NHS Staff: Pay Offer
Steve Barclay Excerpts(2 years, 10 months ago)
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The Secretary of State for Health and Social Care (Steve Barclay)
I am pleased to be able to inform the House that today 16 March 2023, I have made a formal offer on pay for 2022-23 and 2023-24 to the unions representing staff on the agenda for change contract. The NHS Staff Council has discussed this offer and the Royal College of Nursing, UNISON, GMB, the chartered society of physiotherapy and the British Dietetic Association will recommend the offer to their members in consultations that will be held over the coming weeks. Strike action will continue to be paused while they are consulted.
Under the offer, over 1 million NHS staff on the agenda for change contract would receive two non-consolidated payments for 2022-23. This is on top of an at least £1,400 consolidated pay award that they have already received, which was in line with the recommendations of the independent pay review body.
Under the terms of the offer, all staff would receive an award worth 2% of an individuals’ salary for 2022-23. In addition, staff would receive a one-off bonus which recognises the sustained pressure facing the NHS following the covid-19 pandemic and the extraordinary effort these members of staff have been making to hit backlog recovery targets and meet the Prime Minister’s promise to cut waiting lists. This NHS backlog bonus is an investment worth an additional 4% of the agenda for change pay bill, and would mean staff would receive an additional payment of between £1,250 and £1,600. With both of these payments, a nurse at the top of band 5, for example, would receive over £2,000 in total.
For 2023-24, the Government have offered a 5% consolidated increase in pay. In addition, the lowest paid staff, such as porters and cleaners will see their pay matched to the top of band 2, resulting in a pay increase of 10.4%.
For example, this would mean a newly qualified nurse would get over £1,300, increasing their base salary to £28,407. A nurse at the top of band 6 would receive a pay rise of over £2,000, increasing their base salary to £42,618.
The Government firmly believe that this is a fair offer which rewards all agenda for change staff and commits to a substantial pay rise in 2023-24 at a time when people across the country are facing cost of living pressures and there are multiple demands on the public finances.
Setting pay is an annual process and, as is always the case, decisions are considered in light of the fiscal and economic context and ensuring awards recognise the value of NHS staff whilst delivering value for the taxpayer. While it is right that we reward our hard-working NHS staff with a pay rise, this needs to be proportionate and balanced with the need to deliver NHS services and manage the country’s long term economic health and public sector finances, along with inflationary pressures.
The Government asked the NHS Pay Review Body (NHSPRB) to report by the end of April 2023. We anticipate the progress made and the outcome of the union ballot to be taken into account. If the offer is accepted by unions, it will be implemented, but the Government would welcome observations from the NHSPRB on the pay deal in England.
On top of the pay package, the Government are also committing to important measures including the development of a national, evidence-based policy frame- work which will build on existing safe staffing arrangements and amendments to terms and conditions to support existing NHS staff develop their careers through apprenticeships.
In addition, having heard the concerns of nursing staff and their representatives about the specific challenges they face in terms of recruitment, retention and professional development, the Government have committed to address these issues and will therefore work with NHS employers and unions to improve opportunities for nursing career progression.
The Government are also committed to improving support for newly qualified healthcare registrants. It will commission a review into the support received by those transitioning from training into practice. And the Government will consult on the permanent easement of pension abatement rules.
This package, alongside the comprehensive NHS Long Term Workforce Plan that NHS England will publish later this year, will help to ensure that the NHS can recruit and retain the staff it needs to meet the growing and changing health and wellbeing needs of patients.
Alongside making this formal offer, I have today also written to the Royal College of Nursing to outline that, in undertaking work to address the specific challenges faced by nursing staff—in terms of recruitment, retention and professional development—this work will involve: how to take account of the changing responsibilities of nursing staff; and the design and implementation issues, including scope and legal aspects, of a separate pay spine for nursing staff exclusively.
The Government intend to complete this work such that resulting changes can be delivered within the 2024-25 pay year. In conducting this work, the Government will also consider whether any separate measures may apply to other occupational groups, taking into account the views of NHS Employers and unions.
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Ambulance Services: Consultation on Minimum Service Levels
Steve Barclay Excerpts(2 years, 11 months ago)
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The Secretary of State for Health and Social Care (Steve Barclay)
The Strikes (Minimum Service Levels) Bill requires the Secretary of State to consult with such persons as they consider appropriate prior to making regulations to establish minimum service levels for relevant health services in the event of strike action. The regulations must be approved by both Houses of Parliament before they are made. The consultation requirements may be fulfilled before and after the Bill receives Royal Assent. Minimum service levels will enable employers to issue work notices, ensuring adequate staffing for a minimum level of safety to be achieved in the event of strike action.
Minimum service levels aim to limit the impacts of strike action on the lives and livelihoods of the public and to strike a balance between the right of unions and their members to strike with the need for the wider public to be able to access key services during strikes.
This consultation focuses on minimum service levels for ambulance services, which the Prime Minister has identified as a priority, alongside fire and rescue services and rail services. Our proposal is that ambulance services should be covered in regulations as a priority recognising that disruption to blue light services puts lives at immediate risk. This consultation will help to inform a decision as to whether ambulance services should be covered by the regulations and if so the detail regarding the minimum service levels required in the ambulance service.
The consultation will open today, Thursday 9 February 2023, and will be open for a period of 12 weeks, closing on Thursday 4 May 2023.
Copies of the consultation will be deposited in the Libraries of both Houses.
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Urgent and Emergency Care Recovery Plan
Steve Barclay Excerpts(3 years ago)
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The Secretary of State for Health and Social Care (Steve Barclay)
Today we have published our new delivery plan for recovering urgent and emergency care services, which has been deposited in the Libraries of both Houses. Given the scale of the pandemic pressures that healthcare systems around the world and across the UK are collectively facing, we are building the NHS back to where we want it to be. That requires the widespread adoption of innovation, building on best practice already applied in specific trusts, together with significant investment in new ways of working, including a £14.1 billion funding boost for health and social care, as set out in the autumn statement.
Today’s announcement is the second of three plans to cut waiting times in the NHS. Our elective recovery plan is already in action, virtually eliminating the backlog of two-year waits in England. Our primary care recovery plan will be published in the next few weeks, to support the vital front door to the NHS through primary care. Today, together with NHS England, we are setting out our plans to reduce waiting times in urgent and emergency care through an increased focus on demand management before patients get to hospital, and greater support to enable patients to leave hospital more quickly through care at home or in the community, supported by a clinical safety net. In addition, the plan sets out how we will adopt best practice in hospitals by learning from the trusts that have displayed the greatest resilience in meeting the heightened pressures this winter.
Today’s announcement on urgent and emergency care does not sit in isolation, but is part of a longer-term improvements plan that builds on the legislative change enacted last year to better integrate health and social care through the 42 integrated care boards, which became operational in July. That was prioritised for additional funding through the £14.1 billion announced for health and social care in the autumn statement. Following the quick spike in flu cases over Christmas, with in-patient flu admissions 100 times that of the previous year and a sevenfold increase in December, we announced £250 million of immediate funding on 9 January for the pressures this winter, giving extra capacity to emergency departments to tackle the issue of patients who are fit to leave hospital but are delayed in doing so.
Today’s plan, developed in partnership with NHS England and social care partners, builds on the actions and investment that I set out to the House earlier this month as we put in place the more substantive changes required to enable the NHS to have greater resilience this time next year. To do that, this plan involves embracing technology and new ways of working to transform how patients access care before and after being in hospital. That in turn will help to break the cycle of emergency departments in particular coming under significant strain in winter.
Our plan has a number of commitments that are both ambitious and credible. First, we are committing to year-on-year improvement in A&E waiting times. By next March, we want 76% of patients to be seen within four hours. In the year after that, we will bring waiting times towards pre-pandemic levels. Our second ambition is to improve ambulance response times, with a specific commitment to bring category 2 response times—those emergency calls for heart attacks and strokes—to an average of 30 minutes by next March. Again, in the following year we will work to bring ambulance response times towards pre-pandemic levels. I am pleased that the College of Paramedics has welcomed the plan, saying that it is
“pleased to see a strong focus in the recovery of those people in the Category 2 cohort”.
Of course, this will not be the limit of our ambition, but it is vital that we get these first steps right and that we are credible as well as ambitious. To put these targets in context, achieving both would represent one of the fastest and largest sustained improvements in the history of the NHS.
Underpinning these promises is one more essential commitment: a commitment to better data and greater transparency. On data, the best-performing hospitals have benefited from the introduction of patient flow control centres to quickly identify blockages in a patient’s journey, and e-bed management systems to speed up the availability of beds when they become free. Through this plan, we will prioritise investment in improving system-wide data, both within the integrated care boards and on an individual trust and hospital site basis. This will allow quicker escalation when issues arise and a better system-wide response when individual sites face specific challenges.
On greater transparency, for some time voices across the NHS have called for the number of 12-hour waits from the time of arrival in A&E to be published. This is something I know the Royal College of Emergency Medicine has long campaigned for—I can see the hon. Member for St Albans (Daisy Cooper) nodding her head—and there has been criticism of the Government, including from Opposition Members, for refusing to provide this transparency. Instead, the data published to date has been a measure of 12 hours from the point of admission rather than from arrival in A&E. For the commitment to transparency to be meaningful, we must be prepared to publish data, even when that transparency will bring challenges, so today I can inform the House that from April we will publish the number of 12-hour waits from the time of arrival. Dr Adrian Boyle, the president of the Royal College of Emergency Medicine, has previously said:
“The full publication of this data will be an immensely positive step that could be the catalyst for transformation of the urgent and emergency care pathway that should help to improve the quality of care for patients.”
I hope this transparency will be welcomed across the House.
Our plan focuses on five areas, setting out steps to increase capacity in urgent and emergency care; grow the workforce; speed up discharge; expand and better join up new services in the community; and make it easier for people to access the right care. Action in each area is based on evidence and experience, learning lessons from the pandemic and building on what we know can work. More than that, we are backing our plan with the funds we need, and the Government are committing to additional targeted funding to boost capacity in acute services and the wider system. That is why this package includes £1 billion of dedicated funding to support hospital capacity, building on the £500 million we have provided over this winter to support local areas to increase their overall health and social care capacity.
Taken together, this plan will cut urgent and emergency care waiting times by, first, increasing capacity with 800 new ambulances on the road, of which 100 are new specialised mental health ambulances. This comes together with funding to support 5,000 new hospital beds, as part of the permanent bed base for next winter.
Secondly, we are growing and supporting the workforce. We are on track to deliver on our manifesto commitment to recruit more than 50,000 nurses, with more than 30,000 recruited since 2019. The NHS will publish its long-term workforce plan this year. We are also boosting capacity and staff in social care, supported by investment of up to £2.8 billion next year and £4.7 billion in the year after.
Thirdly, we are speeding up the discharge of patients who are ready to leave hospital, including by freeing up more beds with the full roll-out of integrated care transfer hubs, such as the successful approach I saw this morning at the University Hospital of North Tees.
Fourthly, we are expanding and better connecting new services in the community, such as joined-up care for the frail elderly. This includes a new falls service, so that more elderly people can be treated without needing admission to hospital.
Virtual wards are also showing the way forward for hospital care at home, with a growing evidence base showing that virtual wards are a safe and efficient alternative to being in hospital. We aim to have up to 50,000 people a month being supported away from hospital, in high-tech virtual wards of the sort that Watford General Hospital has been pioneering, as I saw last month.
Finally, we are improving patient experience by making it easier to access the right care, including a better experience with NHS 111 and better advice at the front door of A&E, so that patients are triaged to the right point in the hospital without always needing to go through the emergency department—this new approach can currently be seen at Maidstone Hospital, as I saw earlier this month.
