The Minister for Health (Edward Argar)
I congratulate my hon. Friend the Member for Southend West (Anna Firth) on securing this important debate. She is a notable advocate for healthcare in her constituency, and a strong champion and voice for her constituents in this place. The NHS has faced extraordinary pressures over the course of the pandemic, and I am sure the whole House will join me in expressing our utmost gratitude to staff for their outstanding work and dedication during this time.
I will address a number of my hon. Friend’s points, but, although it is rare to do so at the Dispatch Box, I will come to her main point first and seek to address it head-on. My hon. Friend and my right hon. Friend the Member for Rayleigh and Wickford (Mr Francois)—and, although she may not intervene in the debate, the Lord Commissioner of Her Majesty’s Treasury, my hon. Friend the Member for Castle Point (Rebecca Harris)—have asked whether the Government will provide the £8.4 million of funding requested to improve Southend emergency department to unlock the business case to allow it to proceed to do further work. While I regret that I am not able to give a clear answer to my hon. Friend the Member for Southend West this evening, I hope it will come as some encouragement to her that I can say that, following the tenacity of her campaigning on this issue in the Chamber, and indeed outside it, in pursuing me and other Ministers—that is exactly what Members of Parliament are here to do—I have instructed the Department to convene a meeting to review the submitted business case prior to the summer recess, and I anticipate being able to update her and the trust with the outcome of that before the House rises for the summer. That is, obviously, subject to my new Secretary of State’s decision on the recommendation of officials, but I undertake that I have instructed officials to come back to her with that decision before the House rises in a couple of weeks.
In the meantime, work to improve local services continues, and I am aware that Mid and South Essex NHS Foundation Trust hospitals and the East of England Ambulance Service NHS Trust—EEAST—have a range of actions in place to meet the high levels of demand they are experiencing. For example, EEAST is prioritising emergency cases, and, where clinically appropriate, a team of clinicians in its emergency clinical advice and triage service will advise people who do not need an ambulance to use other services. EEAST has also successfully recruited more call handlers and expanded the network of hospital ambulance liaison officers who help to co-ordinate handovers at hospitals, including by diverting crews to other hospitals where they can be seen more quickly.
EEAST is working with acute hospitals to develop cohorting areas, where patients can be assessed before going into the emergency department, helping to get ambulances back on the road more quickly. In the context of ambulances, I am reminded of an incident that was recounted to me—I could not possibly reveal the source from which I acquired this information. When she was abseiling to raise money for charity while dressed as Wonder Woman, my hon. Friend spotted ambulances queued up. As soon as she got to the ground and across the car park, she pursued the issue to find out what was going on. Such is her commitment to her constituents and her passion for this issue, and I commend her for that.
After a successful trial at Lister Hospital, EEAST is now using a rapid release process with some acute hospital partners, where the handover of patients is fast tracked if an urgent response is required in the community. At busy times, EEAST may also offer enhanced pay rates to encourage staff to complete additional shifts.
These local initiatives are also supported by national actions to reduce waiting times, including continuous central monitoring, support from the National Ambulance Coordination Centre and the allocation of £150 million of additional system funding for ambulance service pressures in 2022-23, supporting improvements to response times through additional call handler recruitment, retention and other funding pressures. My hon. Friend has quite rightly highlighted the additional ambulance service staff and the additional ambulances themselves. She is absolutely right to highlight the fact that while the ambulance service may often be the visual manifestation of the challenges faced, it is a system challenge with a number of complex, interrelated parts.
My hon. Friend has raised an important issue concerning the NHS 111 service and the automatic dispatch of ambulances. I am advised that when a patient calls 111 and the automated call handler assessment concludes that a low-urgency ambulance should be dispatched, a clinician will call the patient back to validate that that is actually required. I understand that that happens about 95% of the time. Where the patient is not able to be contacted within a fixed timeframe, as my hon. Friend has said, the call will be passed to the ambulance service for dispatch. However, it is important to understand that the call may still be scrutinised by the ambulance service as to whether an ambulance is really needed.
Although no remote triage process can be perfect, there is consistent clinical review of these calls to ensure the wise use of resource, and NHSEI does not believe that significant numbers of ambulances are being dispatched unnecessarily. I have already asked officials in the Department to look into the specific issue that my hon. Friend has raised to understand the extent to which that is happening, whether it is happening unnecessarily and what the consequences are in terms of cost and time resource.
We are also building the capacity of NHS 111 to act as the front door to the emergency care system, so that patients receive an ambulance or go to A&E only when needed. This is being supported with £50 million in 2022-23, helping to ensure that people can access urgent care when they need it, increasing the ability to book callers into alternative services or into a timed slot at their local A&E where appropriate.
On general practice, we know that general practitioners are still under huge pressure. I am incredibly grateful for the contribution of GPs and their teams over the past two years. They have stepped up to deliver our world-leading vaccination programme while still providing exemplary care for their patients during a pandemic. We made £520 million available to improve access and expand general practice capacity during the pandemic. That was in addition to at least £1.5 billion announced in 2020 to create an additional 50 million general practice appointments by 2024 by increasing and diversifying the workforce.
GPs and their teams will always be there for patients, alongside NHS 111 and community pharmacy teams, and it is important that people do not delay in coming forward with health concerns. In 2021-22, we saw the highest ever number of doctors accepting a place on GP training—a record 4,000 trainees, up from 2,671 in 2014. GP trainees support fully qualified GPs, helping to ease workloads and increase capacity, and allowing more patients to get the care they need. Just as in hospitals, doctors in training are delivering direct patient care while being safely supervised and supported.
I hope that our exchange today provides a degree of reassurance that there is significant support in place at local and national level to address performance issues, as well as a determination to improve the provision of health services in Southend West and more broadly in the local area. As you alluded to, Mr. Deputy Speaker, I have been a regular at the Dispatch Box in these Adjournment debates, certainly over the past two to three years. I am grateful to my hon. Friend for bringing forward this debate, and it has been a great pleasure and privilege to answer it.
Anna Firth
May I thank the Minister very much for the careful way in which he has responded to all my points and for his assurance that there will be some news on the £8.4 million before the recess?
Edward Argar
I am grateful to my hon. Friend for her kind words. I will just conclude by saying that it has been a huge privilege to respond to debates such as this, and I am very grateful to her for affording me that privilege this evening.
Question put and agreed to.