National Health Service Funding

John Howell Excerpts

Tuesday 22nd November 2016 Commons Chamber

[John Howell (Henley) (Con)]

My starting point is that funding in the NHS must be used effectively and efficiently. To that end, we expect the NHS to deliver savings and best value for money.

There are a number of issues relating to social care in the NHS where there is considerable scope for solving existing problems, for ensuring that better health care is delivered and for achieving sustainability, and there is no better place to start the discussion of those issues than bed-blocking.

Oxfordshire’s historical performance on bed-blocking is poor. It came 151st in terms of headcount last November, with 158 people. Bed-blocking decreases the availability of beds and has adverse effects on patients, particularly when they are elderly—for example, incontinence in the over-65s increases, and muscle wasting in the over-80s after 10 days of hospitalisation is equivalent to 10 years of muscle wasting otherwise.

By September, the headcount had fallen to 113 people, improving the county’s performance to 108th—a massive improvement of 50 places over that period. That was achieved through a joint initiative by the clinical commissioning group, Oxford University Hospitals, Oxford Health NHS Foundation Trust and the county council, all working to move people out of hospital when they have been appropriately treated.

However, that improvement was also achieved by putting £2 million into funding extra temporary care beds in care homes, where people can stay until they are ready to return to their own homes, move to a permanent care home or receive care in their own homes. That joint and positive thinking is something I would encourage as we integrate social care and the NHS.

[Craig Whittaker]

Does my hon. Friend agree that one lever for discouraging bed-blocking would be to join up some of the budgets around health and social care?

[John Howell]

I do, and that is precisely what the organisations in Oxfordshire have been trying to achieve.

The second point I would make relates to how we produce better-serving hospitals. In my own area, the Townlands Memorial Hospital, which is in Henley but which serves the whole of south Oxfordshire, has recently gone through a major reprovision. It now has an increased number of facilities serving the population of the area, but the beds are not in the hospital. Although limited in number, they are in an adjoining care home, whose opening I happened to attend with the Duke of Gloucester only the other day. It is good to see the issues at the hospital finally resolved.

That is the way forward for local hospitals: better treatment for people in their home through a system of what has come to be called ambulatory care. Such a system prevents the problems I mentioned, with patients suffering when they stay in hospital for a long time. This view comes not from politicians but from clinicians both local and national. The national clinicians I would point to are those in the Royal College of Physicians, who are fully behind this process. This method costs more in the first instance but provides better value for money and increases better patient outcomes.

The third area I want to discuss is what can happen when we integrate the staff providing care who are employed by the county council and those who are employed by the NHS. This allows us to ensure that the pay and service requirements of both groups of people, who are doing exactly the same job, can be harmonised in a much more positive way. That sets out a good scope for efficiency in the operation of social care within the NHS model. I agree with my hon. Friend the Member for Calder Valley (Craig Whittaker), in that I would like to see them fully integrated, but until then I have set out a very good method of being able to operate in those circumstances and to co-operate in order to achieve the outcomes that I have mentioned.

Sustainability and transformation plans focus on organisations working together and are the best hope of improving health and social care services in the long term. That is not my view but that expressed by the King’s Fund when it looked at the plans. I fully agree with its assessment of the situation and of these plans, which are working towards achieving the same outcomes.