Queen Elizabeth Hospital, King’s Lynn

Duncan Baker Excerpts

Wednesday 23rd March 2022 Westminster Hall

[James Wild (North West Norfolk) (Con)]

I beg to move,

That this House has considered quality of care and the estate at the Queen Elizabeth Hospital, King’s Lynn.

It is a pleasure to serve under your chairmanship, Mr Hosie. I am grateful to Mr Speaker for granting this important debate, which gives me the opportunity to highlight the significant improvements at Queen Elizabeth Hospital, while once again making the compelling case for it to be one of the new hospital schemes that the Government have committed to building. I also want to recognise the close interest that my hon. Friend the Minister has taken in QEH and to thank him for the many meetings and discussions we have had about it so far. Of course, I also encourage him to back the bid.

QEH serves 330,000 people across Norfolk, Lincolnshire and Cambridgeshire, providing a comprehensive range of specialist, acute and community-based services. It is a busy hospital, with 55,000 in-patient admissions, a quarter of a million out-patient appointments and 70,000 emergency department admissions last year. However, QEH has suffered from poor Care Quality Commission ratings and an historic lack of investment, and has therefore been in special measures for some time. However, under the leadership of Caroline Shaw, the chief executive, and the chairman, Steve Barnett—who is moving on shortly, having done a lot of good work—things have changed.

In the last three years, there have been significant improvements in care. However, you do not have to take my word for it, Mr Hosie; that was the verdict of the CQC’s report a month ago. The core services it inspected—medicine, urgent and emergency care, and critical care—were all rated good overall. Indeed, critical care was recognised as having outstanding elements in many areas. That means that QEH is now rated good in three domains: caring, well led and effective. The CQC found that

“Staff provided good care and treatment…treated patients with compassion and kindness, respected their privacy and dignity, took account of…individual needs…and made it easy for people to give feedback.”

The report shows how far QEH has come. As a result, the Care Quality Commission’s chief inspector of hospitals has recommended that QEH come out of special measures, which is very welcome for the area.

It is frankly remarkable that all this has been achieved during a period when covid posed such huge challenges to QEH and other hospitals, and to other parts of the health and social care sector. This has not happened by luck; it is due to the leadership, hard work and commitment of all the staff at QEH. I have seen that dedication at first hand when I have met doctors, nurses, the infection control teams, the porters and all the others who make up the hospital during my regular visits. I commend them for all that they have achieved in the report. As the CQC said, staff were

“passionate about…providing the best possible care for patients”,

and leaders understood

“the priorities and issues the trust faced”

and were

“visible and approachable…for patients and staff.”

Clearly further improvements are required, as the hospital recognises, but it is important that we acknowledge the huge step forward that has been taken, as reflected in the report.

Those improvements have been made despite the decaying and ageing buildings that staff and patients have to experience and operate in. As my hon. Friend the Minister knows, QEH is one of the best-buy hospitals and has major issues with reinforced autoclaved aerated concrete planks—which I think we should refer to as RAAC planks for the rest of the debate—which are structurally deficient. The hospital was built with a 30-year design life, but it is now in its 42nd year. Some 79% of hospital estate buildings have RAAC planks, and I am sorry to say that it is the most propped hospital in the country, with 470 steel and timber supports across 56 parts of the hospital.

Being in a ward or another part of the hospital, surrounded by props holding up the roof, is a poor experience for patients. It makes it harder for staff to care for them. It is not something that we should accept, and we do not. This is a serious situation, and the trust’s risk register has a red rating for direct risk to life and the safety of patients, visitors and staff, due to the potentially catastrophic risk of failure of the roof structure. Last year, the critical care unit had to close for some weeks due to precisely those safety issues. The urgent need for a new hospital, and the strength of that case, is underlined by the fact that over a third of all reported RAAC issues in the east of England were at QEH in the last year.

I know that my hon. Friend recognises the seriousness of the situation, and the £20.6 million of emergency capital funding that he approved last year is very welcome. That is making a difference: a new endoscopy unit is taking shape to modernise facilities, and to create space to enable installation of fail-safe roof supports. In addition, there is £3 million of funding for a west Norfolk eye centre, which along with other projects, including digital, means that QEH is currently delivering a more than £30 million capital programme.

[Duncan Baker (North Norfolk) (Con)]

I thank my hon. Friend for giving way and for securing this incredibly important debate. It is a very poor situation to have a hospital in Norfolk in this position, when it clearly needs a rebuild. I thank my hon. Friend for everything he has done; we would not be in this position without his tireless work to raise this matter with the Secretary of State. May I raise one point? We have three hospitals in Norfolk. We want a new hospital at QEH. That will benefit not just his constituents, but those all over Norfolk, particularly in my constituency of North Norfolk, who will also use its fantastic services when it is rebuilt.

[James Wild]

I am grateful to my hon. Friend for his support and words. He is absolutely right; I think his constituency has the oldest average age in the country, and that poses particular needs. My constituency and that of my hon. Friend the Member for Broadland (Jerome Mayhew), who has joined to support the debate, also have challenges, so we need to ensure that the care is in place. There is also a lot of planned housing growth in the area. The demand is strong across our constituencies, and in Lincolnshire and Cambridgeshire, which is why it is important to show the strength of support for the hospital across Norfolk and beyond.