These are just some of the practical improvements already being delivered in a small number of trusts that, through this plan, we will adopt more widely across the NHS and, in doing so, deliver greater resilience ahead of next winter.
I am pleased that NHS Providers has welcomed today’s plan, and that the Royal College of Emergency Medicine has called it
“a welcome and significant step on the road to recovery”.
Taken together with all the other vital work happening across health and care, including our plan to cut elective and primary care waiting times, today’s plan will enable better care in the community and at home, for that care to be more integrated with hospital services and for existing practice to be more widely adopted. I commend this statement to the House.
Wes Streeting (Ilford North) (Lab)
I thank the Secretary of State for advance sight of his statement.
After 13 years of Conservative mismanagement, patients are waiting longer than ever before. Heart attack and stroke victims are waiting more than an hour and a half for an ambulance. Mr Speaker, “24 Hours in A&E” is not just a TV programme; it is the grim reality for far too many patients. Some 7.2 million people are waiting for NHS treatment. Why? The front door is broken—people are finding it impossible to get a GP appointment—so they end up in A&E. At the same time, the exit door is broken because care in the community is not available. Patients are trapped in hospitals, sometimes for months. Between the two is a workforce who are overstretched, burnt out, ignored by Government Ministers and forced out on strike.
Does this plan even attempt to get patients a GP appointment sooner? No. Does this plan restore district nursing so that patients can be cared for in the comfort of their own home? No. Does this plan see Ministers swallowing their pride and entering negotiations with nurses and paramedics? No. And does this plan expand the number of doctors and nurses needed to treat patients on time again? No.
The Health Secretary said a lot of things, but he did not say when patients can expect to see a return to safe waiting times. His colleague the Minister for Social Care, the hon. Member for Faversham and Mid Kent (Helen Whately), rather let the cat out of the bag this morning. She was asked, “Is there any plan at all for when we will get back to 95% of patients in A&E being seen within four hours?” Her answer—and I am not joking—was, “I can’t tell you that.” How can the Secretary of State claim that his plan is ambitious and credible? What kind of emergency care plan does not even attempt to return waiting times to safe levels? It is a plan that is setting the NHS up to fail right from the start—a plan for managed decline.
These targets are not plucked out of thin air; patients waiting more than five hours in A&E are more likely to lose their lives, and so are heart attack and stroke victims waiting more than 18 minutes for an ambulance. Sadly, that is exactly what has happened this winter, it is what happened this summer and it has been going on since before the pandemic began. The four-hour A&E waiting time target has not been met since 2015. The only time the Conservatives have met the 18-minute target for ambulance response times was during lockdown. What is the Secretary of State’s ambition now? It is 30 minutes —30 minutes waiting for a heart attack or stroke victim to receive an ambulance, when every second counts. Is not the truth that the Government missed the targets, so they are moving the goalposts? They are fiddling the figures, rather than fixing the crisis.
The Secretary of State boasts that he is pouring more money in—£14 billion, which is almost as much as his Department has wasted on dodgy, unusable personal protective equipment—yet standards are being watered down. So can he explain why patients are paying more in tax but waiting longer for care? Why is it that under the Conservatives we are always paying more but getting less? So what is their answer? It is:
“There are so many people in hospital who wouldn’t need to be there if we could provide quality care at home… medical science and technology…offers a world of possibility for the NHS to transform patient care… Virtual wards allow people to receive hospital care at home.”
Those are not his words—that is my party conference speech! He did not have a plan for the NHS so he is nicking Labour’s.
I am happy for the Secretary of State to adopt Labour’s plans, but here is what he missed: you cannot provide good care in the community, in people’s homes or in hospital without the staff to care for people. That is the supermassive blackhole in his plan published today: people. Virtual wards without any staff is not hospital at home; it is home alone. So where is his plan to restore care in the community? Labour will double the number of district nurses qualifying every year, so can he hurry up and nick that plan too?
Of course, good care in the community is not a substitute for good care in hospital—we need both, now. So why, in the middle of the biggest crisis in the history of the NHS, with hospitals so obviously short of staff, is the universities Minister writing to medical schools to tell them not to train any more doctors? This is ludicrous. Labour will double the number of medical school places and create 10,000 new nursing and midwifery clinical placements, all paid for by abolishing the non-dom tax status. I know that the Prime Minister might not like that last bit—[Interruption.] Government Members are all complaining, but they did not complain when they put up income tax. The Prime Minister does not like it, but perhaps this would be a good time for the Conservatives to act tough on tax dodgers. So when is the Secretary of State going to nick that plan?
And when is the Secretary of State finally going to get his act together and end the strikes in the NHS? Perhaps I am speaking to the monkey when the Chancellor is the organ grinder. If that is the case, when will we get a chance to question the real Health Secretary on the strikes that this one is causing in the NHS? Labour will create more front doors to the NHS and we will tackle the crisis in social care. The Secretary of State offers sticking plasters and by now it is very clear: only Labour can offer patients the fresh start the NHS needs.
Steve Barclay
The hon. Gentleman started by thanking me for advance sight of the statement, and then he made a series of remarks that simply ignored what was in it. Even his last point shows how riddled with contradictions the Opposition’s approach is. He says in interviews that he supports the pay review body process—that is the official position, or at least it was—but then he says, “No, we should be negotiating individually with the trade unions and disregarding the pay review process.” There is no consistency on that at all.
The shadow Secretary of State talks about operational performance—[Interruption.] He has just had his go; he should listen to the answers. He says that it is about operational performance, but in my remarks I tried to be fair and said that these are challenges that are shared across the United Kingdom and globally. He seems to think that they are unique to England alone. We need only look at Wales to see that more than 50,000 people—notwithstanding the fact that Wales has a smaller population—are waiting more than two years for their operations, when we cleared that figure in the summer in England, leaving fewer than 2,000 in that cohort.
The shadow Secretary of State talks about the workforce. Obviously, he did not bother to read or listen to what was said in the statement. We are on track to deliver our manifesto commitment of more than 50,000 nurses. We have more than 30,000 so far. We have 10,500 more nurses in the NHS this year compared with last year. The grown-up position is to recognise—[Interruption.] Well, in the first five years we were dealing with what that letter said, which was that there was no money left. [Interruption.] Labour Members just do not like the response, but the facts speak for themselves. We have 10,500 more nurses this year than last year. The grown-up position, as I was saying, is to recognise that we have an older population with more complex needs, and that the consequences of the pandemic are severe—they are severe not only in England, but across the United Kingdom, in Wales and Scotland, and indeed in countries around the globe.
The shadow Secretary of State says that the statement did not cover the plan for GPs. Well, again, I was clear that this was one of three plans. We had the elective plan in the summer, which hit its first milestone. We have the second component today on urgent and emergency care, and we will set out in the coming weeks our approach to primary care. That is the approach that we are taking. [Interruption.] The shadow Secretary of State keeps chuntering. We did not have the pandemic 13 years ago. [Interruption.] I can only surmise that he did not get his remarks quite right the first time, which is why he feels the need to keep chuntering now and having a second, third and fourth go—perhaps next time.
On ambition, the shadow Secretary of State ignores the fact that we need to balance being ambitious with being realistic. These metrics, in the view of NHS England, show the fastest sustained improvement in NHS history. Clearly, his remarks are at odds with NHS England.
On funding, we are putting an extra £14.1 billion of funding into health and social care over the next two years, which reflects the fact that the Chancellor, notwithstanding the many competing pressures he faced at the autumn statement, put health and social care, alongside education, as the key areas to be prioritised.
On virtual wards, I had not quite realised that the shadow Secretary of State was the clinician who had invented virtual wards. I think that the credit for virtual wards actually goes to the staff, such as those I met at Watford, who are driving forward that innovation. It is slightly strange that he sometimes wants to claim ownership of something that has been clinically led by those working on the frontline. We have recognised the value of virtual wards, which is why, at North Tees this morning, at Watford last month, or on various other visits, I have been discussing how to scale up those plans.
Steve Barclay
The funding to put that in place has been earmarked from the £2.8 billion next year. The key thing is less to do with the funding than the accuracy of the data, which will help us to see where there are gaps in coverage and how we get the right levels of community response. The integrated care boards have been set up to take an integrated approach on that. One of the best enablers will be the control centres that the ICBs will set up, which will allow us to get much greater visibility on where that has been delivered and how we escalate it when it has not.
Rachael Maskell (York Central) (Lab/Co-op)
The 300,000 vacancies in health and social care mean that, whatever the Secretary of State puts on the table, his plans will never be delivered. What is he doing to retain the burned-out, traumatised staff who currently work in the NHS, to resolve their pay dispute and to put enough money on the table to pay social care staff enough to come and work in the service?
Steve Barclay
We recognise the huge pressure on social care; that is why, at the autumn statement, the Chancellor set out the biggest-ever increase in funding into social care of any Government, £7.5 billion over two years. We are putting more funding in. On the workforce more generally, the Prime Minister and Chancellor have committed themselves to bringing forward the workforce plan, which will set out the longer-term ambition on workforce and will be independently verified. In addition, we are recruiting more staff, as I updated the House, whether that is the 3% more doctors this year than last year, the 3% increase in nurses, or the 40% more paramedics and 50% more consultants compared with 2010. We are recruiting more staff, but the grown-up position is to recognise that there is also more demand.
Sajid Javid (Bromsgrove) (Con)
I warmly welcome the plans set out by my right hon. Friend today, but he will know that one reason emergency care faces so much pressure is that successive Governments have not focused enough on the prevention agenda. Indeed, last week’s news that the Government will not go ahead with individual focused plans on cancer, dementia and mental health has concerned many. Can he assure this House that the Government’s new major conditions strategy will be published promptly and will be comprehensive and significant?
Steve Barclay
I am happy to give my right hon. Friend that assurance. I assure the House that our commitment to the cancer mission and the dementia mission through the Office for Life Sciences is absolutely there. He is right that we are bringing that together in one paper—I think we should take a holistic approach—but I share his ambition on prevention. In early January, I set out a three-phased approach: first, the £250 million immediate response to the pressures we saw from the flu spike over Christmas; secondly, as I announced today, building greater resilience into the system looking ahead to next winter; and thirdly, the major conditions paper on prevention, which is about bringing forward the innovative work that colleagues are doing through the Office for Life Sciences to impact the NHS frontline much sooner than might otherwise have been the case.
Barbara Keeley (Worsley and Eccles South) (Lab)
I want to raise the case of a constituent who described to me the state of Salford Royal’s A&E earlier in January, saying:
“My partner was taken by ambulance yesterday at about 11am. He has a severe chest infection and breathing problems. He was left sitting in a chair on oxygen until 10pm when a trolley was found for him to sleep on. There are no beds available.”
My constituent said that patients and staff
“feel that no one cares”.
After such a long wait, my constituent’s partner was found to have pneumonia and he has been very poorly. Now the Secretary of State is talking about a target of 76% of A&E patients being seen within four hours by next March. Will he tell me and my constituent why he thinks it is acceptable for patients to wait longer than is safe?
Steve Barclay
We are bringing times down; I think the current mean response for C2s is much more in the region of 25 or 26 minutes than it was in late December-early January, because across the UK there was a massive spike in flu. The hon. Lady will have seen exactly the same in the Labour-run NHS in Wales. Over December there was a 20% increase in 999 calls, for example. That is why we need to put in place greater resilience, as the plan I have set out to the House does.
