Agenda and minutes

Apologies were received from Councillor Alison Rooke and Councillor Adil Sadygov (Councillor Rebecca Breese substituting).

To approve the minutes of the last meeting held on 4 July 2019 (HHOSC3 – to be circulated separately) and to receive information arising from them.

Subject to the following corrections the Minutes of the meeting held on 4 July 2019 were approved and signed as a correct record:

Page 3 - Jessica Williams to be added as the further Pragma representative referred to amongst the attendees.

Page 3, Item (a) 2^nd paragraph – Reference to ‘Ally Green’ to be corrected to read ‘Jessica Williams’.

Page 3, Item (a) 3^rd paragraph – Second sentence to be amended to read: ‘Data indicated that the closure had led to higher levels of anxiety in the Horton General catchment area with families weighing up the fact of using the Midwife Led Unit  at The Horton against the distance to the John Radcliffe Hospital.’

Page 3, Item (a) second bullet point – Reference to ‘Ms Mountford corrected to read ‘Ms Mills’.

Page 3, Item (a) third bullet point – Fourth sentence to be corrected to read: ‘Anxiety around the decision-making was higher in the Horton General Hospital catchment.

The Chairman had agreed the following requests to address the meeting:

Victoria Prentis MP

Cllr Eddie Reeves

Rt Hon Sir Tony Baldry DL

Cllr Andrew McHugh

Cllr Rosie Herring - SNC

Cllrs Jacqui Harris - SDC

Keith Strangwood, Chairman KTHG

Victoria Prentis MP

Victoria Prentis MP thanked the members of the Committee for their efforts and thanked mothers for their powerful evidence to the Committee.

Speaking for the whole area Victoria Prentis MP stated that they were furious at the recommendations but would not give up. Needs in the area had not diminished since 2008 and there had been population growth and increased traffic congestion. It was not that local people distrusted the service offered at Oxford but simply that it was too far away. She expressed shock that her traffic survey was the only one available and highlighted the experience of people travelling on average 1 hour 40 minutes to The John Radcliffe Hospital (JR) whilst in labour.

Victoria Prentis MP was encouraged by the suggestion of an annual review (chaired by herself) and by discussions on working together to apply for funding for essential rebuilding. She expressed her displeasure that over the last three years no applications had been made.

Councillor Eddie Reeves

Councillor Eddie Reeves, County Councillor for Banbury Calthorpe, which included the Horton Hospital, stated that this was the fourth time he had spoken in the last two years and there had not been a lot of change in that time. The de facto downgrading of The Horton was on the cards. The public consultation given the manner of it was consultation only in a very elastic sense. What remained as a fact was the geography of the area. The Committee had heard the harrowing testimonies in December and Councillor Reeves felt that the OCCG and OUHT had not engaged meaningfully with the evidence. The cynicism felt by local people due to past experience had not been addressed.

Local people believed that poor administrative decisions were being presented as good clinical decisions. He asked that no-one be under any illusion about the strength of feeling. It had not abated.

Sir Tony Baldry DL

Sir Tony Baldry DL, speaking against the recommendations made a number of points:

·         He urged the Committee to refer the decision back to the Independent Reconfiguration Panel.  He referred back to the decision of the Independent Reconfiguration Panel in 2008 which had not supported the Trust’s proposals to reconfigure paediatric, gynaecological and obstetric services because they failed to provide an accessible or improved service for local people. Since then nothing had changed except the growth in the population in the area.

·         He questioned what type of provision the Horton Hospital was now providing. Was it a general hospital or a hospital at all or was it just a random collection of services. In 2008 it had been described as a General Hospital but looking now it would not necessarily be considered the case. He asked the Trust and OCCG to set out  ...  view the full minutes text for item 23/19

The CCG and OUHFT to report to the Horton HOSC, in line with their timetable, on the recommendation to be made to the CCG Board (on the 26^th of September) on the future of obstetrics at the Horton General Hospital.

The paper accompanying this item will be published as an addenda to the papers on the 16^th of September

The Committee had before them the report to the OCCG Board on 26 September 2019 and supporting appendices.

The following attendees were at the table: Lou Patten, Chief Executive OCCG; Dr Bruno Holthof, Chief Executive OUH and Professor Meghana Pandit, Medical Director, OUH. In addition, Veronica Miller, OUH and Catherine Mountford, OCCG came to the table to respond to specific points made.

The following statements were made and are set out in full:

Lou Patten

‘At the start of this programme the IRP asked OCCG to do three things:

1.    To fully understand current and future demand for maternity services, taking into account housing/population growth across the wider area of north Oxfordshire, south Northamptonshire and south Warwickshire.

2.    To take a fresh look at the options, to thoroughly review the options previously included and to include any additional options identified.

3.    To clarify any potential co-dependencies of services linked to obstetrics at the Horton.

In delivering this programme we have worked with stakeholders including those from north Oxfordshire, south Warwickshire and south Northamptonshire. We have been open and shared information publically at every stage. We set out our plan at the outset, agreed by the Joint HOSC, and have reported progress at every one of your seven previous meetings.

The process has been thorough and complicated at times as we have got into the complex detail of staffing models, recruitment, patient experience, clinical safety and national guidance.

OCCG have received written confirmation from NHSEI that they are assured that the process we have followed has delivered what was asked of us and this letter is published on OCCG website.

We have seen the JHOSC Chair’s addendum in response to our published Board paper and note several areas that require clarification or correction; whilst we may have the opportunity to go through this today, we have prepared a written response that will be passed to the Chair today and made available on our public website on Friday morning.

Most importantly, I need to ask that one particular point is retracted immediately about smaller hospitals that suggested other hospitals might lie or stretch the truth. I don’t believe this was accurately reported.

Oxfordshire Clinical Commissioning Group understands the recommendation set out in our Board paper will be hugely disappointing for all those who want to see obstetrics return to the Horton. However, although a recommendation has been made, a final decision is still to be discussed and made by the OCCG Board on 26 September.

It is really important for the JHOSC to note that the recommended option if agreed will be a very different decision to that taken by the CCG Board in 2016. There are a number of differences that I wish to point out.

·         In March 2018 the CCG Board overturned the decision to consult on the removal of A&E and Paediatrics; these services will stay at the Horton. System Leaders agreed that the Horton provides a significant suite of services to the people of Banbury & surrounding  ...  view the full minutes text for item 24/19

Update on activity of the committee between meetings