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Gold, incentives and meh

GPs could be asked to do C-sections under proposals to retain maternity unit

GPs should be given additional training to perform caesarean sections, according to new proposals for maternity services in an Oxfordshire hospital. 

This suggestion is one of nine considered by a scrutiny committee today, and follows the downgrading of maternity services at Horton General Hospital in Oxfordshire last year from consultant-led to midwife-led.

GPs called the proposal ‘absolutely astonishing’, and said that while they are often ‘inappropriately used to plug holes’, this suggestion was absurd. 

The Horton Health Overview and Scrutiny Committee (HOSC), which met this afternoon, considered a number of new proposals to meet local demand for maternity services.

This followed Oxfordshire CCG's decision to permanently downgrade maternity services at Horton General Hospital from a consultant-led to midwife-led unit, due to staff shortages.

The HOSC was set up to allow representatives from all catchment areas to re-examine the evidence used by the CCG and Oxford University NHS Trust when making this decision, and consider new proposals for maternity services.

The committee papers, spotted by the Banbury Guardian and discussed at a meeting today, outlined the different proposals including training local GPs to perform caesareans.

It said: ‘There would be obstetric units at the John Radcliffe Hospital and Horton General Hospital and the staffing model at the Horton General Hospital would be specialist GPs (local GPs given extra training to be able to perform caesarean sections) with access to on-call support from the John Radcliffe Hospital.’

But local GPs said this proposal ‘reaches a whole new level of absurdity’.

Berkshire, Buckinghamshire and Oxfordshire LMC chief executive officer Dr Matt Mayer said: ‘Proposing that GPs should be performing caesarean sections is absolutely astonishing.

‘Already across the NHS, GPs are inappropriately used to plug holes in the system caused by ever deeper cuts, but this proposal reaches a whole new level of absurdity. What next? GPs doing hip replacements? Open heart surgery?’

Dr Mayer said that the NHS needs to be funded ‘realistically and seriously’ rather than wasting money on ‘ridiculous schemes such as this one’.

He added: ‘GPs have enough workload and liability of their own without being asked to also perform major surgical operations’.

A spokesperson for Oxfordshire CCG said: 'The Horton Joint Health Overview and Scrutiny Committee has been set up to look at all possible options for the future of maternity services at the Horton General Hospital in Banbury to provide the best possible care to people in North Oxfordshire and the surrounding areas.' 

Readers' comments (44)

  • my next year PDP. learning to do C-section in 10 minutes.

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  • We are not even able to put IUDs in unless we can do at east one a month. That is a relatively easy gynaecologist procedure. I take it that these would be emergency procedures and not elective ones at the most risky times. What support is proposed? Anaesthetics, Paediatrician for flat babies, urgent blood supplies, qualified theatre nurses! You really could not make this up

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  • Don’t over react! This is obviously a case where commissioners have been told they must suggest proposals, so that all options can be seen to have been considered when facing the local MPs and press, who always oppose amalgamating units, despite this being necessary to manage complicated cases safely.

    No one is expecting this to be implemented, rather the author of the paper has succeeded in causing an uproar that confirms why the unit can’t stay open!

    Quite clever really.

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  • Yes , hate to say but I don’t think this is as stupid as it looks. It’s just manipulative. The reaction would be obvious. I’d ignore tbh

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  • The tact that this has even suggested, despite being very unlikely to be implemented, horrifies me. But it also reinforces the fact the ‘managers’ in this scenario and many others, don’t have a clue. When is this madness going to stop?

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  • The real measure of expertise in any given subject isn't whether you can do the procedure properly, but whether you can reliably extricate yourself and your patient from every one of the standard potential snags and pitfalls that may befall you. If you can't deal with the standard complications, you shouldn't even be attempting the procedure on your own.

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  • Would love to see the indemnity bill of any f😀😀😀wit stupid enough to take this on.Im wetting myself laughing now.FFS I’ve woken up in an alternate reality and it’s not very nice,it’s a nightmare please wake me up I don’t like this ride.

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  • *ringring*

    "Yes, hello, MDU? I'd like to discuss a change to the scope of my usual practice.

    Yes, I'll be doing the odd C-section on Wednesday afternoons.

    No, I'm not giving up the day job.
    Yes, I am still a GP.
    No, I haven't retrained as an obstetrician.

    Well... I assisted at lots of C sections during my GP training, it didn't look too difficult?
    Honestly, how hard can it be?

    Oh, and I'll be dropping my usual Wednesday afternoon duty surgery, to do this.

    Oh, a £600 discount on last year?
    Sounds great"...

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  • AlanAlmond

    I’ve heard of GPs being asked to do this kind of thing when helping out on a career gap in places like Uganda. Honestly it’s not uncommon in other parts of the world were Drs are a rare commodity. But in the U.K. ? This is supposed to be a first world country. GPs are not trusted enough to do spirometry without specialist training. Of cause it won’t happen but this blows me away. It’s perfectky possible for a GP with enough additional training to be competent in performing a routine CS. We are Drs after all, what else is an obsetrition other than a Dr with additional training, but that this should be a genuine suggestion in a country with umpteen medical schools, royal colleges and world class medical expertise is absolutely mind boggling. It’s like something out of private eye, pure satire, but reality. And guess what, i doubt it will be reported anywhere other than PULSE.

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  • AlanAlmond

    ..but then again maybe they could ask the pharmacists to do it.

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