John Redwood (Wokingham) (Con)
I strongly support the £1 billion for 5,000 additional beds and 800 more ambulances. I have long argued that, with a growing population and a growing elderly population, we need more capacity. Is it also possible to take some of the £14 billion of additional money to provide even more capacity? I think we are going to need it.
Steve Barclay
Within my right hon. Friend’s question is, I think, how we get more flow into hospital: once bed occupancy goes above a certain threshold, lack of flow is the key interaction that drives inefficiency within hospitals. That is why we are putting in the extra capacity. It is also a question of reducing the numbers going to hospital in the first place and speeding up the discharge of those who are fit to leave. Whereas at the moment someone might sit on a ward for three days because they have to have antibiotics every day, if one continuous dose of antibiotics can be administered through new kit at home, not only is that a much better patient experience but it relieves pressure on the wards.
Daisy Cooper (St Albans) (LD)
I welcome the additional transparency on data for 12-hour wait times, because it is only by shining a light on the problem that we can see just how bad it is, but the targets set out in the plan today are utterly woeful. The Royal College of Emergency Medicine says that we need 13,000 beds; the Government are offering 5,000. The percentage of patients who are seen within four hours should be 95%; the Government are aiming for 76%. Heart-attack and stroke victims should be seen within 18 minutes; the Government are aiming for only 30 minutes. Surely the truth is that this woeful lack of ambition means that our emergency care services are themselves on life support and that patients will continue to die needlessly for a very long time to come.
Steve Barclay
First, I thank the hon. Lady for recognising the steps that we have taken on transparency. That has been an area of challenge and it is part of my wider commitment to transparency.
The ambition of the targets has to be realistic, and targets are not a ceiling but a floor. It is about saying, “How do we set a target that is realistic?” Of course, we will aim to do better than that, but it is about setting something that the system feels is achievable, because that in turn gets much more buy-in.
On beds, we are increasing capacity, as my right hon. Friend the Member for Wokingham (John Redwood) alluded to. What it is really about is freeing up patients who are fit for discharge from hospital, who should not be there and would actually prefer to be getting care at home. It is about looking at the end-to-end bed capacity, not simply at beds within the acute sites.
Dame Maria Miller (Basingstoke) (Con)
I welcome my right hon. Friend’s statement. In the pandemic, the use of local private hospitals by the NHS, particularly in places such as Basingstoke, kept services such as cancer care going uninterrupted. Could the NHS be using more private facilities more widely to relieve some of the pressures that he so eloquently outlined in his statement?
Steve Barclay
My right hon. Friend makes an important point. Again, within that is patient choice and how we empower more patient choice—providing services that are free at the point of use—to use what capacity there is within the system, including in the independent sector. I absolutely agree that we should be maximising capacity. At Downing Street with the Prime Minister, we had a very useful roundtable with the independent sector about how we can make more use of its capacity. That is certainly an area that we are exploring.
Derek Twigg (Halton) (Lab)
I saw for myself only a few weeks ago the real crisis in our hospitals when I accompanied a close relative to Whiston Hospital, where I saw every single space in the corridors taken up by a bed, a trolley or a chair. Quite frankly, what the staff—doctors, nurses and support staff—were doing was amazing, and they deserve all our praise for the hard work that they are putting in. The Secretary of State’s lauding of the fact that two-year waits have virtually been eliminated is bizarre: when Labour left office, waits were somewhat less, with an 18-week target and many people being seen within weeks, not months. The Secretary of State said that the Government are on track to recruit 15,000 new nurses, but how many have left the NHS in the last two years?
Steve Barclay
First, the hon. Gentleman is right to recognise the work that the staff have been doing. He mentioned a family member; when I made a statement earlier in January, I recognised that there has been huge pressure on the system. We saw the flu numbers and the spike in cases. On the two-year waits, the point is simply that there has been pressure on services—the pandemic impacts—across the United Kingdom, but the two-year wait is far worse in Wales, whereas we have cleared it in England. On recruitment and retention, we are bringing forward the workforce plan. The fact is that we are recruiting more nurses, but it is about meeting demand pressure as well.
Simon Jupp (East Devon) (Con)
There is no doubt that the 5,000 extra beds will help the NHS to provide the best possible patient care. Community hospitals across East Devon and NHS Nightingale Hospital Exeter can play their part, too. Does my right hon. Friend agree that community hospitals can play a key role in helping to cut waiting lists?
Steve Barclay
Community hospitals are key to tackling the issue of delayed discharge. Community settings have been a bit of a Cinderella in the past. The data on community settings tends to be weaker than it is in other parts of the NHS. Alongside domiciliary care and making better use of residential care capacity, the third element for discharge is to look at how we use community step-down in a much more constructive way. One key issue there is to have wraparound services so that people do not simply get transferred to a community setting, but that it is a staging post before getting to the home, which is where most patients want to be.
Jeremy Corbyn (Islington North) (Ind)
The social care sector is dominated by dedicated staff who are paid low wages. High profits are made from it and there is an insufficiency of spaces. Will the money that the Secretary of State has announced go to local authorities? Can it be spent on public provision? Does he not think it is time to recognise that the internal market and privatisation have sucked money out of health and social care—money that could have been spent on patient care and caring for people in the community and in special facilities?
Steve Barclay
One area of the right hon. Gentleman’s question where I do agree with him is the importance of local authorities. One reason I am keen to see more clarity on data and transparency is that there can sometimes be a tendency for the local authorities to be blamed for discharge, when often it is factors within the NHS that contribute to some of those who are fit to leave hospital not doing so. On the money allocation, the £2.8 billion is targeted to local authorities—funding set out by the Chancellor—with £4.7 billion the following year. We are increasing the money for local authorities, but alongside that we are working with them to improve the data so that we can see where there are blockages due to local authorities. For example—Mr Speaker will be familiar with this—Blackpool often has visitors from out of the area, so the NHS there deals with a number of local authorities, not simply the nearest one. We are working intently on how we support local authorities as part of the wider discharge package.
Sir David Evennett (Bexleyheath and Crayford) (Con)
I welcome my right hon. Friend’s statement and commend his approach to this difficult problem that he faces and we as a nation face. Does he agree that while speeding up discharge from hospital and freeing up beds for patients needing urgent and emergency care is absolutely necessary, there is a real need for the expansion of new services in the community, which must be a top priority? In my area, one of the biggest reasons for bed blocking in hospitals is that there is no community service to pick up when people go home.
Steve Barclay
My right hon. Friend hits the nail on the head. He is right: it is about how we better manage demand in the community before people get to the emergency department. That is where, for example, action targeted at the frail elderly is so important. It is also about how we enable people to discharge sooner, where they are fit to do so, so that they can recover, whether in a community setting or, ideally, at home, with the right wraparound support.
Karin Smyth (Bristol South) (Lab)
The people of Bristol South will be ever so grateful to have data that they are waiting 12 hours, rather than perhaps ringing me up to tell me they have been waiting 12 hours. The Secretary of State is a Treasury man, so he must know we are now paying more for less. In the interest of transparency, can he be assured that in his own ICB, demand and capacity are matched, and will he know that? How will I know that demand and capacity are matched in my own ICB?
Steve Barclay
I think the hon. Lady was welcoming the transparency on 12 hours—I certainly hope so. The ICBs became operational in July, and we are working with them as to how, by taking a system-wide view, they can baseline the gaps in data, and one key area of that is on the community side. When she talks about matching capacity, part of that is about understanding virtual ward capacity, what conditions that applies to, what the physio wraparound services are, what is available within residential care versus community care and other domiciliary care packages, as the right hon. Member for Islington North (Jeremy Corbyn) touched on in terms of local authorities. We need to look at the data package across the piece on a system-wide basis. That is why we are setting up control centres. I am keen to make that much more transparent, because to be blunt, as a Secretary of State, I get the transparency anyway when things go wrong. Like the hon. Lady, I would rather have much more transparent data so that ICBs themselves can be better held to account, and indeed that is what the Hewitt review is looking at in terms of that wider transparency piece.
Theresa Villiers (Chipping Barnet) (Con)
I welcome the fact that Barnet Hospital’s emergency department will be expanding and improving its facilities and taking on new staff, and of course I welcome today’s announcement, but I urge the Secretary of State to ensure that it is effective on the ground soon, because there is a real crisis out there. This is a good announcement, but it must be delivered so that patients and staff feel it on the frontline as soon as possible.
Steve Barclay
I could not agree more, which is why this morning the Prime Minister and I were at University Hospital of North Tees, where it is effective on the ground. It is about looking at hospitals where such measures have been effective and are having an effect on the ground, such as in North Tees and at Maidstone Hospital, and how we take best practice from them. We then have to do what has sometimes been more difficult in the NHS, which is to scale those innovations and get them adopted across the piece.
Valerie Vaz (Walsall South) (Lab)
There are 165,000 vacancies in social care and there was nothing in the statement about how the Secretary of State will address them. Will he do that through better terms and conditions?
Steve Barclay
We are dealing with that through additional funding—the £500 million for this winter. That relates to the point made by my right hon. Friend the Member for Chipping Barnet (Theresa Villiers) about the impact on the ground, which will be to give ICBs and local authorities discretion. Some of that £500 million is being spent on the workforce, including in social care, so there is discretion as to how they spend that. There is also the £2.8 billion of local authority and ICB funding that will be in place next year, and £4.7 billion the following year.
Kevin Foster (Torbay) (Con)
The Secretary of State will be aware of Torbay’s demographics, particularly the growth in the number of people aged over 85. They are living a good long time but, at that age, they need some level of support from the NHS, which obviously creates demand and puts pressure on our systems. On the resources announced today, what engagement is he planning to have with local ICBs, particularly those that cover areas where the demographics mean that they are at the leading edge and driving innovation, but need support to do so?
Steve Barclay
My hon. Friend makes an important and nuanced point about demographic pressure, which is not evenly spread and is more concentrated in certain parts of the country than others, so the pressure on ICBs is greater in those areas. That is why the ministerial team met almost all the ICBs in a series of meetings with chairs and chief execs in the run-up to Christmas, and it is why we want to bring greater transparency, so that we can right-size solutions for emergency departments and ensure that those facilities keep pace with the increased demand.
Janet Daby (Lewisham East) (Lab)
Last night, my constituent’s 11-month-old son had to wait in A&E for eight hours, which my constituent found extremely unacceptable. The waiting experience in our hospital is like being in a “disaster zone”, in the words of my constituent, who went on to explain about parents having to sit on floors and wait for hours for their children to be seen by a doctor. I press the Secretary of State on whether there is a plan to return to the standard of 95% of patients who come to A&E being seen within four hours.
Steve Barclay
As I said, we are not setting out that ambition in this statement, because the impact of the pandemic has been so severe. We need to set a target that is ambitious but achievable, which is what we have done. The president of the Royal College of Emergency Medicine said:
“This plan is a welcome and significant step on the road to recovery and we are pleased to see it released.”
It is about taking best practice from the areas that are working and ensuring that they are socialised across the piece. It is obviously concerning to hear about individual cases, such as the specific one that the hon. Lady mentioned, which are very traumatic for the families. That is why we have set out this plan and why we are putting in the extra funding.
Sir Julian Lewis (New Forest East) (Con)
From 2005 to 2006, there was a campaign within the NHS to close many in-patient beds in community hospitals. I was pleased by what the Secretary of State said earlier about beds in community hospitals having a role to play. In that connection, will he reconsider the future of the site of Fenwick Hospital in Lyndhurst in my constituency, where the in-patient beds were closed? The NHS is now proposing to sell it off, but I would have thought that, with a bit of imagination, such a site could increase capacity.
