The Parliamentary Under-Secretary of State for Health (Steve Brine)
I very much enjoyed the speech by my hon. Friend the Member for Southend West (Sir David Amess). I congratulate him on securing this debate and commend the fire in his belly that always shines through when he speaks in this House, or anywhere else, on behalf of his constituents. They are lucky to have him. I congratulate him on his re-election once again last month.
It is a strange that there is nobody in front of me and everybody I am talking to is behind me, but such is the layout of the House of Commons—and I am of course talking to you, Madam Deputy Speaker.
I understood before I came into the Chamber, and I certainly understand now, that there is significant local concern about the future of the A&E at Southend University Hospital NHS Foundation Trust. My understanding is that Southend A&E will continue to provide substantial emergency services 24 hours a day, 7 days a week, and any change—I underline, any change —to this position would need to meet the four tests of service change. For clarity, let me outline those tests, because they really are the bottom line of any proposed service change in the health service in England. First, proposed service changes must have support from commissioners; secondly, they must be based on clinical evidence; thirdly, they must be able to demonstrate public engagement; and fourthly, they must consider patient choice. An additional NHS England guidance has been added—that proposed service reconfigurations should be tested for their impact on overall bed numbers in the area, and the impact thereof on safety. It is important to set that out very clearly.
The work of the success regime has now fed into the Mid and South Essex success regime sustainability and transformation plan.
Vicky Ford (Chelmsford) (Con)
I would like to introduce Broomfield hospital in Chelmsford into the discussion as one of the hospitals in the mid-Essex area along with the three in Southend and those in Basildon. I congratulate my hon. Friend the Member for Southend West (Sir David Amess) on bringing so much experience to this debate. Broomfield is deeply loved. It serves our newest city. We too need our 24-hour consultant-led A&E. NHS England made it clear to me on Monday that it is not only 24-hour, but consultant-led. Can the Minister confirm that? Can he also confirm that any decisions made will put patient safety first? The future of our NHS relies on first-class training and innovation in Chelmsford. As part of the mid-Essex area, we have the country’s first new medical centre. Will the Minister confirm that he supports that medical centre?
Madam Deputy Speaker (Mrs Eleanor Laing)
Order. The hon. Lady’s question is slightly tangential to the subject of the debate, but I appreciate that she has made a connection. The Minister might be able to make the connection between the subject of the debate and her question, but I know that he will concentrate on the subject of the debate introduced by the hon. Member for Southend West (Sir David Amess).
Steve Brine
I will, Madam Deputy Speaker. I could feel you bristling at the length of the intervention. I can assure my hon. Friend that none of the options being considered includes the closure of any of the three A&Es, and all will continue to provide emergency care 24 hours a day, seven days a week.
I was mentioning the work of the Mid and South Essex STP, which was published in November 2016 as part of the work to ensure that there are sustainable services in mid and south Essex. There is now a major workstream looking at service configuration across the three hospital sites. Work led by clinicians in 2016 arrived at five possible future configurations for consolidated specialist services across the three hospitals. As well as providing the majority of routine hospital care for its local population, each hospital site would provide some centralised specialist services.
Let me briefly outline the current thinking as it has been set out to me. Southend hospital will continue, as I have said, to provide substantial emergency services 24 hours a day, seven days a week. In addition, it will be a centre of excellence, as my hon. Friend the Member for Southend West rightly said, for planned care, alongside its already well-established cancer centre and radiotherapy services. Basildon hospital will provide enhanced specialist emergency care—for example, specialising in the total management of major life-threatening illness. Broomfield Hospital in Chelmsford will provide a combination of specialist emergency and planned care, with the potential to provide a specialist centre for children. I have to emphasise that these ideas are being further developed by the clinical groups as we speak. No single preferred option for consultation has been arrived at.
Let me now turn to the proposals for emergency care. It is important to note, and I wish to reiterate, that in all potential options for hospital reconfiguration currently being discussed, Southend hospital would continue to provide emergency services 24/7. An options appraisal process was held earlier this year involving clinicians, stakeholders and local people. The higher-scoring options listed one hospital as the provider of specialist emergency care. Basildon was identified as the better location for that. Southend and Chelmsford would continue to provide emergency services, but they would be less specialised than Basildon. Southend would instead specialise in planned care, cancer and radiotherapy, building on the excellent work already being done at the hospital. There would be separate units specially designed to give fast access to assessment and care for older and frail people, children and people who may need emergency surgery. In some cases, that could include an overnight stay, if necessary. Those units would involve both health and social care so that patients could return home as quickly as possible with any continuing support and treatment that they may need.
The potential services in the A&E and assessment units at Southend would be able to respond to a range of emergency needs, some of which could be initiated by a 999 call and may involve an ambulance. The possibility of Basildon hospital being the provider of specialist and complex emergency care has benefits for local patients. It would have several teams of specialists ready to provide immediate access to state-of-the art scans and treatments around the clock, which is not always possible in the current three general hospital A&Es.
I also understand that the practice of taking patients by ambulance from Southend to a specialist centre is already established. For example, people who suffer an acute heart attack in Southend are currently taken by ambulance to the Essex cardiothoracic centre—that was easy for me to say—in Basildon. I have been advised that that arrangement has been in place for many years. Separating some of the major emergency work in that way releases capacity and resources for planned surgery and other treatments.
For the local NHS, new centres of excellence across the hospital group in both planned and emergency care have the potential to compete with the best in the country to attract high-calibre staff and bring the best of modern and world healthcare to mid and south Essex. I emphasise that in all options currently under discussion, about 95% of hospital visits would remain local at each hospital.
As I have stated previously, the programme is currently under discussion and I am advised that the aim is to launch a full public consultation at the end of the year at the earliest, centring on a single preferred option. The public consultation will explore in detail the benefits and implications of the proposals and will inform plans for implementation. Engagement with staff and local people will continue to influence and refine plans at every stage. That is a key principle, as I have said, in local reconfiguration of services, and it has to be right that the process is guided by those who know and understand the local area best.
In conclusion, as a constituency MP I completely appreciate the concerns of my hon. Friend the Member for Southend West, whom I again commend for his work.
Sir David Amess
I should have said in my speech that all my literature had headlines such as, “David pledges support for 24/7 A&E service”. I felt that I was not believed, so it is good that my hon. Friend has repeated that we will have 24/7 care. Finally, given that morale at the hospital has been ruined over the past few weeks, it would be great if we could have a ministerial visit at some stage, perhaps even from the Secretary of State.
Steve Brine
I thank my hon. Friend for that offer and will pass it on to the Secretary of State, although I am not entirely sure whether he or any of his Ministers can compete with royalty.
In the 30 seconds I have left, I commend my hon. Friend for his work on those issues affecting his constituents. He is a doughty champion for them. I think they do believe him, because they re-elected him admirably just a few weeks ago. I encourage both him and his constituents to maintain an open dialogue with the local NHS, as I know they will, especially during the pre-consultation and consultation phase, and reassure him that Southend A&E will continue to provide substantial A&E services.
Question put and agreed to.