Were women from South Warwickshire / Stratford on Avon council area invited to participate?

The actual number of women from south Warwickshire who gave birth during the time period covered was relatively small and the numbers that responded (9 women in total responded from 338 invited to take part) was also small, although the response rate (2.7%) was not very different to the rest of the survey (7.6%). Pragma were appointed because of their experience and expertise in research of this nature and their objectivity to the work. The analysis in the report that will be published is provided based on the responses received and the requirements that ensure statistical reliability. The numbers for south Warwickshire were statistically too small to be presented in the graphs where responses were analysed by geography but the responses are included in the overall analysis.

Who was responsible for sending out the survey?

The plan for the survey was developed with involvement of HOSC and KTHG and was presented to the HOSC and public at various stages of its development. We were clear that all women who had a baby during the two year period in Oxfordshire and those in the catchment area for the Horton in south Warwickshire and south Northamptonshire would be invited to take part. Given the need for protection of personal information there is no single list that includes the names and addresses of all these individuals.  After careful consideration we decided that the best approach was to use a combination of Oxford University Hospitals (OUH) and GP practices sending out the letters on behalf of the CCG.  Those that gave birth in a facility managed by OUH were sent the letter by the OUH. Those women who gave birth at neighbouring facilities including Warwick, Royal Berkshire (in Reading) and Great Western (in Swindon) hospitals were sent the letter by their GP practice (this included the practices in Brackley, Byfield, Shipston-on-Stour, Fenny Compton and Kineton in neighbouring counties). Because we were concerned about adding any barriers that might deter women responding, we did not introduce a password to the survey so it was open access. The local media were informed and social media was used by us, KTHG and county council to help raise awareness. This meant that women did not have to wait to receive their letter before responding and if any letters went astray for whatever reason, women were not unable to respond.  

The information needed to score options is complicated. How will the scoring panel work for such a complex task?

In processes like this where scoring bids or options is based on a range of criteria, it is common to appoint a panel with relevant expertise to be able to score all criteria. Each member will be invited to score the key criteria associated with their area of expertise. Often, those participating in scoring are welcome to score all criteria if they choose and this is what we have done in this instance. However, there is an expectation that some of the information is necessarily complex – this is often an issue for finance but for this task it is also true for the workforce data. There are guidelines that must be followed to meet safety requirements. Because of the complexity, hospital trusts use computer software designed to help create rotas that are compliant. The data being used includes rotas generated to support the different options. Given the importance of the decisions to be taken by OCCG later this year, it is important that we are confident the data ensures compliance.

People are worried about the JR’s ability to cope with the increase in numbers of births since the temporary closure of obstetric services at the Horton.

Despite the temporary closure of obstetrics at the Horton, the JR is not managing significantly more births. This is partly because the birth rate has fallen overall and because some women have chosen to give birth at the Horton MLU or at Warwick hospital. Because of the nature of childbirth, there will always be cases of women giving birth on-route or very soon after arrival at hospital, however far they need to travel.  Pragma have independently gathered the themes and experiences of women giving birth in the area. Staff availability and the burden on the JR has been highlighted in the feedback from the survey.

People are worried that the survey analysis will show the comparison across geographical areas so the impact for people living in Banbury area is understood.

OCCG will publish the full data set and report that together allow detailed comparison. The analysis has highlighted the issues for women from the Horton catchment area and women from other parts of Oxfordshire. The issues and concerns we had been hearing anecdotally are confirmed in this report in relation to travel, transport, distance, parking etc. In addition, we have heard issues that had not been highlighted previously, including the concern about partners being able to stay with mother and baby after the birth. This has been raised consistently at focus groups in Banbury and Wantage.

There was a question in the survey asking whether women would have preferred to give birth at the Horton if an obstetric unit was available. Why ask all women when it would only be of interest to women living in the Banbury area?

In the presentations we made at the first Stakeholder event and to HOSC, we have explored how the catchment area might be expanded. This would mean more babies being born at the Horton which could help in terms of sustainability if the obstetric unit were to re-open. Women can choose where to give birth and so asking women from outside the existing catchment area helps to give an indication of whether women from the wider area would choose the Horton. We would expect the huge majority of women from the current catchment area to prefer to have their baby at the Horton if it were possible, this question helps to get an understanding of how wide the catchment area could expand.