Steve Barclay
We are encouraging integrated care boards to take ownership of individual decisions, rather than trying to make all the decisions centrally from Westminster, so that those closer to the ground and to the issues are in power to make the trade-offs. I am sure my right hon. Friend will want to have those discussions with the chair and chief executive of his ICB. There is a wider issue of how we make greater use of community sites, not least given the workforce pressures and different staffing ratios that they have, and that is absolutely the way we help to get more people out of hospital who are fit to leave.
Luke Pollard (Plymouth, Sutton and Devonport) (Lab/Co-op)
Ten days ago, I shadowed one of the brilliant emergency department consultants at Derriford Hospital. They are working their socks off under some very difficult conditions. The additional capacity for beds is welcome, especially because of the structural under-funding and lack of beds in the south-west, but doctors and nurses were saying that they want to slow the flow of people getting to the emergency department in the first place.
Can the Minister look again at the mothballed Cavell Centre programme—the super health hub programme—which would have done so much to slow the flow and deal with collapsing primary care services? In particular, can he look again at the Government’s decision to withdraw £41 million from the super health hub in Plymouth, which would have been the national pioneer, would have shown that this project works and could help our hospitals to deal with the crisis they are facing?
Steve Barclay
The hon. Gentleman asks how we slow the flow of people going to emergency departments and how we accelerate their discharge once they are fit. The substance of the point he raises is valid and absolutely right. It is why there are schemes such as the community response service and the falls service. We are looking at the likes of the North Tees model and getting more staff into community support, thereby integrating the health and social care side. As I said to my right hon. Friend the Member for New Forest East (Sir Julian Lewis) a moment ago, the trade-offs for individual sites are best determined by ICBs. I am very happy to look with ministerial colleagues at any specific proposals, but it is really for the ICBs to be looking at how to best use their estate.
Greg Smith (Buckingham) (Con)
I warmly welcome my right hon. Friend’s clear and credible plan, but on the uplift of 800 ambulances, which is good news, I urge him when it comes to their deployment to look at rural areas first. In these areas, ambulances by definition spend much longer per patient on the road going in between much more diversely spread out hospitals.
Steve Barclay
I recognise my hon. Friend’s point, not least as a rural constituency MP myself. I have talked to paramedics, as I am sure he has, and the principal cause of frustration of late has not been the issue of pay—important though that is. It has been frustration over long handover times, which has had a particularly damaging impact. I am happy to look at any specific issues in his area but he is right on the wider point about the pressures in rural areas.
Mike Amesbury (Weaver Vale) (Lab)
When can the people of Warrington, and indeed Halton, expect to hear about the new hospital campuses, which are much needed by both communities—with sufficient staff to resource them?
Steve Barclay
This statement is focused on urgent and emergency care. At Health oral questions and on other occasions, we often discuss the wider capital programme and the increased funding we are putting into that programme. Part of that is about outcomes and how we get more from that investment in capital. That is why through the NHS estate we are starting to standardise our builds, starting with the Hospital 2.0 programme. We will be rolling that out more widely through the estate. I am not familiar with the specific issues at the hon. Member’s local site, but I am happy to look at them after the statement.
Maggie Throup (Erewash) (Con)
I welcome this recovery plan and my right hon. Friend’s comments on the role community hospitals have to play in future. The 16-bed Hopewell ward at Ilkeston Community Hospital was re-opened ahead of this season to ease pressures, but it is due to be decommissioned in the spring. To aid with more efficient planning, will he work with my local community health trust and ICB to ensure that these beds form part of the extra beds for next winter and, more importantly, become permanent—rather than this ad hoc approach we have had until now?
Steve Barclay
Again, decisions on the estate are principally for the ICBs, but I am happy to look at any individual proposals my hon. Friend has on how we get more flow into the system, and that is about putting more capacity into the community.
Kerry McCarthy (Bristol East) (Lab)
I think I welcome what has been said about mental health ambulances and trying to divert people in mental health crisis from A&E, but I am a little concerned about whether those attending the scene in those ambulances will have access to the past records of people in that situation or be able to carry out a proper risk assessment for them. Will the Secretary of State reassure me on that, and also on whether there will be places other than A&E to take them to? It is one thing to say that we want to divert them, but we need to have other resources in place.
Steve Barclay
The hon. Lady raises a fair and important point about what is in the wider package, alongside the mental health ambulances, which I think are a positive step. Last week, I met Baroness Buscombe as part of the pre-legislative scrutiny of the proposed mental health legislation, which will pick up some of the points that the hon. Lady raises. Examples of innovation include empowering people before they have a mental health crisis to use one of the apps that have been developed to set out their statement of wishes and other information, which is very helpful for paramedic crews when they have a mental health crisis. We are looking at how we use innovation to better give voice to the patient, and often to do that before they have the mental health incident, rather than when the ambulance arrives.
Tom Hunt (Ipswich) (Con)
I welcome the announcement today; I think the key thing is that it makes a difference in the short term. The Secretary of State will be aware of plans to build a new A&E department at Ipswich Hospital. The plan is for it to open in January 2024. What assessment has been made of the difference that that could make in the medium to long term by increasing capacity and improving waiting times? Will he also be prepared to work with me and the hospital’s trust to potentially expedite the plan, so that it might even happen slightly before January 2024?
Steve Barclay
In a former role, when I was Chief Secretary to the Treasury, I signed off a significant expansion of A&E facilities. I hope that reassures my hon. Friend of my commitment to putting more capacity into emergency departments, not least because they need a certain level of capacity to be able to ensure same-day access, triage and ways of getting flow into the system. As for the wider site proposal, clearly the ICB for his area will want to prioritise that.
Helen Morgan (North Shropshire) (LD)
The urgent care and ambulance crisis has been brewing since autumn 2021 in Shropshire, and it has worsened since. Last week, a doctor went on the record to say that the emergency department was “like a war zone” and expressed her fear that, in a fire, not everyone would get out alive. In a six-week period to 12 January, the category 2 response time in the Oswestry area was two hours and 10 minutes. Will the Secretary of State acknowledge that in some areas the crisis is worse than in others? Will he agree to meet me and the other MPs representing Shropshire to discuss how we progress Shropshire further along this track to solve the urgent care crisis that is so serious there?
Steve Barclay
I am very happy to meet with the hon. Lady and colleagues to discuss this further. I think most people recognise that, since the huge pressures from flu over the Christmas period, the flu numbers have come down, but of course there is continued pressure in the system.
Sir Robert Buckland (South Swindon) (Con)
I welcome my right hon. Friend’s statement. In particular, I welcome the announcement today of over £26 million of funding to expand the emergency department at Great Western Hospital in Swindon. He knows from his previous incarnation that we have worked together on this issue. It is particularly important, not just for the integration of emergency services, but for the freeing up of other space in the hospital to allow for further beds or other clinical interventions. Does he agree that it is this sort of long-term measure that will guarantee progress in our much pressed national health service?
Steve Barclay
My right hon. and learned Friend has been key to securing the funding. He has assiduously lobbied me and ministerial colleagues to make a powerful case on behalf of his constituents, and I think he should be proud of the outcome, which reflects his and his parliamentary colleagues’ work on this issue. He is right; indeed, the case he made was around how this frees up capacity in the system, which will result in much better care for patients in Swindon.
Tim Farron (Westmorland and Lonsdale) (LD)
There is nothing in this plan to address the fact that thousands of people are now turning up at A&E as a direct result of being unable to get regular access to an NHS dentist. Last week, another Cumbrian dental practice, in Grange-over-Sands, wrote to all of its 5,800 patients, as it had been forced to quit the NHS too. There is now not a single NHS dental place available anywhere in Cumbria. What will the Secretary of State do to fix an NHS dentistry crisis that leaves a family of four having to cough up an extra £1,000 a year during a cost of living crisis to get access to dental care that they have already paid for through their taxes?
Steve Barclay
I have addressed that point, in that we are bringing forward the third component of our three plans. I spoke earlier about the elective recovery plan; today’s announcement is on the urgent and emergency care recovery plan; and the third element will be the primary care recovery plan. Of course, alongside the work we are doing on dentistry it is also about access to services, both dentistry and A&E. That comes together in things such as the 111 service and how we review that, as well as the NHS app. It is about looking at how we better manage demand at the front door, and the demand for dentistry is not only through NHS dentistry but often manifests itself through a lot of patients coming forward for dentistry at A&E.
Anna Firth (Southend West) (Con)
I warmly welcome my right hon. Friend’s plan, particularly his focus on increasing capacity in urgent and emergency departments. I welcome the Government’s recent investment of £8 million to reconfigure the A&E at my local hospital in Southend. Does my right hon. Friend agree that this will increase not just the capacity but the quality of the urgent and emergency care on offer in Southend?
Steve Barclay
I commend my hon. Friend for her assiduous campaigning on behalf of her constituents in Southend, through which she played a key role in securing the extra £8 million of funding. She is right that that will make a material difference not only to flow and capacity within the hospital but through that to the overall standard of patient care.
Jim Shannon (Strangford) (DUP)
I thank the Secretary of State for his clear commitment to extra funding for the urgent and emergency care recovery plan. Will he outline whether he is prepared to make additional funding available to meet the needs on maternity wards, which midwives feel are teetering on the brink? In reality, that means it is an issue of life and death, due to staffing levels. Will the Secretary of State ensure that additional funding makes its way to each devolved nation under the Barnett consequentials, to be used before the scheduled new financial year ends?
Steve Barclay
As the hon. Gentleman will know, the additional funding that the Chancellor announced in the autumn statement will lead to an uplift in health funding for Northern Ireland through the Barnett consequentials. On the flexibility within that, the hon. Gentleman will know that I agreed flexibility when I was Chief Secretary; it will of course be for Treasury colleagues to look at the requirements for ongoing flexibility within Barnett consequentials.
Stephen Hammond (Wimbledon) (Con)
I warmly welcome what my right hon. Friend has said. He is right to recognise that one of the long-term impediments to discharge is the disconnect between the NHS and social care and local authorities. Will he confirm that, to ensure that the additional money is well spent, the integrated care boards will be not only responsible for the establishment of the hubs and extra care packages but properly monitored and held responsible for their performance and for generating value for the extra money that is being put in?
Steve Barclay
As a former Minister in the Department, my hon. Friend speaks with great experience on these matters. He is right that the crux of the plan is now in its delivery. As I alluded to in my statement, a key component of that is more transparency in the data so that he and colleagues throughout the House can hold to account not only the ICBs but the local authorities. We need to bring those two datasets more closely into alignment.
Selaine Saxby (North Devon) (Con)
I warmly welcome today’s announcement, but will my right hon. Friend explain how for remote rural hospitals, such as the fantastic North Devon District Hospital, the workforce challenges that were present pre-pandemic might be addressed post pandemic, when we are now also dealing with a housing crisis? Might there be an opportunity to expedite the next phase of the redevelopment programme, which includes key worker housing?
Steve Barclay
I am keen to explore with colleagues how we can put more key worker accommodation on to the NHS estate, particularly by making use of modern methods of construction to expedite that. On the workforce plan, Devon is an area that has seen particular growth, given its older population, and greater pressure as a consequence. Those pressures will be worked through in the workforce plan that we will bring forward shortly.
Several hon. Members rose—
Mr Tobias Ellwood (Bournemouth East) (Con)
I welcome the statement and the extra investment in the NHS. It was a privilege to visit Bournemouth Hospital recently and meet the dedicated staff, and as the Secretary of State will know, it is expanding with a new A&E facility. Will he visit Bournemouth, meet the staff, and see the progress taking place?
Steve Barclay
I would be very keen to visit, subject to my diary. If it is not me, I am sure a ministerial colleague will do so.
