Proposed Hospital: North Hampshire
(1 week, 6 days ago)
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Dame Maria Miller (Basingstoke) (Con)
For heart attack patients suffering from cardiogenic shock, every 10-minute delay in treatment equates to a 3.3% increase in the risk of death. That startling fact not only emphasises that every minute matters when it comes to emergency patients receiving treatment, but highlights the importance of locating our new hospitals strategically. After all, a hospital’s reason to be is to save lives, and we must use the most up-to-date clinical evidence to ensure they do that whenever possible.
Last year, the then Secretary of State for Health and Social Care confirmed the biggest infrastructure investment in my constituency’s history: £700 million to £900 million for a new north Hampshire hospital at the Hampshire Hospitals NHS Foundation Trust. We have just completed an extensive public consultation on how the new hospital will evolve, and on the provision of services at two of the hospitals in the HHFT—the Basingstoke and North Hampshire Hospital and the Royal Hampshire County Hospital in Winchester. The results of the consultation are due to be released in the coming weeks. Although I very much look forward to seeing the views of residents on those important plans, I also believe it is essential that hospital services are configured so that they can best deliver treatment to patients, and that must be done by listening to how clinical experts feel we ought to locate services on a hospital and departmental level.
Although funding was confirmed last year, work to identify potential sites for the new acute hospital began in 2019. A comprehensive search for the right location spanned north Hampshire, including Alton, Andover, Basingstoke, Eastleigh, Winchester and the surrounding areas, as well as practical considerations such as price, availability and size. Fundamental to HHFT’s criteria were a series of clinical considerations on how to improve patient outcomes and increase accessibility. In the end, two viable sites were identified, one of which is the trust’s preferred option, between Basingstoke and Winchester near junction 7 of the M3. The other is on the existing Basingstoke hospital site. During assessments, the current Winchester hospital site was also considered as an option. However, it was deemed too small to accommodate all of the services needed at our new acute specialist hospital and, besides, there is no adjacent land that could facilitate future expansion.
A key reason why junction 7 is the preferred site is that the ambulance service has argued in the past that it would enable the sickest patients to access care more quickly. Locating a hospital in the centre of a town or city may be convenient for patients attending elective surgery, but it is increasingly awkward for ambulances in a race against time. As the statistic about heart attacks demonstrates, ambulances are often in a race against time, and junction 7 is a convenient location between Winchester and Basingstoke with easy access to the M3.
Combined with the important access considerations, building a new hospital at junction 7 would also not disrupt existing services while construction takes place. These proposals are rooted in science and clinical experience, and they will save lives. It is clear to me that residents from across north Hampshire should follow the expert opinion and throw their weight behind supporting the junction 7 approach.
Not only is clinical guidance essential to the siting of the new hospital; so too is the location of specific services. The new HHFT hospital consultation introduced the trust’s new model of care, which centralises crucial services. That approach is underpinned by mountains of clinical evidence and research. Medical evidence suggests that centralising services in this way reduces duplication, increases the quality of care and is best for patients.
This model has already been rolled out in some departments, such as cardiology. A person who has a heart attack in north or mid-Hampshire will be sent to an amazing new heart centre in Basingstoke, where they are assured of top-quality care at all hours of the day. The results have shown that this approach saves lives. Members do not have to take my word for it, because seven of Hampshire’s top clinicians, including the chief medical officer, published an open letter in support of this approach:
“Bringing together more specialist services for the most seriously ill patients onto one site would mean we are able to bring services in line with best practice and national guidelines.
This means if you are critically unwell, you will be seen by experienced senior doctors and nurses who are experts in their field. This would have significant benefits for patients, both in terms of improvements to their care and their clinical outcomes.”
To bring the benefits of the new model into even greater focus, I will touch on two particular areas of service: maternity and emergency care. Neonatal care units are graded on a three-tier scale, ranging from level 1, which can treat unwell babies, to level 3, which can care for the most premature or unwell babies. The trust previously had a level 2 rating, which was temporarily changed to level 1-plus in November 2023 following an unannounced Care Quality Commission visit after a series of complaints.
