Southend Hospital

Mark Francois Excerpts

Wednesday 5th December 2018 Westminster Hall

[Sir David Amess]

Right. Well, there seem to be rumours that, as a result of the plans being referred, there is a real danger that the extra money that we were promised might not materialise or that there could be repercussions for the services at Southend Hospital. I appreciate that the Minister might not be able to comment on that issue at the moment, but in this short debate I hope to set out some of my constituents’ concerns, and my own, about how best to support the world-class services at Southend Hospital and ensure that everyone in all four constituencies receives the best possible care.

Southend has always been absolutely at the top of cancer services generally. I will not delay the House by listing all the organisations that have had a hand in delivering cancer services there, but Southend has always been very highly regarded. From its gynaecology training coming top in the UK and its trauma and orthopaedic team being named training hospital of the year, to its world-leading practice standards for cancer care, Southend Hospital has lots to celebrate about its services and patient care. The radiotherapy department deserves particular mention in the light of its recent CHKS accreditation for its pioneering radiation treatment, as well as its high ratings from the Care Quality Commission. The centre has led the way in utilising highly focused and concentrated radiation treatment on tumours that reduces harm to surrounding organs. It has treated more than 1,700 patients this year and is a great example of the importance of investment in driving world-leading research and developing innovative treatments.

This is where the sting comes in. NHS figures show that 36% of Southend cancer patients wait eight weeks for treatment after their initial GP referral. The Minister may have an answer to this, but more than a third seems somewhat high—more than twice the national NHS target. It is vital that more be done to speed up referrals and avoid such unacceptable delays in treatment, which can cause so much worry for patients. With world-class care on their doorstep, our constituents deserve nothing less than fast access to the treatments that they most need. I would welcome any comments from the Minister about speeding up the process.

Southend Hospital is currently trialling a mobile stroke ambulance unit—a pioneering and innovative treatment service that allows specialists to travel directly to patients and treat them en route to the hospital. Data is still being analysed, but clinicians have reported great successes, with specialists being able to deliver life-saving thrombolysis treatment just 16 minutes after the patient alert. That is absolutely incredible. We all know that the sooner a stroke is treated, the more likely a good outcome. Treatment in the first few minutes can make all the difference, so getting patients to a specialist as quickly as possible is imperative. Not only have patient outcomes been improved, but the unit has shown great potential to alleviate pressure on A&E departments. Some 88% of patients in the trial were admitted directly to a specialist stroke unit, freeing up resources across the NHS.

The trial is due to end on 19 December, but so far there has been no confirmation that this pioneering service, which has been funded entirely by charitable donations, will continue. I believe that greater support is needed to ensure that the hospital can retain the mobile unit. More than 100,000 strokes occur each year in the UK, so it is essential for the NHS to use such innovative services to ensure that we can deliver the best care to patients in the shortest time. I know that my right hon. Friend the Member for Rayleigh and Wickford is particularly interested in stroke care and in how it is delivered at Southend Hospital. I encourage the Minister to review the successes of the trial at Southend and to look into how such life-saving services can be offered to patients across the United Kingdom.

The critical issue of time in stroke care is a great concern for Southend. I appreciate that the Minister will be unable to comment on the STP’s proposed centralisation of stroke services in the constituency that I once represented—Basildon. However, maintaining the established stroke service infrastructure and keeping Southend as a centre of excellence is very important. Whatever the outcomes of reconfiguration, my constituents do not want to see the downgrading of the world-class stroke services in Southend, and patients put at risk.

There is a big issue about transport services, which I know is of great concern to my hon. Friends the Members for Rochford and Southend East and for Castle Point, and my right hon. Friend the Member for Rayleigh and Wickford. While Southend Hospital is leading the way in many areas of care, transfer to specialist services is obviously important. Patients are currently transported to acute services across Essex through the treat-and- transfer model. Although that is working in ensuring that patients get access to the specialist treatment they need, a big concern for our constituents is the impact that an expansion to the model could have. Inter-hospital transfers affect not only the patient, but their carers or families. The costs incurred and difficulties experienced by patients and visitors travelling across services need to be taken into careful consideration. It is essential that the local transport services, whether public transport or community transport organisations, can provide the right support to patients and their families.

[Mr Mark Francois (Rayleigh and Wickford) (Con)]

I endorse everything that my hon. Friend has said about the mobile stroke unit. I encourage the Minister to look at the great success that it has been. As my hon. Friend knows, I have particularly focused on the transport issues. The East of England Ambulance Service, which would be the logical service to provide that transfer, is under great pressure as it is. Does my hon. Friend accept that if the whole of the STP is to stand up and be coherent, we must have clearer answers about exactly how the transfer of critically ill patients from one hospital to another would work in practice?