Ruth Edwards (Rushcliffe) (Con)
I welcome the £1 billion funding announced today, and it is good that hospitals have benefited from innovations such as patient flow control centres, care transfer hubs, and virtual wards. When will hospitals and ICBs such as Nottingham and Nottinghamshire ICB, which has not been part of the pilot, be able to access those innovations, so that my constituents can start to access the benefits?
Steve Barclay
They can start to access them now. We announced £250 million at the start of the month, as part of the £500 million that was announced in the autumn statement, and hospitals know that funding of up to £8 billion is coming in the new fiscal year, so this is an opportunity for them to move at pace.
Andrew Bridgen (North West Leicestershire) (Ind)
The Secretary of State told the House that the NHS was put under pressure with a spike in influenza cases in December. Will he say where he thinks that influenza virus has been hiding for two and a half years?
Steve Barclay
I do not think it has been hiding. Flu seasons are not uncommon in the NHS and come round on a periodic basis, and that is why we anticipated it through the flu vaccine. On the hon. Gentleman’s wider point, it is also recognised that as a consequence of covid some resistance to flu may have been lowered, but we have had flu pressures on the NHS in past years.
Mark Pawsey (Rugby) (Con)
Would the Secretary of State consider more use of existing urgent care centres, such as that at St Cross in Rugby? Our nearest full A&E is 12 miles away at University Hospitals Coventry and Warwickshire NHS Trust, in Coventry, which means that 83% of my constituents are more than 15 minutes’ drive from an A&E. The hospital at Coventry serves a population of 600,000, which is twice the national average. Does he agree that extending provision at St Cross would go a long way towards reducing pressure at the hospital in Coventry?
Steve Barclay
My hon. Friend is right that not every patient accessing an emergency department needs a tier 1 A&E facility. This is about right place, right treatment for the patient, and making better use of urgent care centres. How those centres can better triage patients who can be treated there is a key part of the plan we have set out.
Matt Vickers (Stockton South) (Con)
In Stockton South we are incredibly grateful for the Government’s commitment to build a new diagnostic hospital so that local people can get access to lifesaving scans, tests and checks. We are also grateful for the £3 million announced to establish a new mental health crisis hub, so that people can get support in their hour of need. What is my right hon. Friend doing to ensure that we have the right people with the right skills in the right place to deliver great service at those facilities?
Steve Barclay
I am delighted that, thanks to my hon. Friend’s assiduous campaigning, he has secured his diagnostic centre, and that he assures me he will get it operational in one of the fastest times seen by any area. We are bringing forward our workforce plan, and as I set out, we have 2,500 more nurses this year compared with last year. We are on track for our manifesto commitment of an extra 50,000 nurses, with more than 30,000 recruited already.
Andy Carter (Warrington South) (Con)
May I take my right hon. Friend back to the response he gave to the hon. Member for Weaver Vale (Mike Amesbury) about Warrington Hospital? That A&E unit is incredibly under pressure. Over the weekend nurses talked to me about the 120 patients currently waiting to be discharged, which is putting intolerable pressure on that unit. My right hon. Friend said that he was not particularly familiar with those issues, but perhaps I can invite him to Warrington to see the pressure. While he is there, perhaps he will also look at the Health and Social Care Academy, which was set up by the local college to try to address the shortage in social care. A great level of innovation seems to be happening there, and I am sure he would like to see Warrington for himself.
Steve Barclay
That last question gives me a beautiful opportunity to correct an earlier answer regarding the constituency of my hon. Friend. He knows I am familiar with this issue, because I remember calling him at about half past 10 one evening to discuss his A&E when some particular issues had come to the attention of the media. I am familiar with the pressures on his hospital—[Interruption.] I was just placing the constituency of the hon. Member for Weaver Vale (Mike Amesbury) vis-à-vis that of my hon. Friend. Now clarified on place, I am familiar with the fact that that hospital is under pressure. I know the Minister of State is due to visit, and I am sure she will look forward to meeting both the hon. Gentleman and my hon. Friend.
Mr Deputy Speaker (Mr Nigel Evans)
I thank the Secretary of State for his statement and responding to questions for over an hour.
Oral Answers to Questions
Steve Barclay Excerpts(3 years ago)
Commons ChamberRead Full debate Read Hansard Text Watch Debate Read Debate Ministerial Extracts
Jack Lopresti (Filton and Bradley Stoke) (Con)
The Secretary of State for Health and Social Care (Steve Barclay)
We have introduced a range of contingency measures, such as the provision of military personnel, who are available to assist with the driving of ambulances, and community first responders, who can help before ambulances arrive on the scene.
Jack Lopresti
Will my right hon. Friend join me in thanking call handlers at the South Western Ambulance Service NHS Foundation Trust—and the public—for halving the number of 999 calls to the trust over the last month, and reducing average call answering times by 95%, to just three seconds? Will he also join me in expressing dismay at the approach taken by the Leader of the Opposition during the most recent session of Prime Minister’s Question Time in seeking to sow fear in the hearts of my constituents and others for his own narrow political gain?
Steve Barclay
I am happy to join my hon. Friend in paying tribute to the work of call handlers at the South Western Ambulance Service, and to the staff there as a whole. He is right to draw attention to the improved performance that we have seen in recent weeks, and also right to point out that all parts of the United Kingdom have faced considerable challenges, particularly over the Christmas period when we saw a significant spike in flu levels.
Rachael Maskell (York Central) (Lab/Co-op)
We have just heard in the Health and Social Care Committee that on strike days there was a drop in service demand, but also value added by the increased clinical support, resulting in better and more cost-effective decisions. Why does that happen on strike days rather than on every single day of the year?
Steve Barclay
We are taking a number of steps to improve performance, and not just on strike days—but I thought the hon. Lady was going to refer to the comment that she made about those on her own Front Bench, when she said:
“I think what our health team need to do is really spend more time in that environment with clinicians to really understand what drives them.”
We on this side of the House are spending a significant amount of time with clinicians, and it is important that those on the hon. Lady’s Front Bench do so as well.
Janet Daby (Lewisham East) (Lab)
Karl MᶜCartney (Lincoln) (Con)
The Secretary of State for Health and Social Care (Steve Barclay)
The long-term workforce plan that is being developed by NHS England will help to ensure that we have the right staff numbers with the right skills to deliver high-quality services in the future.
Janet Daby
Is the Secretary of State fully aware that under this Government every part of the NHS is in crisis? Are the Government satisfied with the fact that, as medical students in their second year told me recently, the shortage of staff on hospital wards and the pressures on those wards are affecting their training? The students also told me that they had little aspiration to work as junior doctors in the UK after qualifying, because of the acute strain on the NHS and because they felt undervalued. Does the Secretary of State know about this, and what is he going to do about it?
Steve Barclay
We see a considerable number of applications for medical undergraduate places, far in excess of the number of places available. We have boosted the number of places—[Interruption.] The hon. Member for Ilford North (Wes Streeting) chunters from the Opposition Front Bench, but when I was last in the Department and the Chancellor had my role, we increased the number of medical undergraduate places by 25%. Indeed, we have more doctors and nurses than we had last year, and 3.5% more full-time equivalent staff: we have over 42,000 more people working in the NHS than we had last year.
Jim Shannon
The British Heart Foundation has reported that by the end of August 2022 a record 346,000 people were waiting for heart care. Despite the best efforts of NHS staff, workforce shortages are affecting primary and secondary care services. Can the Secretary of State explain how the Government’s comprehensive NHS workforce plan will address specific gaps in the workforce, especially those in cardiology services?
Steve Barclay
The hon. Gentleman has raised an important issue. I think that, in particular, we should look at our approach to major conditions, and I will say more about our thinking in that regard at the start of topical questions. I also think that we need to look at the issue of heart conditions in the context of the wider debate about excess deaths; we know that there is a particular issue in the 50 to 64-year-old cohort. As well as providing those extra doctors and clinicians—and from next autumn we will also have the additional medical doctor degree apprenticeship route—we need to look at methods of upstream testing, particularly in respect of heart conditions.
Karl MᶜCartney
In reference to my right hon. Friend’s earlier answers, we are keen to see the success of the new Lincoln medical school leading to more locally trained NHS professionals working across Lincolnshire. What more can the Government do to remove barriers to entry to ensure that anyone who can do so is able to train to become a doctor, nurse, dentist or dental nurse in our NHS, specifically in Lincoln and Lincolnshire?
Steve Barclay
My hon. Friend raises an important point on two levels. The first relates to how we boost recruitment in areas such as Lincolnshire, and the new medical school in Lincoln will play a key part in that. The second relates to how we increase the retainability of staff in those parts of the country, and having more on-the-job training and apprenticeships is a key way of doing that. That is why things like the new medical doctor degree apprenticeship will be particularly relevant to cohorts of the population in areas such as Lincoln.
Mr Louie French (Old Bexley and Sidcup) (Con)
One of the biggest issues my local hospitals raise with me in outer London is the impact of Sadiq Khan’s ultra-low emission zone expansion, with nurses and other staff facing charges of £12.50 per shift or £25 if they are working nights. Given that 50% of London’s emergency service workers live outside the capital, does the Minister agree that the Mayor and the Labour party should stop ignoring Londoners and drop their ULEZ tax rate?
Steve Barclay
My hon. Friend raises an important point about the additional costs that the London Mayor is imposing not just on NHS staff but on all staff working in the capital, in contrast to the approach the Chancellor has taken to energy support to help staff across the workforce, including in the NHS, with the cost of living.
Sir Gary Streeter (South West Devon) (Con)
Most of the GP practices in South West Devon report to me that their biggest challenge is recruiting new doctors. Does my right hon. Friend have an estimate of the number of young doctors finishing their training this year who are likely to want to become GPs, and can he reassure us that that is a greater number than the number who are likely to retire in the next 12 months?
Steve Barclay
My hon. Friend raises two important themes. The first relates to how many are in training, and I think it is around 4,000. We have boosted the number of GP training places and we have looked at medical schools as a specific issue. Also, he will have seen some of the changes being made around pensions in order to better retain staff, mindful of those clinicians who are leaving the profession, and further discussions are taking place with Treasury colleagues in that regard.
Helen Morgan (North Shropshire) (LD)
In Shropshire there are 14% fewer GPs and 29% fewer GP partners than in 2019, yet in the period from April to November 2022, they provided 6% more appointments. It is this additional workload that is causing burnout in GP practices and a flight from the profession. What is the Secretary of State doing to improve the retention of GPs as well as recruitment?
Steve Barclay
It is important to look at the number of doctors in general practice, and those numbers are up. There are 2,298 more than there were in September 2019, so we are increasing the number of doctors. What is also important is getting the right care at the right time within primary care, which is about the wider workforce—the paramedics, the mental health support and others working in primary care—and there are an extra 21,000 there. This is enabling GPs to see more patients a day and allowing more patients to get the right primary care, perhaps not from a doctor but from others who can offer specialised support.
Eddie Hughes (Walsall North) (Con)
One of the best ways to improve recruitment and retention is to make sure that staff have an excellent working environment, which is why I campaigned for a new urgent and emergency care department at Walsall Manor Hospital. I was successful, and it is opening in March. Will one of the ministerial team join me to celebrate this success?
Steve Barclay
I welcome my hon. Friend’s drawing attention to the investment that has been made, which is in no small part due to his campaigning and championing his constituents, as he does so assiduously. I think the Minister of State, Department of Health and Social Care, my hon. Friend the Member for Colchester (Will Quince) has plans to join him to mark the opening of that important facility, which shows our investment in the estate within the NHS.
