Healthcare Facilities: Royston

Oliver Heald Excerpts

Monday 5th June 2023 Commons Chamber

[Sir Oliver Heald (North East Hertfordshire) (Con)]

I am very glad that I have been able to secure this debate about healthcare facilities in Royston in my constituency. I have been concerned for some time that there is a danger of Royston not receiving the recognition that it needs from the national health service and the health facilities fit for such a fast expanding town.

Royston has almost 17,500 residents. That is rising in the near future to about 20,000, given the local plan and approved developments. It has a catchment area of villages in Cambridgeshire, Hertfordshire and Essex, covering at least another 24,000 residents. The area is expanding fast—not just Royston, but the villages around it. I will mention Melbourn and some of the other villages in a moment.

Royston is recognised as an important town by retailers; it houses one of the largest Tesco Extras in the region, as well as Marks & Spencer and Lidl. It is home to the major FTSE 100 company Johnson Matthey, which has its headquarters there. The area is full of innovative businesses, including successful science and engineering companies, and the same is true of the area around it. For example, Melbourn Science Park is part of the corridor that is recognised as being part of Cambridge, the A1 corridor and so on. It is clear that Royston is widely recognised as an important hub in this part of the east of England.

Earlier this year, the two main GP practices merged to become part of Granta Medical Practices, which is one of the largest and most innovative organisations when it comes to bringing together a range of local services, while retaining the close link between patient and clinician. Its inspirational leader—the managing partner, Dr James Morrow—has pioneered this approach over many years from his base in Sawston, Cambridgeshire, and he believes that to make the most of this new merger, Royston needs a state-of-the-art health centre and community diagnostic centre. But Royston appears to be a forgotten part of the region by NHS decision makers.

In January, via a reply to a written question to the Secretary of State for Health, I was told that it was for the Hertfordshire and West Essex Integrated Care Board to determine whether such a centre is needed in Royston. Now, the Herts and West Essex ICB covers much of my constituency and has some relevance to Royston, but it is not the lead ICB for Royston. When I queried this with the Department, I was told that I was right and that the Cambridge and Peterborough ICB would be making these decisions. That makes a lot more sense, because it includes Royston within the list of areas that it covers. Cambridge is very close and has good transport links with Royston, and many local residents have always used and continue to use Addenbrooke’s Hospital as “our hospital”. These examples show that Royston is falling between two stools; for a town of such significance, that is not good enough.

One of the four aims on the Cambridge and Peterborough ICB website is to “Think Local”. We want it to “Think Royston” and help our GPs to realise their vision for the future. Investigations show that the NHS may be doing anything but that: the Cambridge and Peterborough ICB estates plan proposes transferring clinical services from the current Royston Hospital site into the Royston health centre, and then disposing of the hospital site. Royston Hospital—a site of six acres—currently offers a number of clinics and treatments, including in obstetrics and gynaecology, and physiotherapy. It also houses our community transport, is the base for our district nurses and is Hertfordshire Community NHS Trust’s depot for its medical devices.

Royston’s growth as a town and its close relationship with its villages nearby is reflected in the fact that the two practices that have merged have patients not only in Royston but in nearby villages in Cambridgeshire, Essex and Hertfordshire; it is a wide catchment area, not just for retail and industry but for health. The opportunity to merge the two practices provides the opportunity for modern facilities and for the secondary sector to follow Government policy and delegate services such as diagnostics to the primary community setting by way of a community diagnostic centre. I understand that Addenbrooke’s Hospital is a keen advocate for that approach and believes that Royston could be a good centre for the CDC.

In Royston, local people have seen the idea of a refurbishment of Royston Hospital co-located with modern community services as the way ahead. There have been campaigns over time to save the hospital site, but that is not out of sentiment or dogmatism; it is simply because it is a six-acre site close to the town centre and already in the NHS fold. If another site were identified and its benefits outlined, I am sure that Royston people would give it a fair hearing, but we do not want to lose our hospital site and be left struggling in the existing GP practice buildings, which come from a time when the town was half its current size. Where would the advantages of the sort of modern state-of-the-art health centre that we want be? They would be absent. There would be no room for our diagnostics unit. A new modern building would mean that the patients reliant on Royston would have guaranteed long-term primary care services provided in a locally based setting, satisfying the ICB mission to think local. It would also be future-proofed.

