• HSJ told Horton General Hospital is “not sustainable in its current form”
  • Transformation plans looking at reducing the number of community hospitals and centralising inpatient care
  • CCG savings taskforce looking at “all areas of spend” to generate funds to invest in service reconfiguration


Oxfordshire health services will see “significant structural change” as part of transformation plans currently under discussion, HSJ can reveal, with the Horton General Hospital singled out as “not sustainable in its current form”.

David Smith, chief executive of Oxfordshire Clinical Commissioning Group and lead of both the local “Oxfordshire transformation plan” and the Thames Valley area’s sustainablity and transformation plan, told HSJ that without making changes the region would “struggle” to meet rising demand.

Mr Smith said the Oxfordshire transformation plan process was looking at reducing the number of community hopitals and centralising inpatient care.

He said: “When patients need inpatient care our view is we have got to be looking at doing this through fewer sites. We haven’t concluded yet what that looks like, but it is pretty clear that is the direction we are going to have to go in.”

He continued: “We are also looking at options on how we are using our community hospitals. We think we need fewer centres and those centres need to be concentrated on supporting primary care, and doing a lot of ambulatory care, diagnostics and outpatients.

The future of Horton Hospital is uncertain, and Mr Smith questioned its “clinical viability”. He confirmed that a “number of options for the future of Horton General hospital” are now being examined and said “we have to question” the benefit of offering doctor-led maternity services in the long-term. Horton hospital has agreed in the short-term to run a midwife-led maternity unit from 1 October after failing to recruit enough doctors to maintain its obstetric service.

Mr Smith also singled out paediatrics as being “vulnerable”, both locally and across the NHS in general, as royal colleges are struggling to give training recognition to junior doctors practising in smaller units that cannot offer the “level of experience they need” for accreditation.

Mr Smith recognised that service reconfiguration was a “very, very sensitive [issue] with the public and will be with our politicians” but said that for long-term sustainability “we have to change the model”. The public will be able to formally consult on Oxfordshire transformation plans this December, although the CCG is awaiting guidelines from NHS England about when to publish its STP.

His comments come as the board of Oxfordshire CCG signed off a “financial recovery” plan last month after identifying a larger than expected savings plan for 2016-17 of £17m.

The board decided to set up a savings taskforce, headed up by locality clinical director Julie Anderson, and Gareth Kenworthy, finance director, with a “broad remit to look at all areas of spend”. Due to report back at the CCG’s November board meeting, the taskforce is looking at what the CCG “might need to do less of, or stop doing” in order to generate savings that the CCG can then invest in its transformation fund. Its financial recovery plans involve using the CCG’s £5m transformation reserve to help “stabilise” its financial position.

Mr Smith said: “We have had to take the decision that we have got to achieve financial balance first before we start investing more money. That is difficult but we can’t continue to spend money until we have our finances back into balance.”