The Minister of State, Department of Health (Mr Philip Dunne)
Let me start by congratulating you, Madam Deputy Speaker, on the resumption of your rightful place in the Chamber. It is a delight to serve under you in what I think is the first Adjournment debate that you have chaired in the new Parliament. I am delighted that you are looking after our proceedings this evening.
Let me also join in the congratulations of all who have spoken in the debate—apart from his usual modest self—to my hon. Friend the Member for Kettering (Mr Hollobone), who has been so gracious in encouraging me to take a personal interest in the hospital in his constituency. He was forthright in inviting me to join him last year when we previously debated the hospital, and I was pleased to be able to take up his invitation. Invitations have been flowing around the Chamber once more this evening from his neighbours, who show a consistent and collegiate approach to managing health issues in their constituencies and Northamptonshire in general.
When I visited Kettering in April, I was delighted to see my hon. Friends the Members for Corby (Tom Pursglove) and for Wellingborough (Mr Bone) taking such a close interest in the primary acute facility serving their constituents. I feel that the area is well represented by its Members of Parliament, who take such an active interest in health.
One thing that disappointed me about the speech made by my hon. Friend the Member for Kettering was the fact that his detailed grasp of the issues confronting the hospital was almost as good as that of the officials who helped me to prepare my speech. I therefore may not tell him too much that he does not know already, but it is a tribute to his perspicacity that he has such a good grip.
My hon. Friend raised a number of detailed issues relating to Kettering general hospital, and I shall try to address as many of them as possible in the time that is available to me. He concluded his remarks by making it clear that his No. 1 priority was to see progress on securing funds for the development of an urgent care hub at the hospital. I am pleased to join him in welcoming the progress that has been made since our debate last October. In particular, the foundation trust has secured funds from the Department of Health, with agreement from NHS Improvement, to enable the production of an outline business case, which, in the NHS approval system, is a necessary precursor of any significant capital investment.
A mobilisation meeting was held only last week to discuss the preparation of the outline business case, which is a welcome development. The initial draft of the outline business case is expected to be shared with NHS Improvement in August. The current intention is for the trust board to approval a final outline business case by the end of the year, provided it is satisfied with the progress that has been made, before a formal submission is made to NHS Improvement. I hope that that gives my hon. Friend some idea of the pace of the process. I am talking about a period of months, but I am afraid that that is the nature of the world we are in. It must be ensured that all appropriate internal procedures are followed correctly in order to give the proposition the best prospect of success.
The business case is intended to create a long-term solution for the hospital: a 10 to 15-year proposition that will take into account the significant increase in house building envisaged in the local plans, and the accompanying population growth to which my hon. Friend referred. In the meantime, the trust has put in place as a temporary facility a modular unit—a Portakabin —which we visited a couple of months ago. The outline business case will include plans to replace it with a permanent structure in due course.
More immediately, I am delighted to join my hon. Friend in welcoming the solution to the current challenge, which was very evident to me when I visited, that faces staff and patients trying to gain access to the hospital. The challenge of finding somewhere to park for anyone arriving by car was such that I had to be plucked out of the queue waiting to get into the car park by the chief executive herself, who had come to find me. Otherwise I might have spent my entire allotted time for the visit trying to get into the car park. The good news, as my hon. Friend has identified, is that work begins next week on the construction of the second level of the car park. The additional tier will provide an extra 240 spaces. I am told that the work will be completed by mid-November, which sounds like pretty pacey progress. This will cost some £1.3 million over five years, and the funding has been found by the trust from its own resources, which is very welcome.
My hon. Friend made reference to various pressures affecting the hospital. NHS England is working closely with the two local clinical commissioning groups to ensure that local care homes, general practices and the ambulance service are supported to care for patients outside the hospital, when that is appropriate. That is designed to help to reduce pressure on the hospital, and it was referred to in the interventions from my hon. Friends the Members for Corby and for Wellingborough.
In the longer term, the draft Northamptonshire sustainability and transformation plan, which was published last December, proposes an early focus on improving the urgent care system to reduce the pressures on A&E. Part of that will include introducing more front-door clinical streaming at Kettering general, with plans to put in place a seven-day discharge capability to help patient flow through the hospital. However, I have heard the comments in this debate about the quality of the STP, particularly from my hon. Friend the Member for Wellingborough. The STPs are being assessed by the Department of Health, and we will be making some comments before the summer recess on their relative attributes. We will see where Northamptonshire comes out in the context of the others.
Tom Pursglove
As part of that work in the Department, will the Minister take away from this debate the significance of the Corby urgent care centre to our local health economy, particularly in the context of how it relieves the pressure on Kettering A&E? Will he also acknowledge that there are significant healthcare needs in the Corby community that that facility helps to address?
Mr Dunne
I was not going to allow my hon. Friend the Member for Corby to leave without passing comment on the Corby urgent care centre, so I shall do that now, as he raised the matter so specifically. As we have heard, the STP does not perhaps place as much emphasis on what is to happen outside the acute hospital setting as hon. Members would like, and I shall take that away.
One of the issues that we need to address is the urgent care centre in Corby. As I understand it, the current service expires at the end of September. A new contract will be let as a caretaker arrangement for the ensuing 12 months to ensure that the existing facility continues, thereby allowing time for the CCG to engage with the public about the future shape of urgent care services in Corby, which will help to inform the development of the STP plan for the long term. The intent is that public engagement will lead to a proposal for an enduring longer-term contract to be procured in the next calendar year—during 2018—which will take into account the additional population around Corby. As we have already heard, the population is extensive around Kettering, but that is not unique to that part of north Northamptonshire. I am reassured by the CCG that the temporary arrangement will continue to provide the highest standards of patient care and safety for Corby’s population. My hon. Friend should not be concerned; this is a short-term contract extension that is facilitating a much longer-term solution.
My hon. Friend the Member for Kettering referred to the better care fund and how services are being provided in the community beyond the acute setting. As he knows, the fund supports programmes not only at Kettering general, but at Northamptonshire general. The better care fund and what we are describing as the improved better care fund—a similar pot of funding for the current financial year—are being used to fund both non-elective admissions and discharge to support at Kettering general, which is aimed at relieving pressure on the hospital.
My hon. Friend mentioned the special measures regime, which was the immediate trigger for my visit in April, the time of the publication of the CQC report that rated the trust as inadequate. I was pleased that he welcomed the introduction of special measures, because they provide an opportunity for focus across the NHS on areas that have been rated as not performing as we would all like. The evidence thus far is that trusts that go into special measures get considerably more attention not only from NHS Improvement, but from right across the NHS and up to a ministerial level. Special measures have a significant impact on improving performance within a hospital. I see that as a positive step, and I was pleased that he welcomed it. NHS Improvement has agreed an initial package of support. It has allocated an improvement director who will be working with the trust from next month. NHSI is also setting up “buddy trust” arrangements with highly rated trusts.