Local primary care services are suffering from recruitment problems in our area. I am sure that both Government and the NHS want to show professionals a modern vision for the future. What local doctors are proposing satisfies the current national programme seeking to improve access to common diagnostic tests using community diagnostic centres. The combining of services from the two Granta practices plus utilising the opportunity to cascade services from Addenbrooke’s into primary care and diagnostics at Royston is both opportune and efficient, and it would help with solving the problem of staff shortages. This issue is addressed in Dr Morrow’s recent BMJ article with Dr Sinsky about how to retain GPs, the importance of the patient-doctor relationship and how CDCs can help with that by doing the diagnostics locally and enabling that relationship to flourish.

I would like to see constructive discussions between Granta Medical, the Cambridgeshire and Peterborough ICB and Addenbrooke’s Hospital, hopefully supported by the Hertfordshire authorities, to see how this vision can be realised. The Minister has kindly already had one meeting with me and the various stakeholders, and he has played a part in helping this to happen. I note that last week I received a letter from the Cambridgeshire and Peterborough ICB—I wonder if it was aware this debate was to take place—asking me to work with it on a programme of engagement with local people and communities about health and care services around Royston. It also made it clear that no decision has been made about the future of Royston Hospital. I welcome that, and I will be happy to take part, but I hope that the Minister will continue to help us by backing the vision of our local doctors and ensuring that Royston does not fall off the map again.

If we take the map of the ICB area for Cambridgeshire and Peterborough and place it next to the map for Hertfordshire and West Essex ICB, the significance of Royston emerges clearly. It is in the middle, it is one of the fastest growing towns, it is surrounded by burgeoning villages, and it is at the heart of the innovation and engineering corridors that are the future of the UK economy. I am certain that, if meaningful discussions were held between all the interested parties, a long-term solution could be found for Royston. I am hoping that today’s debate, with the support of the Department, will go a long way to persuading Cambridgeshire and Peterborough ICB to re-evaluate its options and to accept that a health centre and CDC in Royston is an eminently sensible way forward.

[The Parliamentary Under-Secretary of State for Health and Social Care (Neil O’Brien)]

I congratulate my right hon. and learned Friend the Member for North East Hertfordshire (Sir Oliver Heald) on securing this important debate and I thank him for his work advocating for health services for his constituents. If there were any danger of Royston being forgotten, my right hon. and learned Friend and his activities are ensuring that that does not happen. It was genuinely a huge pleasure to meet him, his local ICB, Addenbrooke’s and in particular his local GPs, who I thought were a particularly impressive and thoughtful bunch with many interesting ideas that he is helping to catalyse. I also congratulate him on his imaginative and thoughtful advocacy on behalf of Royston Hospital and the opportunities presented by that site, which he has explained further in this debate.

We absolutely recognise the importance of suitable and well-functioning premises for healthcare facilities, expanding our NHS workforce further, and accommodating and enabling good-quality healthcare services for growing populations, particularly in areas such as Royston that are expanding so rapidly. We are taking action to support ICBs in that aim, and we are aware that many areas, including Royston, are set to experience further increases in population, which of course puts pressure on local health services.

We announced in the delivery plan for recovering access to primary care, which is part of the wider review going on of the national planning policy framework—the subject of the most recent debate, in fact—that we would be better considering how primary care infrastructure can be supported and how we can get more of the profits of development flowing into our primary care facilities. So we will be updating guidance to encourage our local planning authorities to engage with ICBs, particularly on large sites where there is opportunity and the need for extra primary care capacity.