Although the trust’s overall rating remained good, it was concerned that the neonatal units did not see enough seriously unwell babies for the staff to maintain the specialist skills needed for level 2 status. This relegation now means that, each year, around 100 very sick or premature babies have to travel to Southampton or Frimley Park hospitals for treatment. This is clearly not easy for families, but we have been gifted a golden opportunity to make sure the decision is reversed so that more babies can be looked after closer to their families.
Good practice and standards suggest that there should be 98 hours a week of on-site consultant cover, with 60 hours being the minimum requirement. At the moment, both maternity sites in Winchester and Basingstoke are able to provide only the minimum requirement. Were services not duplicated across two sites, the hospital could provide one unit with more hours of consultant cover, thereby reaching the recommended number of cases necessary to regain level 2 status.
The current level 1-plus status of our maternity service shows that the status quo is not an option. North and mid-Hampshire need a better service, and the surest way to secure it is by following the medical advice and centralising the services of the maternity units into one hub at the new junction 7 site.
Another area where the new model of care will have an enormous impact is emergency care, which is set to be reconfigured to reduce waiting times and streamline patients’ treatment. A large emergency department, complete with trauma unit and children’s emergency department, will be centralised at the new junction 7 site. It will specialise in treating the most serious cases. However, both Basingstoke and Winchester will have an urgent treatment centre, and each will be led and supported by advanced nurse practitioners, doctors and other health professionals. Both will be open 24 hours a day, seven days a week, and have been designed to provide quick treatment. It has been estimated that two thirds of cases currently being treated in A&E could be seen at an UTC, including all but the most serious illnesses and injuries. Restructuring facilities in this way will free up staff in A&E to focus on the most unwell patients, while simultaneously reducing the waiting times for patients with less serious ailments. Plans have been rigorously drawn up in a way that ensures patients are rapidly assessed, diagnosed and treated.
Both those cases, of maternity and emergency services, underline the importance of listening to and following clinical guidance when determining not only the location but the configuration of our new hospital services. The Government have made it very clear that they wish to see both Basingstoke and North Hampshire Hospital and Royal Hampshire County Hospital, Winchester continue to provide services. That has been reiterated by the hospital trust itself. The plans are about a significant reconfiguration of where and how those services are provided. The recommendations are based on expert clinical advice, because clinicians are best placed to identify the best way to treat patients. We would do well to listen carefully to their advice and, as far as possible, to follow the plans informed by their methodological research.
The Hampshire and Isle of Wight integrated care board is due to publish the findings of the consultation that has been carried out imminently. We are all looking forward to seeing those results, but the Hampshire Hospitals NHS Foundation Trust must ensure, on behalf of residents and its patients, that the clinical evidence, best practice and expert experience of clinicians remains at the forefront of its mind throughout.
The £900 million investment in our health service in north and mid Hampshire is a once-in-a-lifetime opportunity to improve what is on offer to residents throughout those communities, but we only have one opportunity to get it right. I hope the Minister, in her reply, can confirm to me her intention to support Hampshire Hospitals NHS Foundation Trust to make sure that it follows clinical advice, while also ensuring that it has listened to residents.
The Parliamentary Under-Secretary of State for Health and Social Care (Dame Andrea Leadsom)
I congratulate my right hon. Friend the Member for Basingstoke (Dame Maria Miller) on securing a debate on this really important issue. I am responding on behalf of the Minister for Health and Secondary Care, my right hon. Friend the Member for Pendle (Andrew Stephenson), who tells me that she has been a tireless campaigner for Basingstoke on this matter, as well as on countless others.
The Government believe that the people of Hampshire should, of course, have a say on where their new hospital should be built. As my right hon. Friend said, we have asked people from across the county to share their views with Hampshire Hospitals NHS Foundation Trust. I am sure she understands, however, that it would be wrong of us to pre-empt their views, or indeed to interfere with their decision making, but I am happy to assure her that we remain committed to delivering the new hospital.
