Kettering General Hospital

Debate between Andrew Lewer and Philip Hollobone

Wednesday 2nd February 2022 Westminster Hall

[Mr Philip Hollobone (Kettering) (Con)]

I beg to move,

That this House has considered the redevelopment of Kettering General Hospital.

It is a delight to see you in the Chair, Mr Twigg.

I thank Mr Speaker for granting me this debate, and I welcome the Hospitals Minister to his place. I also welcome my hon. Friend the Member for Northampton South (Andrew Lewer), who is kindly here to support the calls for the redevelopment of Kettering General Hospital. I thank the very hard-working, dedicated and loyal workforce at Kettering General Hospital for all they do to address the healthcare needs of the local population across Northamptonshire, particularly north Northamptonshire—in particular, Simon Weldon, the group chief executive, and Polly Grimmett, the director of strategy at Kettering hospital.

The Hospitals Minister knows Kettering hospital well and has always been extremely attentive and courteous to the healthcare needs of the local population in Kettering and beyond. He kindly visited the hospital on 7 October 2019, and he has responded to Adjournment and Westminster Hall debates on the hospital on 23 October 2019, 8 June 2021 and 10 September 2021. We have had regular meetings with him, most recently on 17 January this year.

I welcome the Government’s unprecedented investment in the NHS as a whole, and their commitment to the national hospital building programme. It has resulted in commitments to Kettering hospital of £46 million for an on-site urgent care hub, £350 million in health infrastructure plan 2 funding for 2025-30 and a write-off in 2020 of all the hospital’s £167 million trust debt. That is a total investment package for the hospital of a staggering £563 million, which is the biggest ever investment in Kettering General Hospital.

Kettering hospital is 125 years old this year. It has been on the same site ever since its inception in 1897. It is a much-loved local hospital that I hope will have a bright future. Let me reassure the Minister that I am not asking for more money. I welcome his recent decision that the two funding streams—the £46 million for the urgent care hub and the £350 million HIP2 funding—be meshed together, so that a synthesis of investment can be provided to the hospital. I have said this to the Minister before, and I repeat it today: promises are one thing, but delivery is quite another, and we now need the cash. The hospital needs the £46 million in cash so that works can continue.

In announcing the award of £46 million for the new urgent care hub in the debate on 23 October 2019, the Minister himself said:

“My officials and NHS England will be in touch with the trust to discuss further details, in order to ensure that funds are released and that work starts on the project as swiftly as possible. I am conscious of the urgency that my hon. Friend the Member for Kettering highlighted.”—[Official Report, 23 October 2019; Vol. 666, c. 30WH.]

I welcomed those words, but that was over two years ago. While we have been promised £46 million, the hospital has not yet received the cash.

My first main ask is for the imminent provision to KGH of the £46 million sustainability and transformation partnership wave 4b funding, which was first pledged in the debate here in October 2019, so that the initial enabling works for the redevelopment of the hospital can continue to 2023-24. Secondly, I reinvite the Minister to visit Kettering hospital. He has kindly visited before and has promised to visit again. I hope that that visit will take place soon.

Thirdly, can we have confirmation that the NHS’s new hospitals programme team will approve, and give feedback on, the hospital’s strategic outline case for its redevelopment, which was submitted early last year, so that the hospital can develop the next stage—an outline business case—in May 2022? Fourthly, can the Minister confirm that he will look favourably on Kettering hospital’s eligibility for £53 million of slippage from other more complicated and larger hospital development schemes—such slippage will inevitably occur across the redevelopment of 40 hospitals—so that work can continue on the Kettering site all the way through to the 2025 to 2030 HIP2 period?

The hospital is straining at the leash to get the redevelopment project under way. Initial work has already commenced, but the hospital must go through various approval processes to fulfil the NHS’s investment requirements. Essentially, there is a three-stage business case approval process: a strategic outline case, an outline business case and a final business case.

The hospital submitted its SOC early last year, but it has not yet received feedback from the new hospitals programme team to inform the outline business case, which it is keen to submit in May this year. Once the OBC is achieved, feedback is required for the final business case. The big risk is that these various business case approval processes are extended too long, which will mean that substantial development on site will be held up.

The second risk is that the hospital needs the cash from the £46 million to allow the initial enabling work to continue. That work covers things such as the reprovisioning of car parking, clinical and office spaces to create construction space for the redevelopment itself, as well as road and utility diversions and site clearance. Without the cash from the £46 million, the risk is that those enabling works will have to stop, and that would be of extreme concern to local people.

The third risk is that the trust does not receive any slippage money from the other 40 hospital building programmes around the country. The Kettering scheme is relatively small, compared with some of the very large hospitals being rebuilt, but it is flexible. It can respond extremely well to receiving any slippage money from those other projects.

[Andrew Lewer (Northampton South) (Con)]

My hon. Friend is giving a remarkably impressive run-through of some of the complex bureaucracy and procedures. I want to pick up on his point about integration. Does he agree that Northampton General Hospital and Kettering General Hospital working together more efficiently provides some promising opportunities? While I cannot join him in saying that I will not ask the Minister for more money, because Northampton General Hospital is in the next stage of needing this sort of funding, I join him in asking the Minister to come and look at Northampton General Hospital and Kettering General Hospital as soon as possible.