Gareth Thomas (Harrow West) (Lab/Co-op)
One way to improve retention and recruitment of NHS staff at Northwick Park Hospital, which serves my constituency and which I believe the Secretary of State visited last Thursday, would be to invest in doubling its intensive care beds. Did the Secretary of State discuss that issue with the chief executive of Northwick Park when he visited last week? Will he tell us when he might be able to announce funding for the new 60-bed unit that Northwick Park needs?
Steve Barclay
The hon. Gentleman is right to highlight the importance of bed capacity at Northwick Park, but my discussions with the chief executive were more in the context of how step-down capacity will relieve pressure on A&E. The hon. Gentleman will know that Northwick Park has one of the busiest, if not the busiest, A&Es in London on many days, and the chief executive spoke to me about the value of adding extra bed capacity from a step-down perspective, much more so than from an intensive-care perspective. If there are specific issues for intensive care, I am happy to follow them up with the hon. Gentleman.
Dr Rosena Allin-Khan (Tooting) (Lab)
In mental health we rely on staff, not shiny machinery, so why is the Secretary of State rehashing old announcements and scrapping plans? It is because the Government have run out of ideas. Labour has a plan. We will recruit 8,500 more mental health professionals, ensuring a million more patients get treated every year. We will double the number of medical school places. We will train 10,000 extra nurses and midwives every year, and we will focus on retaining the fantastic staff we already have. Where is the Government’s plan? We have had our plan for two years, but they are binning theirs.
Steve Barclay
It is slightly odd for the hon. Lady to talk about a plan when she does not agree with the plan of the shadow Health Secretary, the hon. Member for Ilford North (Wes Streeting). He plans to use the private sector, which he describes as “effective and popular,” whereas the hon. Lady said:
“In my own brief in mental health we have use of the private sector, which ultimately often lets patients down.”
First, the hon. Lady does not agree with the shadow Secretary of State. [Interruption.] The hon. Lady chunters, but she asked about a plan when she does not agree with her own Secretary of State.
Secondly, the hon. Lady talked about shiny new equipment. I am delighted that she allows me to draw the House’s attention to yesterday’s announcement of a fleet of 100 new mental health ambulances, which will relieve pressure on A&E. I am delighted that she gave me an open door to highlight that investment, which is part of our £2.3 billion investment in mental health.
Ellie Reeves (Lewisham West and Penge) (Lab)
Mohammad Yasin (Bedford) (Lab)
The Secretary of State for Health and Social Care (Steve Barclay)
We recognise that increased demand has had an impact on GP services. That is why we are investing at least £1.5 billion to create an additional 50 million GP appointments by 2024.
Mohammad Yasin
There is a clear failure to invest in critical infrastructure across the primary care estate, for example, in modernising in-patient mental health services and GP hubs. To make matters worse, Government bureaucracy is holding up capital funding allocations. My constituents deserve better community care and hospitals need relief, so when will the Government finally release the funding to build the facilities desperately needed in Bedford and Kempston?
Steve Barclay
We have literally just heard in this questions session from my hon. Friend the Member for Walsall North (Eddie Hughes) about the investment the Government are making in infrastructure across the NHS. That is why we have also, alongside the investment we are making in primary care, invested in the new hospitals programme, as part of this Government’s commitment to the NHS estate.
Dame Caroline Dinenage (Gosport) (Con)
Since the beginning of January, Gosport patients have learnt that one of our GP practices is threatened with closure, while another is about to merge with an already very subscribed group of practices. Partners are retiring, with no replacements. Will the Secretary of State confirm what he is doing to ensure that my constituents can access a GP? Will he please meet me to discuss this issue?
Steve Barclay
My hon. Friend raises an important point, and we are investing over a fifth more than in 2016, as part of our wider investment programme. I am very keen to work with her on the role of her ICB. It was set up operationally last summer, and its role is to commission primary care services for the community and to assess the needs of her Gosport constituents. I am very happy to work with her and her ICB on the issues she raises.
Emma Hardy (Kingston upon Hull West and Hessle) (Lab)
Hull has the second highest ratio of GPs to patients in the country. Even though GPs see 46 people a day on average, it is clear that demand for their services outstrips supply. Of course the Labour Government will have a plan to resolve this, but in the meantime will the Secretary of State look at giving women direct access to specialist nurses and services, such as endometriosis or menopause specialists, to prevent them from having to go via their GP each time they need renewed treatment and updated medication?
Steve Barclay
First, that is exactly what the women’s health strategy is doing through designing women’s health hubs. It is exactly why we are appointing a wider portfolio of roles into primary care. The hon. Lady says that Labour has a plan, but Labour’s plan is to divert £7 billion out of primary care property, which will not improve services for women and will actually impede the ability to deliver exactly the sort of services she is calling for.
Paul Maynard (Blackpool North and Cleveleys) (Con)
Thornton Cleveleys will see a 17% increase in new patients registering for primary care in the next five years, exceeding the physical capacity. Cost-effective solutions have been found, but the obstacle is the integrated care board, which keeps changing its mind as to whether money is or is not available. The clock is ticking on the need for this new capacity. Will the primary care Minister meet me to resolve this impasse and get the ICB to sort its act out?
Steve Barclay
My hon. Friend brings welcome transparency to the issue. The Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Harborough (Neil O’Brien) was listening intently, and is nodding his head about meeting him to discuss it.
Justin Madders (Ellesmere Port and Neston) (Lab)
The Secretary of State for Health and Social Care (Steve Barclay)
I am pleased to announce that we will be developing and publishing a major conditions strategy. Around 60% of disability-adjusted life years in England are accounted for by just six conditions: cancer, cardiovascular disease, chronic respiratory disease, dementia, musculoskeletal disease and mental health. An increasing number of us live with one or more of these conditions. Tackling them is a significant opportunity to improve the lives of millions of people and to support our goal to improve healthy life expectancy.
This work will bring together our existing commitments to develop plans for mental health, cancer, dementia and health disparities, and our new strategy will shift our focus on to integrated, whole-person care, with a focus on prevention, early detection and the use of innovative technology to improve patient outcomes. It will also improve how the NHS functions, relieving pressure on hospitals, promoting integration and putting us on a sustainable long-term footing.
We look forward to involving partners in the NHS, the charitable and voluntary sector and industry in developing this important work. Further detail about the strategy is included in my written statement published today. The statement also confirms that we will publish a suicide prevention plan this year, building on the important work of my predecessor, my right hon. Friend the Member for Bromsgrove (Sajid Javid), and I look forward to updating the House in due course.
Justin Madders
During the passage of the Health and Care Bill in 2021, safe staffing levels in the NHS came up, and the Government told us then that they
“do not believe that there is a single ratio or formula that could calculate what represents safe staffing.”––[Official Report, Health and Care Public Bill Committee, 27 October 2021; c. 773.]
Is the truth not that the Strikes (Minimum Service Levels) Bill is not about safe staffing levels, but about preventing nurses, doctors and paramedics from exercising their fundamental right to withdraw their labour, because they have lost all confidence in this Government?
Steve Barclay
The hon. Gentleman is right to say that it is a fundamental right that people are able to strike, and the legislation will balance that right, in the same way that other countries in Europe do, with minimum safe staffing levels. That is something that the French, the Italians and many other European countries have, and the Bill is simply bringing the NHS into line with other health systems.
Sarah Atherton (Wrexham) (Con)
Steve Barclay
My hon. Friend makes an extremely powerful point. I hope the Labour-run NHS in Wales takes heed of her comments. She brings professional experience to this issue and is absolutely right that there needs to be investment in the NHS estate in Wales.
Steve Barclay
I can see from your reaction, Mr Speaker, and the reaction of colleagues in the House, that that is a misrepresentation of the Prime Minister’s position. For the majority of its existence, the NHS has been run by Conservative Governments. We remain committed to treatment free at the point of use. That is the Prime Minister’s position and the Government’s position.
Wes Streeting
I note that the Secretary of State did not rule out any future extension of user charging, and I am sure that patients will have noticed too. Given that the chief executive of NHS England has said that the NHS needs to expand training; that many of the Secretary of State’s own Back Benchers are echoing Labour’s calls to double the number of medical school places; and that he has no plan whatsoever to expand NHS medical school training places, nursing and midwifery clinical training places, to double the number of district nurses qualifying, or to provide 5,000 more health visitors, is it not time for the Conservatives to swallow their pride, admit that they have no plan and adopt Labour’s workforce plan instead?
Steve Barclay
I am not surprised that the hon. Gentleman wants to misrepresent the Government’s plan, not least because his own plan is disintegrating before his own Front Bench. The hon. Member for York Central (Rachael Maskell), who spoke earlier, contradicted his point. Not only have the hon. Gentleman’s Front-Bench colleagues contradicted it; even the deputy chair of the British Medical Association has said that Labour’s plan would create higher demand and longer waiting times. I am not surprised that the hon. Gentleman does not want to talk about his own plans anymore; that is why he has taken to distorting ours.
Paul Holmes (Eastleigh) (Con)
Eastleigh, Hedge End and the villages have many vibrant pharmacies, but it is disappointing that Lloyds has closed two branches in my constituency. I welcome the additional £100 million that this Government are investing in community pharmacies, but can my right hon. Friend confirm how that funding will cut NHS waiting times and, more importantly, reverse the trend of closures?
Steve Barclay
Those discussions are ongoing with my right hon. Friend the Chancellor. The hon. Gentleman will know that we made progress in the summer on a couple of areas in relation to pensions, and my right hon. Friend is having further discussions with us in that context.
Dr Luke Evans (Bosworth) (Con)
I declare an interest as a GP and the immediate family of a GP and doctors. GPs are working incredibly hard in tough times. It is true that supply has gone up, but so too has demand. Change needs to happen in primary care, but one of the bedrocks is the GP partnership model. Does this Government agree?
Priti Patel (Witham) (Con)
The Secretary of State is well aware of the challenges facing Essex mental health care and the independent inquiry there into so many patients who have died. Can he tell the House and my constituents what steps he is taking to make this a statutory inquiry?
Steve Barclay
My right hon. Friend raises an extremely grave and serious issue that I know is of concern to a number of colleagues. Following representations from parliamentary colleagues, I had discussions with the chair of the inquiry, and I then with the chief executive and leadership team, in terms of the level of engagement with the inquiry. The Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Lewes (Maria Caulfield), and I are closely involved in that issue, and I am happy to have further discussions with my right hon. Friend.
Stephen Morgan (Portsmouth South) (Lab)
Steve Barclay
The hon. Gentleman is just factually wrong. We have increased medical undergraduate places by a quarter—I was in the Department at the time the decision was taken—so he is wrong on the facts. We also need to look at new ways of getting medics in and having more diverse recruitment in relation to social profile. That is why the apprenticeship route is an extremely important one that I am keen to expand.
Kelly Tolhurst (Rochester and Strood) (Con)
The Kent and Medway integrated care board reported that we had an increase of over 230,000 in the number of GP appointments offered to patients between September 2020 and September 2022. However, Medway has some of the lowest numbers of GPs per head in the country, and demand has increased. What support is the Department giving to the ICB to further increase access to GP appointments in Medway?
Steve Barclay
I welcome the increase in appointments and the numbers that my hon. Friend has drawn to the House’s attention. There is targeted funding of up to £20,000 for areas that are having difficulty recruiting; I am happy to discuss with her how we ensure that Medway can adequately access that fund.
Jessica Morden (Newport East) (Lab)
Steve Barclay
I agree that that is an important issue and I am keen to expedite it; we are having urgent discussions about how we maximise the use of physician associates. The hon. Lady raises an important point that we are discussing with the devolved Administrations, because it applies across the United Kingdom. I am keen to move quickly on that important area.