[Sir David Amess]

As ever, my right hon. Friend is absolutely right; he is intuitive. We need greater clarity on this matter, and our constituents want reassurance and certainty.

I have outlined some of the successes of Southend Hospital, as well as the areas in which greater support and investment are needed. The hospital serves just under 340,000 people and, although challenged by the pressures on the system, has managed to lead the way in world-class care. Southend is becoming a hub of medical education and training, with both the gynaecology and trauma teams recognised as among the best in the country. Pioneering cancer and stroke care at the hospital is at the forefront of treatment innovation, but those excellent services cannot continue at such a standard without investment and support. I hope that the Minister will closely consider our constituents’ concerns, and I look forward to hearing from him what more the Government can do to ensure that Southend Hospital retains its world-class services. I would also be grateful for an update in due course from the Secretary of State, perhaps by letter, on the STP referral when that decision has been made. I look forward to working with the Department proactively on that issue.

--- Later in debate ---

[The Minister for Health (Stephen Hammond)]

It is a pleasure to serve under your chairmanship, Mr Davies, and to take part in this debate. I congratulate my hon. Friend the Member for Southend West (Sir David Amess) and pay tribute to my hon. Friend the Member for Rochford and Southend East (James Duddridge) and my right hon. Friend the Member for Rayleigh and Wickford (Mr Francois) for their contributions. They have all raised points that I wanted to come to and I hope I can respond to them in my reply, because the subject is very important. As constituency MPs, whether a Minister or no, we all recognise the crucial importance of local healthcare systems and what they deliver for our constituents.

My hon. Friend the Member for Southend West is well known as a passionate advocate for his constituents, and has been for many years, but he was also right to point to his distinguished service on the then Health Committee, a Committee that has always done so much to drive thought. He mentioned a number of issues and said he did not want to blow his own trumpet, but some of the issues that he raised are now mainstream issues, and that is hugely important.

My hon. Friend was right when he said in his opening remarks that he thought the NHS was the best health service in the world. I completely agree; that is right. He is also right, of course, as was my hon. Friend the Member for Rochford and Southend East, to say that it is the staff who drive the hospitals and the service for our constituents. As my hon. Friends did, I extend my thanks and those of everybody to those staff, and to everybody who works in the health service, whatever they do. They all contribute in a significant way. They also spoke of the role of volunteers, which was again right. I see the work that volunteers do in my local hospitals. People sometimes forget how that work contributes to the whole experience; it makes life easier for people at an extraordinarily stressful time. I also note with interest the comments made about the stars awards.

I had the chance to speak to Clare Panniker yesterday. She is clearly an impressive professional, driving change for the right reason, which is listening to clinicians and ensuring the best outcome for patients.

I wanted to make those remarks right at the start, and I will say a few words on the three issues that my hon. Friends have talked about—stroke, cancer, and transport and access. The national picture on stroke services is that there is a need to improve the quality of service provision and outcomes for all patients. It is well recognised that stroke is the fourth-biggest killer in the United Kingdom and a leading cause of disability. Although the 10-year national stroke strategy came to an end last year, a programme board was established in March 2018 to oversee the development of a new stroke plan. The fact that one has continued does not mean in any sense that the prioritisation has changed; indeed, that board is now chaired by NHS England’s medical director, Steve Powis, and by the chief executive of the Stroke Association.

To add to what my hon. Friend the Member for Southend West said about specific local issues, we should also mention the importance of the national context. I absolutely understand some of the issues that he raised, and he is right to say that changes, and the rationale for changes, should be clinician-led rather than politician-led. As my hon. Friend the Member for Rochford and Southend East acknowledged, that is actually what is happening with the transformation programme, which is why I understand the frustration of my hon. Friends. They will understand that it is impossible for me to comment on that in detail today due to the referral, but I give the guarantee that when the process has ended and the decisions have been made, all my hon. Friends—not only the three who are present, but others who are concerned—will of course be given sight of that recommendation and the chance to comment on it.