[Mr Hollobone]

I thank my hon. Friend for his helpful intervention. How about this as a constructive suggestion? Would it not be wonderful if, on visiting Kettering, the Minister was able to call in at Northampton on the way? We are only 18 miles apart. Northampton and Kettering hospitals work together under the same NHS trust umbrella, and there is a lot of close working between the two hospitals. I recognise the need for more investment in Northampton hospital as well. I congratulate my hon. Friend on all his work for his constituents, which I know is hugely appreciated.

The risk is that, if Kettering hospital is not allowed to begin work on its full business case approval process this summer, the hospital will miss its 2023 target date for substantial construction on the site. The hospital continues to work towards a timetable that sees construction start on site in 2023. This is an accelerated timeline, because the hospital is eager to go on what is a relatively low-risk project. The hospital does not need to do any land deals; it owns all the land. There is strong local support among health system partners and planners. The hospital is keen to use repeatable designs from other hospital projects that have worked well elsewhere.

Can we have feedback from the new hospital programme team on the business case and designs for the hospital, so that the hospital can incorporate national thinking on programme priorities such as digital, net zero carbon and modern methods of construction? Can we have, as early as possible, the selection by the new hospital programme team of an appointed construction partner to work with the trust on developing the final scheme details, and can the hospital have the funding to cover the fees associated with this stage of the design? The risk is that, unless this support from the new hospital programme team is forthcoming, work on the hospital’s main scheme may have to come to a stop, with key resource being stood down and reassigned. I am sure the Minister wants to avoid that.

It is welcome news that the trust has received confirmation that the £46 million can be combined with the £350 million, so that it is a united programme. However, at present, there is no process in place to allow the hospital to start accessing these funds once existing programme budgets run out in March this year. Unless the trust is able to access these funds this year, early enabling work required to prepare the site for construction in 2023 will not be completed and the main build will not be possible on time.

One thing that keeps the chief executive awake at night is the power plant at Kettering hospital: £25 million of the money required for enabling work relates to the need for a new energy centre on site to replace the temporary plant and life-expired distribution system. This is an immediate risk to patient safety due to ongoing shutdowns caused by testing and repair work. If the Minister were kind enough to agree to visit the hospital, I am sure the trust would want to show him the power plant, which is in urgent need of attention. If we get the £46 million, the scheme can progress, enabling works can continue and the hospital will be on track for early construction work beginning in 2023.

I reiterate that Kettering hospital is a much-loved local hospital. It serves all the residents of Kettering, Wellingborough, Corby and others, sometimes including patients form Northampton. We live in one of the fastest-growing areas in the country. Corby has the country’s highest birth rate, and Kettering hospital expects a 21% increase in the number of over-80s in the local area in the next five years alone. The area has committed to at least 35,000 new houses over the next 10 years. The local population is set to rise by some 84,000, to almost 400,000 people. The A&E now sees up to 300 patients every single day in a department that is sized to safely see just 110. Over the next 10 years, the hospital expects the number of A&E attendances to increase by 30,000, up from 100,000; that is the equivalent of almost 80 extra patients every day.

The A&E is full. It was constructed in 1994 to cope with just 45,000 attendances each year. By 2045, 170,000 attendances are expected. Seventy per cent. of the buildings on the main site are more than 30 years old, and there is a maintenance backlog of £42 million. Sixty per cent. of the hospital estate is rated as either poor or bad. Local people know that this investment is needed. The Government have also accepted that the investment is needed. What we need now is the cash to make sure that the works can start on time in 2023.

Health and Social Care (Kettering)

Debate between Andrew Lewer and Philip Hollobone

Wednesday 23rd October 2019 Westminster Hall

[Mr Philip Hollobone (Kettering) (Con)]

I beg to move,

That this House has considered health and social care in Kettering constituency.

I welcome you to the Chair, Mr Wilson, and I thank Mr Speaker for granting this debate. I also welcome Northamptonshire colleagues who are here: my hon. Friends the Members for Wellingborough (Mr Bone) and for Northampton South (Andrew Lewer). If he is released from his important role in the Government Whips Office, my hon. Friend the Member for Corby (Tom Pursglove) hopes to be able to attend. Others with a local interest are also here, including my right hon. Friend the Member for Rutland and Melton (Sir Alan Duncan), who I welcome to his place.

I also welcome our excellent Minister for Health, my hon. Friend the Member for Charnwood (Edward Argar). He is not only excellent in his own right, but he is super excellent because within just a few weeks of being appointed as hospitals Minister, he made a visit to Kettering General Hospital one of his very highest priorities. He did that on 7 October and met: the superb chairman of Kettering General Hospital, Alan Burns; our wonderful chief executive, Simon Weldon; the medical director, Andrew Chilton; the chief nurse, Leanne Hackshall; the chief operating officer, Joanna Fawcus; the director of strategy and transformation, Polly Grimmett; the director of finance, Nicola Briggs; the director of estates, Ian Allen; the clinical director of urgent care, Adrian Ierina; and the head of nursing in urgent care, Ali Gamby. All those magnificent people were there to meet the Minister because the hospital is absolutely determined to get the necessary funding for a new urgent care hub at the Kettering General Hospital site.