Anna Firth (Southend West) (Con)
“The Future of Pharmacy” report was published yesterday and highlighted again the funding pressures on the sector, including for the brilliant Belfairs Pharmacy in Leigh-on-Sea, which asks whether the Minister will urgently consider writing off the £370 million of covid loans given to pharmacies during covid-19.
Lucy Allan (Telford) (Con)
In today’s Shropshire Star, my local paper, there is an eight-page spread on what is happening to healthcare in Shropshire, which is described as a war zone. Will the Secretary of State meet me and other Shropshire MPs to discuss the challenges we face?
Steve Barclay
I am happy to meet my hon. Friend to discuss the issues in Shropshire. I draw her attention to the fact that we have more doctors, more nurses and more funding going into the NHS, and more people are being treated.
Dr Rupa Huq (Ealing Central and Acton) (Ind)
James Morris (Halesowen and Rowley Regis) (Con)
Although I welcome the new investment in emergency mental health services that was announced this week, does the Secretary of State agree that we must not lose sight of the fact that we need a long-term plan for the transformation of mental health services so that we achieve parity of esteem between mental and physical health in the NHS?
Steve Barclay
I do agree. That is why the long-term plan signalled the importance of mental health and the parity of which my hon. Friend speaks. It is also why, as the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Lewes (Maria Caulfield), has said, additional funding is being targeted at mental health—the extra £2.3 billion a year from 2024—signalling this Government’s commitment to mental health, as he will have seen with the announcement on mental health ambulances this week.
Liz Twist (Blaydon) (Lab)
Steve Barclay
What we have signalled, and I agree with the hon. Member on this, is the importance of the suicide prevention plan. It is something my predecessor, my right hon. Friend the Member for Bromsgrove (Sajid Javid), highlighted. I am keen to work with him and Members across the House on that. I set out in the written ministerial statement today not a specific date, but our commitment to a bespoke plan, and I am very happy to work with her and other Members on that.
Jack Brereton (Stoke-on-Trent South) (Con)
Current plans for community diagnostic hubs in North Staffordshire would see only a single facility, which is meant to serve over half a million people. That is totally insufficient, so will the Secretary of State look at my suggestion that there should be two of these facilities in North Staffordshire?
Richard Burgon (Leeds East) (Lab)
Will the Secretary of State for Health—today, on the record—condemn the call from his predecessor to impose charges on visits to the GP or to A&E?
Steve Barclay
I am not sure how many times one needs to say the same point. The Government’s position on this is clear: we are committed to treatment free at the point of use. That is the Government’s position, and it has been throughout the NHS’s history, the majority of which has been under Conservative Governments.
Mr Philip Hollobone (Kettering) (Con)
How many operations have been lost to strike action in the NHS so far?
Maggie Throup (Erewash) (Con)
The all-party group for diagnostics will hold its inaugural meeting on 8 February, and plans to conduct a short inquiry with the aim of providing a blueprint for how community diagnostic centres should operate in the longer term. As part of the inquiry, will my right hon. Friend commit to meeting members of the group to discuss what more the Government can do to maximise the role of diagnostics in addressing the pressures on the NHS?
Steve Barclay
I am very happy to give my hon. Friend that commitment. She is absolutely right to highlight the centrality of diagnostics and its importance in our overall plan to get elective numbers down.
Major Conditions and Diseases
Steve Barclay Excerpts(3 years ago)
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The Secretary of State for Health and Social Care (Steve Barclay)
As this House is aware, the health and social care system faces long-term challenges to ensure the public enjoy longer and healthier lives. Currently in England, 5.4 million people live with cardiovascular disease, around 8.6 million live with chronic respiratory disease and 8.2 million live with mental health issues.
An increasing number of us live with one or more major conditions. People with diabetes are twice as likely to have depression. Nine in 10 dementia patients have another long-term condition. Half of people with a heart or lung condition have musculoskeletal disorders.
Tackling the major conditions that lead to people spending more years in ill health is a significant opportunity to improve the lives of millions of people. That is why today, I am announcing that, in consultation with NHS England and colleagues across Government, my Department will develop and publish a “Major Conditions Strategy”.
The strategy will set out a strong and coherent policy agenda that sets out a shift to integrated, whole-person care, building on measures that we have already taken forward through the NHS Long Term Plan. Interventions set out in the strategy will aim to alleviate pressure on the health system, as well as support the Government’s objective to increase healthy life expectancy and reduce ill health-related labour market inactivity.
Our approach will be rooted in the best understanding of the evidence to tackle the major conditions that contribute to the burden of disease in England, namely:
Cancers
Cardiovascular diseases, including stroke and diabetes
Chronic respiratory diseases
Dementia
Mental ill health
Musculoskeletal disorders
These areas account for around 60% of total disability adjusted life years in England. Tackling them is critical to achieving our manifesto commitment of gaining five extra years of healthy life expectancy by 2035, and our levelling up mission to narrow the gap in healthy life expectancy by 2030.
Our approach will harness the potential of whole person care, addressing the fact that our health and care system has been built in silos, often focused around specific diseases or organs in the body. Our workforce model needs to adapt, reflecting that the NHS is caring for patients with increasingly complex needs and with multiple long-term conditions. We need greater emphasis on generalist medical skills to complement existing deep specialist expertise in the NHS, supporting clinical professionals to heal with whole person care. The Major Conditions Strategy and the upcoming NHS Long Term Workforce Plan work together to set out the standards patient should expect in the short term and over a five year timeframe.
This is about shifting our model towards preserving good health, and the early detection and treatment of diseases. We have a proud record of opening new treatment possibilities in the NHS. Diseases that were once a death sentence have become conditions that can be managed over the long term. By harnessing innovation and technology, we are increasingly capable of detecting diseases at an early stage, in some cases before symptoms emerge. Intervening at this point will reduce demand downstream on health and care services.
Healthy, fulfilled, independent and longer lives for the people of England will require health and care services, local government, NHS bodies, and others to work ever more closely together. People living in England’s most deprived places live, on average, 19 fewer years in good health than those in the least deprived places. The strategy will set out the supporting and enabling interventions the centre can make to ensure that integrated care systems and the organisations within them maximise the opportunities to tackle clusters of disadvantage in their local areas where they exist, informed by the Hewitt Review. This will include addressing unwarranted variation in outcomes and the care people receive in the context of the recovery from the pandemic.
This work combines our key commitments in mental health, cancer, dementia and health disparities into a single, powerful strategy. It will align to the Government’s ambitious life sciences missions. We will take forward a separate suicide prevention strategy this year.
Alongside work on common diseases, the Department and the NHS also continue work on rare diseases, under the 2021 UK Rare Diseases Framework. All four nations of the UK have now published their first action plan, and England’s second Rare Diseases Action Plan is currently being finalised.
As we develop this strategy, I continue to be grateful for the thoughts and contributions from colleagues across the House, stakeholders, citizens and industry. I will set out opportunities to contribute further in due course. We also intend to publish an interim report on the strategy in the summer.
Strategies alone will not change outcomes. Delivery will require concerted effort from Government and the NHS working in tandem, alongside social care, patient representatives, industry and partners across the health and care system.
[HCWS514]
Mental Health: Expected Spend
Steve Barclay Excerpts(3 years ago)
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The Secretary of State for Health and Social Care (Steve Barclay)
Last year, the Health and Care Act 2022 received Royal Assent, enacting the most significant health legislation for a decade into law. The Act introduced a statutory requirement for the Secretary of State for Health and Social Care to set out expectations for the year ahead on NHS mental health services spending. This is to ensure better transparency as part of the Government’s commitment to parity of esteem, ensuring that patients are able to access services that treat both mental and physical health conditions equally and to the same standard. 2022-23 2023-24 Recurrent NHS baseline (£bn) 142.4 153.0 Total forecast Mental Health spend (£bn) 12.7 13.6 Mental Health share of recurrent baseline 8.90% 8.92%
This requirement supports the Government’s existing commitments to increase spending on mental health services in real terms by at least £2.3 billion a year by 2023-24 and to uphold the mental health investment standard, which requires that integrated care boards’ spending on mental health grows at least in line with growth in overall recurrent funding allocations.
Today I lay before Parliament the first annual statement in fulfilment of this commitment.
In this statement I will set out the Government’s expectation for mental health spending by NHS England and ICBs in aggregate in the 2023-24 financial year. Specifically, I will set out whether the Government expect there to be an increase in expenditure by comparison with the previous financial year—2022-23—in relation to mental health, both in amount and proportion. It should be noted that, owing to the statutory requirement to lay this statement before Parliament ahead of the new financial year, the figures contained within this first annual statement will, in part, be based on projections.
In financial year 2023-24, the Government expect mental health spending to continue to increase as a proportion of the total recurrent expenditure incurred by NHS England and ICBs in aggregate. In financial year 2022-23, mental health spending made up 8.90% of all recurrent NHS spending. In the coming financial year we expect this to grow by 0.02 percentage points and account for 8.92% of total recurrent spend, as shown below.
This includes, at aggregate ICB level, baseline spend within scope of the mental health investment standard, which covers all spending on mental health from an ICB’s core allocations, and at NHS England level, service development fund spending and specialised commissioning spending on mental health.
These encouraging projections demonstrate the Government’s continuing commitment to expanding and transforming mental health services across England and to delivering sustained investment in this area across the country, and our ongoing commitment to parity of esteem for mental health.
[HCWS511]
NHS: Long-term Strategy
Steve Barclay Excerpts(3 years ago)
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The Secretary of State for Health and Social Care (Steve Barclay)
I beg to move an amendment, to leave out from “House” to end and add:
“pays tribute to the work done by the National Health Service and recognises that there are pressures on health systems around the world; recognises that all parts of the UK are facing pressures; welcomes that the Government has committed to reduce waiting times in England as part of its strategy to strengthen the NHS and care system with up to £14.1 billion additional funding being made available by government over the next two years to improve urgent and emergency care and tackle the backlog—the highest spend on health and care in any government’s history; and regrets that the Scottish and Welsh governments have refused to make similar such commitments.”
I am grateful for the opportunity to update the House further to my statement on Monday, in which I recognised the very real pressures faced by the NHS, particularly in emergency departments and with ambulance handovers, and the fact that the experience had not been acceptable for some patients and staff in recent weeks. I set out a range of actions that we are taking in response to those pressures—pressures that are being experienced by healthcare systems throughout the United Kingdom, and in Europe and beyond.
Before I turn to the honourable Opposition’s flawed motion, I want to reflect on a few points that the hon. Member for Ilford North (Wes Streeting) did not cover. For a start, he hardly mentioned social care, although that was an issue raised on his own Benches. We have made £2.8 billion and £4.7 billion available for social care in each of the next two years, recognising that what happens in one part of the system impacts the other. He also failed to mention any of our life sciences success stories, such as our 10-year partnership with Moderna, our deal with BioNTech to give 10,000 people early access to cancer therapies, and how we were the first country in the world to have the bivalent vaccines. That kind of work will shift the dial on prevention.
Karin Smyth (Bristol South) (Lab)
Will the Secretary of State give way?
Steve Barclay
I will, and perhaps the hon. Lady will explain why none of her Welsh colleagues is here for the debate.
Karin Smyth
I speak for the people of Bristol South. Let me talk about social care: can the Secretary of State explain why he will not publish information about the trailblazers on social care? The Government made a huge commitment to people in this country that they would fix social care, but they have reneged on that promise. They spent £2.9 million on trailblazers. I have asked written parliamentary questions of the Secretary of State and have been told that they are not publishing information. We do not know what has happened to that money. We do not know the outcome of that trailblazers report. If we are to learn from the disaster of the last year in which the Government marched us up the hill and back down again, we need to understand the outcomes. Will he commit to publish the evidence that we have had thus far?