The trust and the integrated care board are going through the responses as we speak. They will submit a business case for NHSE regional approval through the ICB in a few months’ time. I should be clear that while the trust and the ICB do that, there will be no final decision on the new hospital’s location or the services it will deliver, but once a decision has been taken we will, of course, update the House. I am sure my right hon. Friend will have much to say about that herself, too.
I want to address the points my right hon. Friend raised on the importance of clinical guidance in forming decision making. She is absolutely right to say that decisions should be locally led and based on the best clinical evidence. That is why proposals must meet our tests for good decision making, which include a clear evidence base that is in keeping with clinical guidance and best practice. In developing the consultation, the trust has looked at a variety of options to deliver clinical care in Basingstoke and Winchester. Experts have been consulted at every stage of the process to provide appropriate clinical guidance. Two particular examples in the consultation demonstrate how the trust used clinical guidance to inform the options it has put forward.
First, on proposals around accident and emergency services, the trust received expert clinical guidance from local doctors, who strongly agree that maintaining emergency departments at both Basingstoke and Winchester would be unsafe and unsustainable. The trust also received advice from the South East Coast Clinical Senate, an independent panel of senior doctors who expressed concern over retaining an A&E department at both sites, due to serious concerns around patient safety. Instead, it has argued that acute medical services must be twinned with surgical services in order for patients to receive first-class care. Therefore, the proposal includes two brand-new 24/7 doctor-led urgent treatment centres and same-day emergency care to deal with most urgent care needs—one at the new specialist acute hospital and one at Winchester’s Royal Hampshire County Hospital.
Secondly, the proposals give the people of Hampshire an emergency department with a trauma unit and a children’s emergency department at the specialist acute hospital, which will treat the most serious conditions. As my right hon. Friend said in her remarks, it is essential for new mothers and mums-to-be to have the best possible care for themselves and their babies—she will know that this is an area of healthcare that is very dear to my heart. The trust has looked carefully at keeping obstetrician-led maternity services at the Royal Hampshire County Hospital, but found that many patient safety issues have left them not viable, particularly following the 2022 publication of the independent Ockenden review of maternity services at the Shrewsbury and Telford Hospital NHS trust, which set out the need for obstetrician-led maternity services to be in hospitals that can also provide emergency surgery and critical care.
In Hampshire, those services could only be provided at the new specialist acute hospital, because the neonatal units at the Winchester site currently do not treat enough babies to meet the requirements for level 2 care, while consolidated services at the new specialist acute hospital will meet that requirement. The rationale is that the proposals will lead to fewer babies’ being transferred out of the area to receive vital neonatal care, and I think the whole House will agree that the last thing new mothers need after giving birth is an extra journey to receive critical care.
I thank my right hon. Friend for raising this important issue and for continuing to engage with the new hospital scheme. She is a real champion for her constituents in this place, and they will have seen her fighting their corner today. We want to do everything in our power to get the people of Hampshire the world-class care they deserve. We will continue to support the trust throughout the development of the business case, to ensure that plans meet the needs of staff and patients as well as offering value for money for taxpayers. I understand that my right hon. Friend the Member for Pendle has recently committed to visiting Basingstoke and I am sure my right hon. Friend the Member for Basingstoke will take immense pride in showing him around one of England’s extremely beautiful towns.
Dame Maria Miller
I thank my right hon. Friend for confirming that her, and my, right hon. Friend the Member for Pendle will be taking the time to come and visit the new hospital. May I encourage her to encourage him to visit the new hospital site that the hospitals Minister has already announced that he is in the middle of procuring?
Dame Andrea Leadsom
I shall certainly pass that message on to my right hon. Friend the Member for Pendle, and I again congratulate my right hon. Friend the Member for Basingstoke on securing a debate on this very important topic.
Question put and agreed to.