• Horton General Hospital to have critical care and maternity units downgraded despite three active appeals lodged with health secretary
  • Two live referrals and one judicial review application question adequacy of consultation process
  • Jeremy Hunt has sent one of the referrals to the Independent Reconfiguration Panel

Oxfordshire Clinical Commissioning Group has approved controversial plans to downgrade maternity and intensive care units at the Horton General Hospital – despite Jeremy Hunt considering appeals against the plans.

The CCG held an extraordinary board meeting today to approve the first wave of reconfiguration plans since it closed its first public consultation in April.

Oxford University Hospitals Foundation Trust

The IRP rejected plans to remove the Horton’s obstetric provision in 2008

All five recommendations to the board were approved and the area now intends to downgrade the critical care unit and remove obstetric care at Horton, run by Oxford University Hospitals Foundation Trust. It will also shift stroke care out of the hospital and close 146 beds across the region.

However, the transformation plans are the subject of two live referrals to the health secretary and a judicial review application.

Mr Hunt is currently considering a referral from the Oxfordshire joint health overview and scrutiny committee about the trust, for lack of consultation about the extension of the temporary downgrade of Horton’s obstetrics unit to a midwife led only one.

Earlier this month, Mr Hunt referred the issue to the Independent Reconfiguration Panel for an initial assessment, with the panel due to respond by 1 September.

In 2008, a previous referral to the IRP of similar plans – to remove the Horton’s obstetric provision, among other service downgrades – found against the trust. The panel said it did “not support” the proposals and did “not consider that they will provide an accessible or improved service to the people of north Oxfordshire”. But it did say “a standalone midwife led unit at Horton could work satisfactorily” but the “overall benefits to people from the proposed changes [are] difficult to argue”.

On Monday, the scrutiny committee indicated that it intended to refer the decision to permanently close obstetrics at Horton to Mr Hunt, on the basis that it was not in the best interests of residents and local health services. It expressed support for the four other decisions.

The CCG decided to consult on the planned care reconfigurations in two phases. It has closed phase one of the consultation but has not given a date to launch phase two. Campaigners against the plans claim splitting the consultation is confusing to residents and means decisions made in phase one could predetermine the outcome of phase two.

In April, Stratford-on-Avon district council also referred its concerns about the adequacy of the consultation process to Mr Hunt, who has asked for more information from the local authority.

A separate application in April for a judicial review of the consultation process by five local councils was recently not granted permission. They are currently seeking to renew the application, meaning they have applied to give oral evidence in addition to the written evidence submitted.

Victoria Prentis, MP for North Oxfordshire, said she was “furious” at the decision to downgrade Horton’s maternity unit, warning it would have “very significant” consequences for mothers.

She told HSJ: “We were told this was a consultation process but we feel our views were completely ignored. Locally people are furious and disappointed. People have no trust in the trust, very little in the CCG and no faith in the consultation process.”

The CCG also approved plans to permanently close 146 acute beds – 110 are already closed on a temporary basis and 36 will be closed once it has made “significant progress in reducing the numbers of delayed transfers of care”. These closures will be spread across the area’s community and acute hospitals.

Under the approved plans, the Horton critical care unit will lose its level three provision meaning people who need advanced respiratory or multiorgan support will be sent directly to the John Radcliffe Hospital in Oxford. Similarly, mothers needing obstetric care will also be sent to this hospital.

The plans will also see new facilities built at Horton to improve the diagnostic, assessment and outpatient facilities for elective care.

This article was updated at 4.15pm on 11 August following further information from the CCG.