NHS England is currently undertaking a formal assessment of all general practice premises through a primary care data collection programme, and this will provide an overview of the current capacity, suitability and ownership of all premises, with the information made available to local commissioners to inform their planning. But the activity of my right hon. and learned Friend in pointing out the opportunities and the challenges will be very clearly in the minds of his local ICB as it thinks about its future plans.

From 2023, a substantial proportion of primary care business-as-usual estates and GP capital is included within overall integrated care system capital funding envelopes. That allows local systems to take a more cohesive and coherent approach to how they spend capital across that system, and to prioritise the primary care investment needs in their own local strategies.

As well as funding from specific national programmes, Cambridgeshire and Peterborough ICB—as we now know, it is responsible for commissioning health services in Royston; my right hon. and learned Friend was quite right about that—received £77 million in operational capital funding in 2022-23, totalling over £205 million during this spending review period. Cambridgeshire and Peterborough integrated care system has worked in partnership with NHS Property Services to develop the first estates strategy for the region. This was consulted on earlier in 2023 and approved by the ICB on 10 March.

The ICB has been working closely with primary care providers to try to stabilise primary care provision locally, and is now reviewing estates and local health care provision to make sure that they are also fit for the future. I know that the ICB is in conversation with the Hertfordshire Community NHS Trust, Granta Medical Services, and NHS Property Services—my right hon. and learned Friend has mentioned some of this—to review all the sites and consider options for a potential healthcare centre, co-located with primary care and diagnostic facilities.

In its decision-making capacity for estates and healthcare service commissioning, it is essential that the ICB is able to fully assesses capital and revenue costs, and service implications, that would arise from any decision. The ICB has noted that, while it recognises the community hospital is not currently functioning as it should, it is important that any future decisions on its use are not taken until it has fully considered and appraised all options, as my right hon. and learned Friend has quite rightly insisted on. That is why the ICB is about to begin a comprehensive listening and engagement exercise for an initial six weeks, encouraging local communities to take part in that conversation through a range of routes. The ICB will share more details in the coming weeks, on its website, on social media channels and through updates to key stakeholders, as well as via the printed materials in the community so that everyone knows that this conversation is ongoing.

Another approach and consideration that integrated care boards may take when they are shaping healthcare estates locally is the reconfiguration of services. This is a clinically-led local decision following appropriate engagement with patients and stakeholders. Responsibility for the delivery, implementation and funding decisions for services ultimately rests with the appropriate NHS commissioner. All substantial planned service change is subject to a full public consultation, and must meet Government and NHS England’s tests to ensure good decision making. As my right hon. and learned Friend has sometimes pointed out, community diagnostic centres are an important development to allow patients to access planned diagnostic care nearer to home, without the need to attend acute sites. That is only one of the ways we are doing that, including through virtual wards and a closer tie-up between primary and secondary care. Funding for community diagnostic centres has been allocated so that areas with unmet need receive more funding. That will help to tackle health inequalities.

My right hon. and learned Friend rightly raised the Priors Field surgery closure at Sutton. NHS Cambridgeshire and Peterborough ICB is pleased to conform that from 1 April, Malling Health took on an interim contract to provide primary care services to the patients of Priors Field surgery. While that interim solution is being secured, the ICB continues to work with key stakeholders in the local community to ensure that communities in Sutton and the surrounding areas continue to have access to primary care services that meet their needs, both now and in the future. Knowing my right hon. and learned Friend well, I know that he will not be backward in coming forward to make the case strongly for investment in his local community and constituency, and we will continue the useful and helpful conversation that we have been having.

[Sir Oliver Heald]

I am grateful to the Minister for the help he has given us. Would he be prepared to continue to take an interest in Royston and its future plans, because I think that has been very helpful so far?

[Neil O’Brien]

I am happy to conclude as I started, by saying that I would love to continue that conversation with my right hon. and learned Friend, his constituents and local clinicians. I thought it was extremely interesting, and they had some powerful ideas. I look forward to continuing that with my right hon. and learned Friend and local clinicians.

Question put and agreed to.