Urgent and Emergency Care

Robin Walker Excerpts

Monday 5th September 2022 Commons Chamber

[Steve Barclay]

Let me start with the areas where the hon. Gentleman and I agree. The David Wakeley case was shocking, and we accept that there have been severe pressures, particularly linked to certain trusts; just 10% of trusts account for 45% of ambulance handover delays. His second charge was about what the Government have been doing on this over the summer. We have had a 100-day sprint with NHS colleagues, a taskforce has been set up and I have met those troubled trusts, particularly Cornwall, to look at how we better support them.

Some of the factors affecting ambulance delays are within the trusts’ control. Those include understanding why delayed discharge is much lower at the weekend, and things that they can do within the emergency department. However, as the hon. Gentleman recognised, some factors are beyond the trusts’ control, whether that is variance in performance on conveyancing by ambulance trusts, differences in hear and treat or see and treat, or the challenges in social care. We recognise that, as I said in my opening remarks, the heatwave and a covid infection rate of one in 25, compared with one in 60 now, created significant pressure on the ambulance system.

In addition to the taskforce, we have enacted a whole range of other measures. NHS England has tasked the system with putting in place an additional 7,000-bed capacity for the winter. We have been expanding emergency department capacity. One thing we funded in spending review 2020, when I was in the Treasury, was additional funding for trusts where there are emergency department constraints.

The hon. Gentleman did not mention mental health, but I know he takes an interest in it, so he will be pleased to know that over the summer we have particularly targeted action that can be taken in emergency departments and across the hospital estate in support of mental health, led by Claire Murdoch in NHS England. We have increased staffing by 16% and there is an extra £2.3 billion going into mental health next year compared with 2016. There is additional funding and workforce, because we recognise the pressures.

There is also bespoke action with NHS colleagues. Sometimes, relatively low numbers of patients—for example, patients needing palliative care, patients with dementia and patients with Parkinson’s—are particularly challenging in terms of delayed discharge, and their discharge may be delayed for an extended period of time. Although the quantum of patients may be modest, that leads to delay.

The hon. Gentleman recognised other things we have been doing over the summer, such as the St John Ambulance contract that has been put in place to help with auxiliary ambulances, the work on international recruitment—I do not accept that people are being paid less; that is bringing people in to work in important roles in our care sector—and the consultation on retire and return.

Finally, the hon. Gentleman mentioned the cost of living. He will know that the new Prime Minister has made it clear that she will have further things to say on that over the next week, and I know there will be ample opportunity to debate that further in the House.

[Mr Robin Walker (Worcester) (Con)]

My right hon. Friend knows that Worcestershire is at the sharp end of ambulance pressures; I understand that Worcestershire Acute Hospitals NHS trust is one of six trusts that he has met in recent days to discuss those pressures. Can he assure me that he will do everything he can to reduce delayed discharge and address capacity at our A&E, so that I no longer have to witness situations such as the one I saw earlier this summer, with more than 10 ambulances waiting at the door of the emergency department?

[Steve Barclay]

I know my hon. Friend is a strong champion for this issue; when I was Chief Secretary to the Treasury, I remember him lobbying me about how a bridge from one bit of the hospital estate to another could provide additional capacity to meet the pressures his trust has faced. That is partly why we have been working intensively with the trusts that have the most severe cases of ambulance delays, looking through the work of the taskforce at best practice and what works best in those settings, and ensuring that the trust chief execs have the right level of support. It is important to recognise that the problem does not always manifest where it is caused. Quite often, challenges on the social care side, or further upstream in the conveyancing rate, put pressure on an emergency department and on the trust.