The Parliamentary Under-Secretary of State for Health and Social Care (Jackie Doyle-Price)
I really thank my hon. Friend the Member for Redditch (Rachel Maclean) for the passionate, articulate pitch she made on behalf of her constituents and the health services that they deserve, because obviously we all deserve good-quality health services. As the Minister responsible, it is my job to give challenge to ensure that we are delivering the best services we can. Obviously, they are not always as good as we would like them to be, but I can reassure my hon. Friend of my determination to make sure that we continue with the constant campaign for improvements, and for the best possible services. All our constituents, as taxpayers, are paying for those services, and they all deserve an equivalent service.
I thank my other hon. Friends from Worcestershire—my hon. Friends the Members for Wyre Forest (Mark Garnier) and for Mid Worcestershire (Nigel Huddleston)—for showing their support. The issues that my hon. Friend the Member for Redditch raises are clearly of concern across the wider area. Indeed, my right hon. Friend the Member for Bromsgrove (Sajid Javid) has also lobbied me about this, notwithstanding the wider interests that he has in this place.
My hon. Friend the Member for Redditch raised several important points and areas of concern, which I will seek to address. She raised a number of points about maternity services. She is absolutely right that we must ensure that we have the safest possible environment in which people have their children. Obviously, having safer births is very much a national priority, so that issue is of particular concern to me. As my hon. Friend is aware, the decision to move maternity and children’s services from the Princess Alexandra Hospital to the Worcestershire Royal was implemented in 2017, and it was clearly controversial—many changes are, and this is no exception. That is why we need to continue to give appropriate scrutiny—my hon. Friend is absolutely right to do that—to ensure that we are serving all our constituents as well as we possibly can. She is also right to say that challenges remain. The trust continues to be scrutinised closely by the Care Quality Commission and in this House.
My hon. Friend asks how long we have to wait. Quite often, changes can be achieved very quickly. Sometimes, however, whether cultural or behavioural changes, they take much longer than any of us are happy with. I say to her that in my experience, constant scrutiny by the CQC does deliver results. I encourage her to continue her discussions with local interest groups and the CQC to ensure that all the constant scrutiny and challenge drives improvement. I do not know how many times I have said it in this place, but sunlight is the best disinfectant. Accountability will drive improvement and change.
All that said, we should recognise that there has been some important progress in the service at the trust. The CQC looked at the maternity in-patient survey for February 2017, which found that the Worcestershire Royal rated well against other maternity services in all aspects of care and scored among the best in the country in partner engagement and involvement in the appropriate length of stay in hospital. In addition, following the reconfiguration of services the neonatal rota is now fully staffed and recruitment is going in the right direction; the maternity doctors’ rota is fully staffed; and the trust has avoided a lot of the cancellation of antenatal or gynaecology clinics that was previously seen. I know that people will be concerned because of the historical record, but the scrutiny of the CQC shows that there are improvements.
According to the most recent CQC report, maternity and gynaecology services at the Alex are rated “good” for caring and “responsive” and “requires improvement” for other domains. Worcestershire Royal is rated “requires improvement” for safety and “good” in all other categories. The CQC recognised that the Worcestershire Royal’s maternity service was especially caring and responsive to parents who had suffered a pregnancy loss, such as miscarriage, stillbirth or neonatal death, and was committed to continually improving the care and services it provided for bereaved parents. That shows that there are some areas where the leadership are making an impact, but we clearly need to keep the situation under review.
In October 2018, the trust’s professional development team won the workforce team of the year award at the prestigious Nursing Times awards, which celebrate excellence in supporting the nursing and midwifery workforce. We congratulate them on that award. We should not be complacent, however. There is still very much more to do. I look forward to further discussions with my hon. Friend in the light of further investigations. We will do our best to support the entire community by making sure that performance is improved.
