Leaders of Oxfordshire Clinical Commissioning Group (OCCG) have made decisions on proposed changes to some healthcare services in the county.

An extraordinary board meeting of OCCG today (Thursday 10 August 2017) has given the go-ahead to essential changes which will ensure safety, quality and better outcomes for patients. 

The changes have been made following the Big Health and Care Consultation, which took place at the beginning of 2017 as part of the Oxfordshire Transformation Programme. After careful deliberation and taking into account the preferences and views of a wide variety of patients, public, partners and stakeholders, OCCG has now accepted five recommendations to bring about changes to:  

Critical care
There will now be a single Level 3 Critical Care Unit (CCU), aka intensive care, for the sickest patients in Oxfordshire (and some neighbouring areas) at the Oxford University Hospital (OUH) Oxford sites. The CCU at Horton General Hospital in Banbury will become a Level 2 centre for less seriously ill patients – those, for example, who have single organ failure, need closer observation after being in intensive care and for post-operative care. The Horton CCU will work closely with the main centre in Oxford.

Acute stroke services
All Oxfordshire patients (and those from some neighbouring areas) who are suspected of having suffered a stroke will go directly to the Hyper Acute Stroke Unit (HASU) at the John Radcliffe Hospital (JRH) in Oxford for the best available treatments, such as surgical removal of clots and clot busting drugs. Patients across Oxfordshire will be supported by the roll-out of countywide early supported discharge to improve outcomes and rehabilitation, either at home or in other community settings.

Changes to acute bed numbers
The closure of some acute beds across the OUH sites (including the Horton General) is now permanent. Beds were temporarily closed in November 2015 as part of the ‘Rebalancing the System’ project to tackle the issue of patients stranded in hospital when they no longer need to be there (delayed transfers of care). This allowed funding to be invested in other services to support frail and vulnerable people in their own homes or care homes.

The implementation of these closures will now be staged:
• 110 beds are already closed and will remain closed so investment in alternative services can be made permanent. 

• An additional 36 beds will only be permanently closed when the system has made significant progress in reducing the numbers of delayed transfers of care. Any further planned closures will need to be reviewed by Thames Valley Clinical Senate and assured by NHS England.

Planned care services at the Horton General Hospital
The NHS in Oxfordshire has committed to the development of new 21st century diagnostic and outpatient departments at the Horton General Hospital in Banbury; an advanced pre-operative assessment unit; and improvements to the planned operations service at the Horton General. These changes will allow more patients to be treated closer to where they live in North Oxfordshire, South Northamptonshire and South Warwickshire. They will allow up to 90,000 more outpatients appointments, diagnostic tests and operations to be provided at the Horton.

Maternity services
The Board accepted the recommendations for a single specialist obstetric unit for Oxfordshire (and its neighbouring areas) at the John Radcliffe Hospital and a permanent Midwife Led Unit (MLU) at the Horton General Hospital in Banbury.  

Dr Joe McManners, clinical chair of OCCG, said: "The changes we have approved today are about making services safe and ensuring people across the county and beyond get the best available treatments, and access to services as quickly as possible.

"These were difficult decisions to make and we understand the strength of feeling among local people, especially those who live in the north of the county.  But we believe these decisions will ensure safe and sustainable patient care for now and the future .  We thank everyone in Oxfordshire and beyond who took part the consultation, sharing their views and opinions with us. We also appreciate the participation of campaign groups who work hard on behalf of their local communities.

"We will now work with our health and social care partners to ensure the recommendations we have approved are carried out in the best interests of patients. The Board also agreed to maintain oversight of the implementation of these changes."