Oxford Health NHS Foundation Trust will cease admissions to inpatient beds at Wantage Community Hospital from July to ensure patient safety in light of a known legionella risk. Inpatients are the most vulnerable in terms of clinical risk factors for legionella, together with the additional risk of having to be relocated quickly in an emergency. This decision allows for safe planned discharge of the majority of patients over the coming weeks. Alternative hospital beds will be made available at our other community hospitals and assistance will be offered to local families who need help with transport.
We have met local people and their representatives and taken account of their wish for us to maintain services at Wantage. We have re-examined our initial plans, with expert advice and will continue to offer outpatients physiotherapy services alongside Oxford University Hospital’s midwifery service at Wantage, while appropriate safety measures to monitor and treat the water system remain effective. We also know that these services can be reprovided from alternative sites if required, with minimal disruption to patients. The long term position is subject to the outcome next year of a wider public consultation on health services in Oxfordshire.
Independent experts assure us that, while current treatment is working, a recurrence of legionella is ‘almost inevitable’, because the ageing plumbing system provides a breeding ground for these naturally occurring bacteria.
The lasting solution for this is to replace the plumbing system at a cost of over £300,000, entailing closing the hospital for three months or more to carry out the works. We have set aside the funds to do this, pending the outcome of wider public consultation.
A formal public consultation across the Oxfordshire health and care system is due to begin later this year and to conclude next spring. It will look at the configuration of health services for the county, including community hospitals. It would not be responsible for us to commit public money until the consultation has determined any changes or refurbishments that may be required. Our decision to close inpatient services on safety grounds until then does not prejudice or prefigure the outcome of that consultation.
- In 2015 and into January 2016, there were persistent problems with legionella colonisation at Wantage Community Hospital (33 raised counts of legionella over 18 months). During that period the Trust took rigorous steps to eradicate including chemical dosing, heat treatment, increasing mains water pressure and re-plumbing accessible areas. Nonetheless, high legionella counts remained persistent through this period.
- Since January 2016, a testing and servicing regime to monitor and minimise the risk of transferring legionella to a person has so far proven effective. This includes the application of medical filters to the water system and dosing with hydrogen peroxide at a level that is safe for humans but deadly for the bacteria, with weekly testing of the system.
- However, the Trust has been advised by specialist engineers and the local anti-microbial resistance team that it is ‘almost inevitable’ that legionella will return, and it is thought likely within the next 6-9 months. This is because legionella is a naturally occurring bacterium and high colonisations occur in older plumbing systems where flow is compromised and steady temperatures are difficult to maintain.
- Closing inpatient beds will inconvenience approximately four families per month for whom Wantage is their nearest hospital and for whom an inpatient stay – typically of up to a month – is required by their relative.
- This change will not affect the total number of beds provided across Community Hospitals over time, as we aim to provide extra beds in other Community Hospitals in South Oxfordshire, once appropriate staffing is in place.
- Inpatient admissions will cease from 1st July and until the outcome of the consultation, expected to begin in late 2016 and to have concluded by Spring 2017. Any refurbishment will depend on the agreed designation of Wantage Community Hospital.
- Outpatient physiotherapy services and the Oxford University Hospital’s midwifery and birthing service can remain open with appropriate mitigations including taking weekly legionella counts and proactively risk assessing patients. These services would be subject to emergency closure if there is a further safety risk identified, and could be closed quickly if needed with minimal disruption to patients.
- A human resources consultation with staff is to conclude this week. Staff have been offered the opportunity to relocate to neighbouring community hospitals at Abingdon, Didcot and Wallingford including support with transport arrangements. Where vacancies arise we will continue to recruit to all of our community hospitals.
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