My hon. Friend raised the wider challenges facing the trust. It has been in special measures since December 2015. The latest CQC inspection judged the hospital as inadequate, with key concerns in urgent and emergency care, surgery and outpatients. I say again that scrutiny is the first catalyst to achieving improvement. It is worth noting that the trust achieved a “good” rating for the caring inspection domain in the latest CQC report, so in terms of patient experience there is clearly some improvement. However, nobody should be complacent about the scale of the task. As she says, her constituents really should not be expected to wait an undue length of time to achieve the quality of service that patients in other parts of the country receive.
I assure my hon. Friend that both the Government and national NHS bodies are committed to providing both the support and investment needed to help the trust make progress. I will be ensuring that we use our levers at a national level to give that appropriate challenge and support. Support currently in place for the trust includes a support package focusing on culture, risk and governance. That is very important. We always find, when a trust is going through the journey from requiring improvement to good, that leadership is crucial. I cannot overstate the importance of making sure that we are getting the right leaders in and mentoring them to deliver that. That support is crucial.
There is a quality improvement director, and there is a nurse retention collaborative programme to reduce turnover. There is a suggestion that that is starting to bear fruit. There will be emergency care support from the emergency care intensive support team and a peer support buddying arrangement with the Royal Wolverhampton NHS Trust. We have seen such buddying arrangements achieve real change, more than anything else by giving local leaders the confidence to be innovative and imaginative and really give additional challenge.
Local commissioners are closely involved in working with the trust to ensure that the quality of children’s and maternity services improves. Given the concerns my hon. Friend has expressed, I encourage her to engage with local commissioners to discuss how they are interpreting reviews of monthly divisional data and what they are doing to assure themselves of the quality of service. As a Minister, I can stand at the Dispatch Box and make promises, but ultimately I rely on local commissioners to do their bit to give challenge too. In giving me challenge, I encourage her also to give them challenge and have those discussions. The spirit of co-operation across the whole system is there to achieve improvements.
My hon. Friend rightly made her pitch for her constituents’ share of the increased funding for the NHS. While improvement is about more than just money, investment is clearly part of the picture. We will make the appropriate investments to support the trust. Recent examples of investments we have made are an award of £3.96 million for a breast imaging improvement plan, which will improve breast screening at the Alex; the development of a maternity hub to serve the Redditch area; and £3 million for a link bridge between the main hospital building and an outer building to be in place for the winter to assist with winter pressures.
I am confident that this will not be the last discussion my hon. Friend and I have about her local health services. I am grateful to her for bringing her concerns to me and putting them on the record. As I say, sunlight is the best disinfectant when it comes to inspection and challenge on the ground, but the opportunity to raise things here on the Floor of the House gives a signal to the entire health system that where we think things are not good enough and need to improve, we will not be shy in our determination to achieve that improvement.
Rachel Maclean
I thank the Minister for her comments and share her view that sunlight is a great disinfectant. May I press her? We have been undergoing this journey for four years, which is a long time. I had not been a Member of Parliament before and have never seen a trust turn around, so I would be grateful for some indication of how long she thinks it is reasonable for us to wait, with me as the local MP explaining to people, “You have to keep waiting.” Has she any examples of how it can happen and at what pace?
Jackie Doyle-Price
I will answer my hon. Friend’s question, but I will answer a different one too. She asks how long it is reasonable to wait. It is not reasonable to have to wait at all, because we should be delivering services of an appropriate quality. How long will people have to wait? We should be entirely honest when an institution requires improvement. She is right that four years seems like a long time. When my local trust went into special measures, it came out within two years, and the crucial ingredient was getting the right leader in at the top. Other trusts wait longer because other challenges can come into play that mean they are judged to require improvement—some trusts still struggle to get the right personnel, for example. We need to look in detail at exactly where the weaknesses are. My challenge to the system is to come up with a good plan to help get out of it. I would expect the buddying system with the Wolverhampton trust to start to deliver that more effectively, because there is no better driver of speed than external challenge.
With that in mind, I would like to close this excellent debate. The points made here should be considered very seriously by the local health system.
Question put and agreed to.