, said: "Each expectant mother has an antenatal care and birthing plan that relates to their own pregnancy. It is important that pregnant women discuss any concerns with their antenatal care provider including discussions about the options for giving birth which are available to them."