My hon. Friend the Member for Southend West has explained that he has a particular interest in transport. For the sake of clarity, it is important that I set out what has been agreed by the clinical commissioning group and what some of the alternative paths are, in response to the point made by my right hon. Friend the Member for Rayleigh and Wickford. On the transfer of patients, we all know that the CCGs have approved a treat-and-transfer model, whereby a small number of patients will receive initial treatment at their local A&E before being transferred to another hospital. Decisions on patient transfer will be made solely as clinical decisions and discussed with patients prior to transfer. Modelling by the CCG and clinicians suggests that, on average, 15 patients a day might be transferred from their A&E to a different site for clinical reasons and due to the proposed changes. It is a vital part of a joined-up service, especially where specialisation increases—the need for this may or may not increase. Like my right hon. Friend the Member for Rayleigh and Wickford, I encourage hon. Members to continue to press this matter with the STP once it is resolved, because I think it is vital.

[Mr Francois]

The critical thing we need to know is who will provide the service. The obvious answer is the East of England Ambulance Service, but it faces serious resource and capacity challenges. It is difficult for us to support this plan wholeheartedly until we are given definitive answers. Who will provide the service, and how will it work in practice?

[Mr Hammond]

There are three answers to that: critical cases, non-critical cases and transport for patients’ families and carers. Let me start with non-emergency transfers, which at the moment are provided through patient transfer services, as my right hon. Friend knows. They are available in Southend when medical conditions are such that patients require the skills or support of staff on or after the journey. He is absolutely right to say that critical cases, or those that do not fit into the first category, are provided by the East of England Ambulance Service. He will not be surprised to learn that, even in my short time as Minister, I have already been made aware of some of the issues with that service. Nor will he be surprised to hear that the Department is working with the relevant authorities to ensure that standards and resources are made available to bring the service up to the expected standard, and that ambulance response standards are met.

On patients’ families and carers, I understand—my hon. Friends will know better than I do—that there is a joint CCG-local council transport working group. It has been exploring a number of options to make transport easier, including, I understand, the creation of a shuttle service between hospitals in Southend, Basildon and Broomfield. Key to that endeavour will be the volunteers who we spoke about earlier and the expansion of volunteering.

My hon. Friend the Member for Southend West spoke a little about cancer services, and he will understand that the proposed new model maintains Southend as the specialist cancer centre. He was right to make the point that it meets the two-week standard for GP referrals, and that more than 1,700 patients have been treated this year, but he is equally right to say that the length of waiting times is indeed high. I reassure him that we are absolutely committed, as a Government, to increasing the levels of early diagnosis, and that a comprehensive plan is in place to drive down those waiting times. He is right to have that concern, which I share.

My hon. Friend the Member for Southend West talked about the new model of stroke provision. He will know that the idea is for people to be seen initially at their local A&E, where thrombolysis treatment will be provided should it be required, and then there will be a transfer to a specialist stroke unit at Basildon, should that be necessary. That will be a clinician-led decision and based on the confirmation of stroke. That hyper-acute stroke unit would give patients, in that critical first 72-hour period, the intensive nursing and therapy support they need to have the best chance of recovery and the best outcomes. Basildon has been selected for the specialist centre because its stroke services are co-located with the vascular, interventional radiology and cardiology teams; it therefore makes sense to have the service there.

My hon. Friend the Member for Southend West raised the issue of the mobile stroke unit, and he is right to say that the trial is ongoing and not yet complete. I join him in thinking that this is really quite an exciting project. I look forward to seeing the results of the trial and the evaluation. We know that the project is separate from the STP, and therefore any decision to locate a permanent mobile stroke unit at Southend will be made at the local level, but I think the national implications of this trial will be exciting.

My hon. Friend the Member for Southend West said that he wanted to hear about future funding and whether there would be any delay. Any funding of course depends on local plans and on clinical support. I was going to read out a quote from Dr Paul Guyler just to reinforce the point that everything that is being done in this area is being led by clinicians, but as my hon. Friend has already made the point that Dr Guyler supports these things—his support is one of the drivers for the change—I will not delay us by reading that aloud. When a decision is made on a clinical basis, the Department and its arm’s length bodies are committed to ensuring that there is the investment available to deliver what is necessary and to make a real difference, but clearly that would depend on the plans and the outcome of the reconfiguration. My hon. Friend knows that I cannot say much about that now; none the less, I give him the commitment that I will speak to officials about this after the debate. If there is more to add at this stage, I will write to him and to my hon. Friends.

In the 30 seconds I have left, I want to say that this has been a short but fascinating debate. It shows that my hon. Friends recognise the contribution of professionals and what Southend Hospital does for their constituents. I appreciate that the potential changes to the local health services inspire impassioned debate—it is right that this is led by clinicians, and that the Government give it proper consideration.

Motion lapsed (Standing Order No. 10(6)).