NHS Provision (Brighton and Hove)

Debate between Philip Dunne and Caroline Lucas

Monday 24th October 2016 Commons Chamber

[Caroline Lucas]

I want to put this on record. The Minister referred to the fact that up the road there is a more successful trust. Not only are we operating in a very old building, but we are trying to do that when the hospital is becoming a major trauma centre. That is a massive change in Brighton and Hove. I re-emphasise the points that my honourable colleague, the hon. Member for Hove (Peter Kyle), made. We need real finance and I do not think that the STP is going to do it. It needs some money.

[Mr Dunne]

I thank the hon. Lady for her intervention. I am going to move on, but I acknowledge her point. I hope that, in part, the STP will focus the attention of the wider area to support the new trauma centre that is being established. That is part of the purpose of the STP, although, like her, I have yet to see the full details.

I think we all recognise that patients deserve the highest quality care and we expect the trust to take action to ensure the root causes of the CQC concerns are addressed. NHS Improvement has confirmed that the trust has developed a recovery plan and as part of a package of support for the trust for being in special measures, NHS Improvement has appointed an improvement director and a board adviser.

We should also acknowledge along with the trust’s challenges the fact that there are good things going on in Brighton. We should praise the team that delivers services for children at the Royal Alexandra children’s hospital in Brighton as the CQC rated them as outstanding for being innovative and well led.

Emergency care services at the trust are not as we would expect, as the hon. Member for Brighton, Pavilion identified. With support from the national emergency care improvement programme, a clinically led initiative that offers intensive practical help to trusts looking to improve their emergency services, NHS Improvement is working closely with local clinicians to make a difference for the people of Brighton and Hove seeking emergency care. The trust is also developing plans to create capacity to support delivery of the planned care standards.

As the hon. Lady said, on Monday of last week NHS Improvement announced that the trust has entered financial special measures, a programme launched by the regulator that provides a rapid turnaround package for trusts and foundation trusts that have either not agreed savings targets with local commissioners or planned to make savings but deviated significantly from this plan in their quarterly returns. As part of financial special measures, the trust will agree a recovery plan with NHS Improvement. The trust will also get support from and is held accountable by a financial improvement director.

The hon. Lady also referred to the challenges faced by the ambulance services in her constituency and the area. In addition, South East Coast ambulance service was recommended for special measures by the CQC in its inspection report published last month. NHS Improvement acknowledges that there are wide-ranging problems across the trust, including in governance structures and processes, culture, performance and emerging financial issues. NHS Improvement has agreed a support package for the trust, which was formalised on 9 August this year, and includes a formal peer support relationship with a neighbouring ambulance trust that is rated good by the CQC.

As part of the support package, NHS Improvement has also appointed an interim chair and will appoint an improvement director in due course.

[Mr Dunne]

The hon. Gentleman will recognise that NHS Improvement only came together in April of this year when the two previous regulators, Monitor and the NHS Trust Development Authority, were combined. It is to a degree finding its feet in working out how best to assist trusts that get into difficulty. It has introduced a number of different schemes for different types of challenge, and we have touched on the care challenge and the financial special measures challenge. It is also undertaking a five-point A&E improvement plan to focus particularly on challenges in emergency care. It is fair to say that it is early days in seeing how NHS Improvement undertakes its functions, but we have every confidence that it will be able to assist trusts in dealing with these challenges.

Finally on the South East Coast ambulance service, NHS Improvement is also undertaking a capability and capacity review and will provide the trust with support with its finances. The hon. Lady mentioned the problems with the non-urgent patient transport service provider. This has clearly been a very difficult time for its staff and for some patients, as she has highlighted. My understanding is that the High Weald Lewes Havens CCG has overseen the implementation of plans to ensure continuity of service, and has recently appointed a specialist transport adviser to look into the resilience of the contract and to explore options to strengthen this further.

The provision of the services is, quite rightly, a matter for the local NHS. The hon. Lady asked who is responsible for monitoring contracts. The reality is that the CCG is the statutory NHS body with responsibility for the integrity of the procurement, as well as for managing the contract. It has powers within the standard NHS contract to intervene where a contractor’s performance falls below what is expected.

[Caroline Lucas]

Will the Minister give way?

[Mr Dunne]

I will give way for the last time.

[Caroline Lucas]

The Minister says that the CCG has such a power, but the CCG told me that it could not see the contract between Coperforma and its subcontractors, because that was not for the CCG to see. It therefore cannot have such a degree of oversight.

If this is the last time the Minister gives way, will he say if he will step in on the issue about whether the Docklands phoenix company is properly licensed to provide the service it is providing? Right now, we do not know whether it is, and our patients may be at risk.

--- Later in debate ---

[Mr Dunne]

My hon. Friend makes a very powerful case. As I have already undertaken to do for the hon. Member for Brighton, Pavilion, I will take up the issue with the CQC and ask it to give me some reassurance about both the regulation of the entity and, to the extent that it is relevant to the CQC, the procurement. I accept that we should look at the due diligence for such activities.

I will close, without taking any further interventions, by saying a brief word more, as I promised to earlier, on the sustainability and transformation plans. These were submitted to NHS England by 44 regions across the country during the course and by the end of last week—by last Friday. As I said earlier, the intention is that the plans build on the work already undertaken to strengthen care. They will help deliver the NHS’s own plans for its future, set out in the five-year forward view, by encouraging providers and commissioners within an area to work more collaboratively—without the barriers of stovepiping that in the past have led to conflict between them—and co-operate to try to come up with the best plan for patients; that must take into account the increasing integration with social care providers in the area, which the hon. Member for Brighton, Pavilion has mentioned, so local authorities are also integral to the plans.

[Caroline Lucas]

Will the Minister take one final intervention?

[Mr Dunne]

I am afraid I really do not think that I can.

We expect most areas to undertake public engagement from now until the end of the year, building on the engagement they have already done to shape thinking. But we are clear that we do not expect changes to the services that people currently receive without proper, full local engagement and, where appropriate, public consultation. There are long-standing processes in place to make sure that happens.

[Caroline Lucas]

Will the Minister give way? This is on a serious point.

[Mr Dunne]

I have been very generous and have spoken for substantially longer than I normally would in winding up an Adjournment debate.

In closing, I emphasise that it is the responsibility of local NHS organisations to determine how local services are delivered. They are best placed to understand the needs of the people they serve, and we must ensure that changes are led locally, in some cases with improved local management where there have been management shortcomings. Changes need to be focused on the needs of the local population and not driven by central Government. This Government recognise the importance of ensuring that the NHS is held to the highest standards of care, in the hon. Lady’s constituency and across the UK, and we will continue to work to ensure that services are high-quality, safe, appropriate and affordable.

Question put and agreed to.