Kettering General Hospital is a much-loved local hospital. It has been on its present site for 122 years, and there cannot be many hospitals that have such a record. The problem at Kettering General Hospital is that the A&E department is full. It was constructed in 1994 to cope with 45,000 attendances each year. This year, we could well go through the 100,000 attendances mark, which is well over 150% of the department’s capacity. By 2045, 170,000 attendances are expected at the same site. The solution to that pressure is for an urgent care hub facility costing £46 million to be constructed on the site. It would be a two-storey, one-stop shop with GP services, out-of-hours care, an on-site pharmacy, a minor injuries unit, facilities for social services and mental health care, access to community care services for the frail elderly and a replacement for our A&E department. All the NHS organisations in Northamptonshire, as well as NHS Improvement regionally, agree that that is the No. 1 clinical priority for Northamptonshire. They are all saying the same thing to the Government, and I am delighted to support their campaign.

The A&E department at Kettering General Hospital was visited in 2016 by Dr Kevin Reynard of the national NHS emergency care improvement programme. He said:

“The current emergency department is the most cramped and limiting emergency department I have ever come across in the UK, USA, Australia or India. I cannot see how the team, irrespective of crowding, can deliver a safe, modern emergency medicine service within the current footprint.”

Despite some temporary modifications over recent years, including moving other patient services off the hospital site, detailed surveys show that no further opportunities remain to extend the department and that a brand-new building is required on the site. The hospital has developed a superb business case for a fit-for-purpose emergency care facility that will meet local population growth for the next 30 years. It has been developed with all the health and social care partners across the county so that patients can get a local urgent care service that meets all the Government guidance on good practice, ensuring that they get the care they need to keep them safely outside of hospital if necessary, and ensuring that if they come into hospital, they are seen by the right clinician at the right time, first time. The bid has been submitted to the Government. We have been pressing the case for the facility since 2012. It is about time that the Government listened to the concerns and responded by promising the funding.

The pressure on Kettering General Hospital is primarily being driven by very fast population growth locally. The Office for National Statistics shows that we are one of the fastest growing areas in the whole country, at almost double the national average. The borough of Corby is the fastest growing borough outside of London. The population served by the trust has grown by almost 45% since the A&E opened in 1994. The area is committed to at least 35,000 new houses over the next 10 years. That means a population rise of some 84,000, to almost 400,000 people locally. The A&E department now sees approximately 300 patients every single day in a department that is safely sized to see just 110. Every day, 87 patients are admitted into the inpatient wards from A&E, and over the next 10 years, the hospital expects the number of A&E attendances to increase by 30,000, equivalent to almost 80 extra patients every day. Bluntly, a solution is required immediately if the hospital is to have time to prepare and build for that.

[Andrew Lewer (Northampton South) (Con)]

I thank my hon. Friend for giving way. I recently visited A&E at Northampton General Hospital, which also has a space and crowding problem, particularly in paediatrics. Does he agree that investment there would assist Kettering with the problems it has and would lead to a whole Northamptonshire approach to solving some of these problems?

[Mr Hollobone]

I am delighted to take that intervention from my hon. Friend, who is a superb representative for his constituents in Northampton and is very much in touch with the importance of local healthcare issues to our constituents. He is absolutely right.

I am delighted to welcome the Government’s commitment to include Kettering General Hospital on the list of hospitals that will be considered for health infrastructure plan 2—or HIP2—funding from 2025. That is important for Kettering, because the hospital has been there for 122 years, 70% of the buildings on the main hospital site are more than 30 years old and there is a maintenance backlog of £42 million. We need the reconstruction of many wards at the hospital. I welcome the Government’s commitment to investment in the hospital site from 2025 onwards, which could transform the whole of Kettering General Hospital. The point about the urgent care hub is that we need the money now to address the pressure on the A&E department.

The second part of the debate is about the need for us to use the opportunity of local government reorganisation in Northamptonshire to create in the county a combined health and social care pilot that will put responsibility for healthcare and social care under one organisation. Northamptonshire County Council has faced tremendous financial difficulties. The Government appointed an inspector, who concluded that it was not possible to turn around the organisation. The Government’s solution is to create two unitary councils in the county: a “north” council and a “west” council that will take over all the responsibilities of the eight different councils in the county from May 2021. We can use that once-in-a-generation opportunity to create a new organisation on a pilot basis to combine health and social care in Northamptonshire.

That is important for Kettering General Hospital because it has 531 beds; at any one time 110 of those beds—21%—are occupied by patients who should not be in hospital at all, but in a social care or other setting. In Government jargon, they are defined as super-stranded patients who have been in hospital for more than 21 days. If the hospital discharges 87 patients a day from the A&E department to the hospital, and 110 of the beds are occupied by patients who should be in a different setting, it creates huge problems for the A&E department, so finding a solution to the social care issue is also important for the A&E department.