Kettering General Hospital Urgent Care Hub

(Limited Text - Ministerial Extracts only)

Tuesday 3rd September 2019 Westminster Hall

[The Minister for Health (Chris Skidmore)]

It is an honour to serve under your chairmanship, Mr Bone, in my first debate as the new Minister of State for health.

I congratulate my hon. Friend the Member for Kettering (Mr Hollobone) on securing this debate on the proposed urgent care hub at Kettering General Hospital. This is an important issue for not only my hon. Friend but his constituents in the wider Kettering community, and it is one on which he campaigns tirelessly. I congratulate him on his diligence and determination to continue that, bringing it before the House today.

Kettering General Hospital, as my hon. Friend mentioned, has stood on the same site for nearly 122 years. It plays a vital role in the community, and he set out eloquently the importance of the hospital to that community. In January this year, my predecessor, my hon. Friend the Member for Wimbledon (Stephen Hammond), discussed the urgent care hub proposal with my hon. Friend the Member for Kettering and visited the hospital, following the foundation trust’s unsuccessful £45.7 million sustainability and transformation partnership bid in July 2018. My hon. Friend set out clearly the need to cope with rising demand, with which the urgent care hub could assist.

Given the unsuccessful bid, I am sure that my hon. Friend is aware that the sustainability and transformation partnership programme has been the main funding route for strategic capital development projects. Under that programme, capital has been allocated to more than 170 STP schemes since July 2017, which now amounts to about £3.3 billion. STP investments will modernise and transform NHS buildings and services across the country, including new urgent care centres, integrated care hubs that bring together primary and community services, and investment in new mental health facilities.

On 5 August this year, the Government announced a £1.8 billion increase in NHS capital spending, on top of the additional £3.9 billion announced in the 2017 spring and autumn budgets. Of the increase in NHS capital spending, £1 billion will allow existing upgrade programmes to proceed, to tackle the most urgent infrastructure projects. Some £850 million will allow 20 new hospital upgrades to start as soon as possible. Those hospitals were chosen because they applied for funding in tranche 4 of the sustainability and transformation partnerships, but narrowly missed out. I will set out the short process that we go through to designate the waves, whereby the 20 hospitals that narrowly missed out on upgrades previously will receive funding this time.

[Mr Hollobone]

Kettering General Hospital narrowly missed out on previous funding allocations. Northamptonshire is the only one of the 44 STPs in the country never to have received any capital funding in the four waves that have taken place. I find that staggering, given the overwhelming support from the local NHS for the urgent care hub proposals.

[Chris Skidmore]

NHS Improvement and NHS England follow an independent assessment process. Previous waves, and the allocation of the 20 hospital upgrades that were announced last month, were assessed on the following six criteria: deliverability; patient benefit and demand management; service need and transformation; financial sustainability that delivers savings to both the organisation and the sustainability and transformation partnership; value for money, including return on investment; and estates.

As well as the top-scoring schemes, a number of schemes of critical service importance have been included, such as mental health and learning disability schemes, drawing on the advice from sustainability and transformation partnerships and national and regional NHS leadership. Together, the schemes demonstrate that they will deliver clear improvements to services. That may not be the answer that my hon. Friend wants to hear, but let me reassure him that I am happy for NHS England and NHS Improvement to discuss how the process and the scoring of requirements operate in greater detail with the chief executive, Simon Welden, who is sitting in the Public Gallery. If the trust would like to have that meeting, I will happily help to arrange that feedback for the hospital and my hon. Friend.

On future capital funding, an extra £1.8 billion was announced in August. That money, to enable investments in critical infrastructure, was not previously available, and gives new spending power to the NHS to fund new projects. The £1.8 billion is a brand-new capital injection on top of money announced in previous Budgets and spending reviews. The Department’s capital spending limit has increased accordingly: following the announcement on 5 August, the capital spend on health for 2019-20 has gone up from £5.92 billion to £7.02 billion. It is important to make that clear, given some wish to look for bad news in any good news announcement. It is important to recognise that the £1 billion boost, and the £100 million of the £850 million allocated this year, will be spent on that capital allocation.

[Mr Hollobone]

I join the Minister in welcoming the £1.8 billion of extra capital funding for the NHS and the £1 billion wave of funding at the end of 2018. That is all very good news, but given there is almost £3 billion of extra capital injection, we simply cannot understand why £49 million of that could not find its way to Kettering, particularly as there is already a worked-up business case, to get the project up and running quickly.

[Chris Skidmore]

As a new Health Minister, I have found that the wave approach to the sustainability and transformation partnerships programme has highlighted a wider issue with NHS capital. My hon. Friend’s point about geographical distribution applies not just to bricks and mortar but to diagnostic equipment. We must make sure that our national health service is truly national, by giving every trust equal opportunities to apply for and receive funding. That is why the Secretary of State recently set out that, as a Government, we will establish a new health infrastructure plan. The plan will mean that we take a strategic approach when looking at hospitals that need upgrades, and how that will fit into a wider strategy that will be organised in the Department, taking into account local needs and NHS clinical requirements.

We will put in place a long-term strategy to upgrade and improve our NHS. That will deliver a major strategic hospital rebuilding programme that will provide the necessary health infrastructure across the country. I cannot go into any further detail, apart from to say that the shape of that will be confirmed in due course. To offer a comparison, the road investment strategy—RIS 1 and RIS 2—has a longer term process by which we can move away from a succession of waves. We have waves 1, 2, 3 and 4 of funding as part of the STP processes: some of those projects are further along and more developed than others; some have more advanced business cases than others, as my hon. Friend mentioned. It is important to take a strategic approach for the future.

I understand that my hon. Friend was disappointed that Kettering General Hospital was not selected for funding this time. However, as he mentioned, the trust secured £6 million in emergency capital funding this year, to deal with safety-related estates work. In addition, between 2017-18 and 2018-19, the trust received more than £14 million in capital to fund improvements to the hospital, including £12 million to tackle the urgent capital backlog and other essential capital expenditure. It received £2.4 million for winter pressures and £820,000 for electronic prescribing. That does not make up for what my hon. Friend recognises as an important development and improvement to the estate, but in Kettering the trust has improved enormously and has made great strides in recent years.

I note that while the Care Quality Commission rated the hospital as “needs improvement” after its inspection earlier this year, the trust has been taken out of special measures for quality following the CQC report published in May 2019. I am pleased that, despite the rising demand my hon. Friend mentioned, it is still providing patients with safe and good quality care and is focused on embedding a culture of continuous quality improvement. I am delighted that Kettering General Hospital is participating in a national urgent and emergency care standards pilot, and I await information and learnings on that this year.

[Mr Hollobone]

I am glad that the Minister highlights the huge improvements made at the hospital and the superb leadership we now have in place. Will he accept an invitation to visit the hospital and see the A&E department at first hand?

[Chris Skidmore]

I thank my hon. Friend for that invitation; I would be delighted to visit the hospital. I pay tribute to the staff at Kettering General Hospital, who continue to work hard and who contributed to the hospital’s receiving a good rating for care. I hope we will continue discussions during my visit.

I hope that, if my hon. Friend and the trust are willing, I can arrange the meeting to go through the criteria for STP wave 4 in finer detail. I hope that he understands that we are looking at setting up a new process by which capital infrastructure projects will be delivered. The Government have made significant investments in the NHS as part of their long-term plan. We recognise that we need to mirror that investment in NHS capital. I thank my hon. Friend for raising this important issue, and I look forward to working with him.

Question put and agreed to.