Mental Health Services (Norfolk and Suffolk)
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The Parliamentary Under-Secretary of State for Health and Social Care (Jackie Doyle-Price)
I congratulate my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter) on securing this important debate. I also acknowledge his own contribution to the NHS, not just as one of my predecessors but, as he has explained, as a doctor. He was entirely right to raise in the House the challenges facing his mental health trust. I am not in any way sanguine about those challenges, but we are determined to see the trust perform better for my hon. Friend’s constituents and for people throughout Norfolk and Suffolk.
My hon. Friend raised a number of issues, which I shall do my best to address. He mentioned the trust’s bid for £5.2 million of capital with which to raise its facilities to an appropriate standard, as advised by the CQC. We received a number of good bids, some of them from trusts that were more financially distressed than my hon. Friend’s and others that required more improvements. We could not meet all the bids that we wanted to, but may I, through my hon. Friend, encourage the trust to bid again, as we will look at it sympathetically? I hope that gives due encouragement for it to do so.
My hon. Friend is right that there are very challenging recruitment issues for that trust, and, as he has said, the vacancy rates for doctors are 19% and 16% for qualified nurses. That is particularly high. Central to dealing with that is the issue of leadership. We have a new chief executive in place, a new director of human resources, and a new director of nursing, and we are looking to them to lead the effort to recruit the necessary staff. The trust is also taking additional actions to deal with this. Hotspot areas have been identified and focused action plans are being implemented. As my hon. Friend said, this will include premium payments to encourage recruitment and help attract doctors and nurses to those locations. The trust is also running a series of recruitment campaigns and careers fairs, and is reviewing its skills mix and the appropriate balance of service. Rather than just leaving vacancies open, it is looking at using more occupational therapists and assistant psychologists, and at developing advanced practitioners. We are relying on good local leadership to deal with some of these challenges, but we pay close attention to what is happening there, and we will assist in any way we can to facilitate that improvement.
My hon. Friend mentioned out-of-area placements. At one time they were particularly high, but I am pleased to report that the trust has done a great deal to bring the number of out-of-area placements down. I am told that, as of today, there are eight intensive care out-of-area placements. That represents a massive downward trend from the high point of February this year, but the situation must be closely monitored, and I look forward to there being more co-operation and collaboration between the clinical commissioning groups, through the sustainability and transformation partnerships process, to make sure that there is the appropriate bed mix in the right places for that service to continue to be delivered.
An interesting point was made about integrating with other services, particularly housing, the police and addiction services. I believe that silo policy making tends to end in failure, and my hon. Friend is right that we must be much more joined-up and perhaps have interventions earlier in the process. There are particular points for intervention, such as when people start to hit the criminal justice system due to their addictions. Times of housing crisis also tend to be times when people are particularly vulnerable, and we are looking closely at that. I am not going to pretend anything is perfect; all the issues my hon. Friend raised tonight are entirely valid, and we are looking at them closely.
Turning to local action to put things right, since the CQC report, NHS Improvement has supported the trust to address the major safety concerns and is chairing monthly meetings with stakeholders to monitor progress on improvement. I am also mindful, however, that the CQC might well re-inspect against the areas identified in the warnings notice imminently, which is only right. That will give us more intelligence about what needs to be fixed.
Central to our approach is that all patients must be kept safe and receive the highest quality care. My hon. Friend mentioned the number of bed closures; that was driven entirely by issues of patient safety. Those beds were on wards that were particularly undermanned, but the intention is that those facilities will be reopened once a safe level of staffing can be guaranteed.
I am pleased that the new chief executive officer has been appointed and that he started work yesterday. He has quite a big to-do list, it has to be said. Leadership is so often the crucial ingredient in resolving endemic issues such as safety and recruitment, and we will have a completely refreshed leadership team, including a new chief operating officer, a new director of nursing and a new HR director. We will be looking to that team to build the foundations to tackle the problems that my hon. Friend has identified. It is also important that we, along with NHS England and the Care Quality Commission, continue to support the trust as it leads itself out of these difficult circumstances. Further support is being given by an improvement director from the East London NHS Foundation Trust, which is rated as outstanding by the CQC and will act as a buddy trust. That support will focus on quality improvement.
There is not much more I can say in the limited time I have left, but I can tell my hon. Friend that this is obviously not going to be tackled overnight, and my door is always open if he wants to raise these issues again. However, we now have new leadership in place with a focus on tackling recruitment, and I believe that we can make progress. I re-emphasise that I encourage the trust to bring forward another bid for that capital.
Question put and agreed to.