When compared with the turnover, the level of capital programme is significant, and it is important to acknowledge that the programme is being managed well. QEH has submitted a further bid for £18 million for an orthopaedic centre, as part of the funding to tackle the backlog. Given that it is the area with one of the longest waiting lists for QEH, I strongly endorse that bid, and encourage the Minister to approve it when it comes to his desk. Seeing is believing. When the Secretary of State visits QEH—which he has agreed to and I hope will happen soon—he will see those improvements, but he will also see the props and the very real need for investment. My hon. Friend the Member for North Norfolk (Duncan Baker) will be able to join him on that occasion or another, as he will be very welcome.

As well as the structural issues, the hospital has outgrown its footprint. The emergency department sees 70,000 patients a year—more than double what it was designed for. The layout of the hospital does not meet modern care pathways, with too few consulting rooms, and wards well below the recommended size.

--- Later in debate ---

[Edward Argar]

As my hon. Friend knows, each region will feed in its views about which of the schemes and bids in its area are the highest priority. Without prejudging that assessment process, I hope I can reassure him that one factor that I know he considers to be of significant importance—RAAC—will be considered. Patient safety and the safety of the buildings will be a factor in the analysis of which bids should go forward to the long list, but I do not want to go further than that at this point, however much he may charmingly seek to tempt me to do so.

Elective recovery is an area of real focus for the Department and for the whole Government, and I am aware that covid-19 has placed an unprecedented strain on routine and planned care, with waiting lists in England reaching a record high, at just over 6 million in January 2022. I understand that 19,366 of those patients are waiting for treatment at the Queen Elizabeth Hospital.

In February, the NHS published the “Delivery plan for tackling the COVID-19 backlog of elective care”, which set out a clear vision for how the NHS will recover and expand elective services over the next three years. That delivery plan commits to eradicate waits of longer than a year for elective care by March 2025. Within that, by July 2022, no one will wait longer than two years, and we will aim to eliminate waits of over 18 months by April 2023 and of over 65 weeks by March 2024.

To support elective recovery specifically, the Department plans to spend more than £8 billion from 2022-23 to 2024-25, in addition to the £2 billion elective recovery fund and £700 million targeted investment fund already made available this year to help drive up and protect elective activity. Taken together, this funding could deliver the equivalent of around 9 million more checks, scans and procedures, and will mean that the NHS in England can aim to deliver around 30% more elective activity by 2024-25 than it was delivering before the pandemic.

In highlighting the extra resources that we are putting into our NHS, it is vital to understand that this is not about the inputs; it is about the outcomes for patients and how those resources are used wisely to deliver improved patient outcomes and improved experiences for patients, with shorter waits. With regard to what is needed to achieve those outcomes, a significant part of that funding will be invested in staff, in terms of both capacity and skills.

I understand that an orthopaedic unit bid for about £18 million has been submitted by my hon. Friend’s local hospital trust. That is in the context of the £5.9 billion elective recovery funding, and the £1.5 billion from that for capacity and social hub improvements. Those bids will be carefully considered. They will need to meet the recommendations arising from the pilots that took place in London and the getting it right first time review, but I certainly look forward to considering the bid from my hon. Friend’s trust in due course.

[Duncan Baker]

Does the Minister know that the Queen Elizabeth Hospital was named after the Queen Mother? As it is Queen Elizabeth’s platinum jubilee this year, does he agree that it would be a fitting tribute to give the green light to rebuilding a hospital that is named after her mother?

[Edward Argar]

My hon. Friend is even more dextrous than our hon. Friend the Member for North West Norfolk in seeking to tempt me into an indiscretion or a prejudgment of the application process and consideration. I hear what he says and he makes his point eloquently, but I will not be drawn while that analysis and assessment of the bids is under way.

Ambulance services, like other emergency care services in the NHS, have come under significant pressure, as hon. Members will know. In February 2022, the service answered over 764,000 calls to 999—an increase of 13% on the number of calls in the same month before the pandemic. High levels of demand on the emergency care system, alongside the need for infection prevention and control measures, has resulted in higher instances of delays in the handover of ambulance patients to A&E in some areas.

I reassure hon. Members that significant support is in place for acute trusts, to help address handover delays. NHS England and Improvement and its regional teams are working with local systems—in this case, with the Queen Elizabeth Hospital in the constituency of my hon. Friend the Member for North West Norfolk—to improve their patient handover processes, helping ambulances get swiftly back on the road. Ministers are in regular contact with NHSEI on the performance of the emergency care system, including the ambulance service and accident and emergency departments.

In conclusion, I once again pay tribute to my hon. Friend the Member for North West Norfolk and all my hon. Friends who have spoken in this brief but very important debate for the work that they are doing to champion the Queen Elizabeth Hospital, King’s Lynn. As I say, his constituents are incredibly lucky to have such a champion of their cause, of healthcare in his constituency, and of investment in his local hospital, and I look forward to continuing working with him to ensure that the quality of healthcare his constituents receive is the best the NHS can provide. I note his very kind offer, which has been reiterated to me, to visit him in sunny Norfolk—as I suspect it will be in the coming months—to see his local hospital. If I am able to do so, I will be delighted to visit.

Question put and agreed to.