A SERIES of seismic changes to the fabric of healthcare in Oxfordshire is just around the corner but could be as 'exciting' as it is necessary.

This from Diane Hedges, chief operating officer of Oxfordshire Clinical Commissioning Group, the body tasked with producing a plan to reshape the NHS in the county.

Now set to go to consultation in January and May 2017, the Oxfordshire Transformation Programme and the broader set of changes it relates to have been decried as 'secret' by campaigners who fear it could equate to hospital downgrades, A&E departments axed and community services lost in the name of savings.

In reality very little is known about the Oxfordshire plan but hundreds of clinicians and managers up and down the county have now contributed to the draft.

Mrs Hedges said: "Because of a series of factors affecting Oxfordshire there is a real need for us to change the way we deliver services.

"Particularly striking for us is workforce and the resources we have to deliver care. We've got issues around some of our estates and issues around how we spend our money.

"From acute care to obstetrics right through to the GP, the scope of work we are doing is very wide and requires an enormous amount of thinking on how we address some inevitable challenges, in a very short time. Clearly that's an ambitious task but also very exciting."

The programme forms part of a wider Sustainability and Transformation Plan (STP) for Berkshire West, Oxfordshire and Buckinghamshire.

The 'Bob' region is one of 44 'footprints' in the UK ordered by NHS England to set out how it will balance the books and deliver better quality care.

If nothing is done, by the end of 2020/21 the 'Bob' footprint will have a budget of £2.9bn and deficit of £587m, while Oxfordshire itself will be £134m out of pocket before the cost of social care. The over-85s population is set to grow by 22 per cent, significantly faster than the national average, leading to an increase in demand.

Mrs Hedges said: "We particularly collaborate on NHS 111, some ambulance services and higher-degree mental health services.

"People will always get anxious but what we are talking about is improvements and patients getting the care they need, when they need it, in the right place."

In January the first part of the plans is due to be released.

It will focus on critical care facilities, stroke care, maternity services including obstetrics and the Special Care Baby Unit, changes to bed numbers to move to an 'ambulatory' model where people are treated away from hospital where possible, as well as planned care at the Horton General Hospital.

Mrs Hedges said: "We have a 'the best bed is your own bed' policy and we are looking at how we can support people as close to hope as possible.

"In Oxfordshire we have had a poor history of delayed transfers of care and people who are in hospital beds that are fit to go home. It's not the right place.

"There are more than 60,000 outpatients currently cared for at the JR who could actually be closer to home, and we are seeing if we can move them to the Horton."

In May 2017 the second part of the plan is due to go out, relating to emergency care in Oxfordshire, children's services and community hospitals.

Throughout the process Wantage Community Hospital is to remain closed as the risk of Legionella has not changed and would cost in excess of £300,000 to rectify, which Mrs Hedges said would 'not be appropriate' when 'we need to understand what its future looks like'.

But she said despite the long wait OCCG was 'absolutely' intends to hear what the public has to say on the Transformation Programme before final decisions are made.

She said: "There are some significant changes we need to take consultation and we genuinely want to engage with the public about proposals.

"It has been a whole-system piece of work and an ambitious ask. But strategic planning is our job and when we address the issues, it will be very satisfying."