Steve Barclay
I support transparency, so I will take away the issue of trailblazers that she raises. [Interruption.] The hon. Member for Wallasey (Dame Angela Eagle) chunters from a sedentary position, but I am agreeing to look at the point that the hon. Member for Bristol South (Karin Smyth) raises. She and I have debated in the past, not least when I was a Minister of State and she raised the issue of NHS property. She knows that I was a supporter then of transparency. She raises an interesting point that has not been raised with me previously.
I am very happy to take that away and look at how we get some transparency on that, because it is important that the House is able to see the evaluation of innovation and where pilots are done. Secondly, one of the challenges that the NHS faces is that it does not adopt that innovation at scale. The substance of the hon. Lady’s point is fair and I will happily take it away. On why I mentioned Welsh MPs, given Bristol’s proximity I thought she may be able to shine a light on the strange absence of any Welsh MPs, unlike the Secretary of State for Wales who is taking a keen interest in this debate.
I turn to the motion moved by the shadow Secretary of State, which seems, incidentally, to have been written before my statement on Monday. I might have thought that he would change it. We set out a further £250 million to support emergency departments and to get those patients out of hospital who are medically fit to be discharged. Across the House, people recognise that the pandemic has had a significant impact on that. It effects flow in hospitals and it is an area of common ground between the shadow Secretary of State and me: the issue of delayed discharge is a big factor in the compression in emergency departments.
Dean Russell (Watford) (Con)
My right hon. Friend’s visit to Watford just last week highlighted the incredible innovation there in virtual hospitals and the power of people being looked after at home. I know the work area that he looked at; I would like his opinion on that fantastic visit and on how we can roll that out across the country.
Steve Barclay
My hon. Friend highlights an extremely important area of innovation that speaks to the point about how to adopt that at scale. I will come on to the issue of virtual wards. At Watford, they told me that it was saving the equivalent of another ward of the hospital by enabling people to be discharged to recover in their homes where it was more comfortable. Patient satisfaction was extremely high—over 90% in the programme in Watford. Not only that; the clinical wraparound support means that if they need to return to hospital, they are able to do so.
Daisy Cooper (St Albans) (LD)
I, too, have seen the virtual ward at Watford General Hospital, which serves my constituents. We are very proud in west Hertfordshire that we were the first hospital trust to have that virtual ward, but he will know from his visit that the No. 1 priority of every member of clinical staff in that hospital is to have funding from the new hospitals programme to improve our hospitals in Watford, Hemel and St Albans. Could the Secretary of State please pledge to write to me within the next seven days to report on his meeting with the hospital trust and tell us whether and when we will finally get some funding, after being overlooked for decades?
Steve Barclay
It was extremely helpful to discuss the priorities for the new hospital build with the clinical team and the leadership team at Watford. I could see that for myself, and we are committed to it. This is an issue that my hon. Friend the Member for Watford (Dean Russell) champions assiduously on behalf of the people of Watford, but I know that it matters to a wider cohort there and I am happy to write further to the hon. Lady as she requests.
The virtual ward at Watford—it is great to have cross-party support for that innovation—is further facilitated by the funding we announced in the autumn statement: the further £500 million this year, £600 million next year and £1 billion the year after. The Opposition say we are “failing to recognise” the scale of the current challenges in the NHS, yet when I set out in the statement the additional actions that we are taking, it was both to respond to the pressures from flu—the sevenfold increase we have seen, with 100 times the number of patients in hospital with flu compared with last year—and to facilitate the innovation that they highlight in programmes such as virtual wards.
Debbie Abrahams (Oldham East and Saddleworth) (Lab)
The Health Secretary will be aware that our hospital bed numbers are approximately half the OECD average, at fewer than 2.5 per 1,000 compared with 5 per 1,000 in the OECD. He will also have read reports in The Observer about the facility that was made available in the Health and Social Care Act 2012 that allows hospitals to allocate up to 49% of their hospital beds to private patients. Does he regret that?
Steve Barclay
The issue of bed capacity does indeed matter. I made the point a few moments ago that flow in hospitals is obviously constrained when bed numbers are high. That is exactly why, in the statement on Monday, I highlighted the importance of discharge, and of things like discharge lounges so that we can better facilitate those patients that are free to leave. But this is not simply about hospital bed capacity; it is about step-down intermediate care capacity and also, as we heard a moment ago, about the innovation that means we are better able to facilitate those patients who want to recover at home but want the safety net of some clinical support when they are doing so. It is about looking at the capacity in the whole of the system, not simply in the hospital; otherwise, the hospital itself becomes a magnet.
Dame Angela Eagle (Wallasey) (Lab)
The crisis this winter was predictable and building long before we arrived here. Normally, the NHS and the Department plan for winter crises in the summer months, but this year something else was going on in the summer months, wasn’t it? The Tory leadership election. Does the Secretary of State regret what the distraction of the Tories’ internal faction fighting has led to, which is the inability of this Government to plan ahead and do the day job, and the fall below minimum standards of the Government service?
Steve Barclay
I do not think those are factors that affected what happened in Scotland, where the First Minister warned on Monday that the hospitals were almost completely full. Indeed, the Scottish Government are taking emergency measures, including cancelling some non-essential operations. I do not think that was a factor in France, where the French Health Ministry is saying that intensive care beds are at saturation point. I do not think that was a factor in Wales, where more than 54,000 patients are waiting more than two years for an operation. I am glad that the hon. Lady highlights the summer, because it was in the summer that we hit the first of our elective recovery targets in terms of the two-year wait, getting those below 2,000, in stark contrast to what we saw in Wales. The surge in flu has happened across the United Kingdom, not just in England, and it has also affected France, Germany and other countries in Europe.
John Redwood (Wokingham) (Con)
I am very conscious that this Government have put a lot of extra money into the health service, and that Ministers have consistently wanted to get waiting lists down so that we have the extra capacity we need. Will the Secretary of State share a little of the thinking of senior management, who run the NHS day to day, in not using more of that resource for extra beds and extra staff to back them up?
Steve Barclay
As so often, my right hon. Friend raises an extremely important point about how we best use the resources and significant investment being put into the NHS. He will recognise that a key part of delivering value for money is looking at the interfaces on the patient pathway through the healthcare system. Handover points are often when we have the most difficulty.
I am sure my right hon. Friend will welcome that I recently visited Maidstone to see how we track the patient journey through a hospital and into care—residential care or domiciliary care. We are putting control centres in place through the 42 ICBs, and our reforms are bringing health and social care closer together. An area of common ground across the House is on the need to bring social care and healthcare closer together, and the ICBs, which were operationalised from July 2022, are a key part of that.
I suspect that one issue on which my right hon. Friend and I strongly agree is that it has to be underscored by data, so that we can see where the blockages are and prioritise the use of technology, such as machine learning, artificial intelligence, virtual wards and other innovations.
Clive Efford (Eltham) (Lab)
Will the Secretary of State give way?
Steve Barclay
I am being pretty reasonable on interventions, so if the hon. Gentleman will give me a moment.
Steve Barclay
The Opposition want to hear what the Government are doing, and then they tell me that they do not want to hear.
Clive Efford
The Association of Directors of Adult Social Services surveyed English local authorities back in 2019, and it found that they had endured cuts of £6.3 billion in adult social care, resulting in a drop since 2014 of 425,000 beds. How much does the Secretary of State think that has contributed to today’s crisis?
Steve Barclay
I am delighted that the hon. Gentleman raises the additional funding that the Government are putting into social care. In his autumn statement, the Chancellor made the biggest social care spending increase of any Government in history: an extra £2.8 billion next year and £4.7 billion the year after. That is £7.5 billion over two years, on top of the £6.6 billion he put into the NHS over two years. At a time when, as a consequence of the pandemic and the war in Ukraine, inflation is extremely high and there are acute cost of living pressures for constituents across the country, the Chancellor prioritised spending not just on health but, as the hon. Member for Eltham (Clive Efford) helpfully highlighted, on social care. Bringing health and social care together is exactly what I set out in my statement to the House on Monday.
Imran Hussain (Bradford East) (Lab)
Will the Secretary of State give way?
Steve Barclay
I will take one further intervention, and then I will make some progress.
Imran Hussain
The Secretary of State refers to significant challenges, as though this crisis started a few weeks ago. This crisis has been ongoing for more than a decade, and it is worsening year on year, but Ministers come here blaming it on anything other than, frankly, their incompetence and negligence over the last decade. When will they wake up, move away from their ivory tower and accept that it is on their watch that their incompetence and negligence have resulted in our constituents suffering today?
Steve Barclay
The data shows very clearly the profound impact of the pandemic, and the data shows that the impact is not constrained to England. It is acute in—[Interruption.] The hon. Member for Bradford East (Imran Hussain) has just had his intervention. If he wants to hear the answer, the reality is that the pandemic has had a profound impact on the NHS in Wales and Scotland, just as it has across Europe. That is what he is ignoring. He does not like the facts, but the facts are clear.
Steve Barclay
I will answer the hon. Gentleman’s first question. I will then give him a second go, as he is chuntering. Hospital flu admissions went up sevenfold in a month. The figure is 100 times higher this year than last year, and that comes on top of the severe pressure from the pandemic—9,000 cases. Perhaps he wants to explain the situation in Wales and why he feels the pandemic has not had an effect.
Imran Hussain
Of course, the Minister did not answer my question. I ask him about two things. First, every time this Government are put on the spot, they refer to what has become the Welsh defence; they would much rather not talk about their own incompetence. Secondly, how does he explain that in at least seven of the past 12 years they have missed their target overwhelmingly? That suggests we were in a crisis a long time ago.
Steve Barclay
Again, I can understand why the hon. Gentleman does not want to talk about the performance of the Welsh Government, but I was talking about the Scottish, French and German Governments, and about the fact that the pandemic has had a severe impact across the UK and across Europe.
Steve Barclay
I know that the hon. Gentleman has been keen to get in, so I will give way, but then I must make some progress.
Grahame Morris
I am grateful to the Health Secretary for that. On the point about relative performance, I want to touch on cancer treatment capacity. Our performance as a nation is lamentable on the seven most common forms of cancer. If the buzzword is innovation, surely we have a tremendous opportunity to roll out advanced radiotherapy. About one fifth of the machines we have in our hospitals are more than the recommended limit of 10 years old. Surely that is a perfect example of a cost-effective means by which we could apply artificial intelligence and diagnostics in parallel, and we could treat many more patients and improve outcomes. Is he open to that idea?
Steve Barclay
I am very open to that idea. For all the sound and fury that there sometimes is within the political debate, I know that there are certain topics within health on which people across the House are keen to work. Cancer is one issue that affects all families and all constituencies, and there is often scope to work extremely closely together on it. Knowing the hon. Gentleman well, I am happy to work with him moving forward.
Steve Barclay
May I just answer the last point, as the hon. Member for Easington (Grahame Morris) raised an important issue, and one that matters to many families? On the substance of his point about equipment, tech and innovation, we are looking at how we innovate. GP direct access is part of that, as it provides direct access to diagnostics. More patients are having their first cancer consultation following an urgent GP appointment. If we take the cohort of more than 810,000 who have started treatment for cancer since March 2020, the statistics show that 94% did so within their first month.
Given the seniority of the hon. Member for Westmorland and Lonsdale (Tim Farron), I will take his intervention, but then I must make some progress.
Tim Farron
I wanted to seize the moment, based on the excellent question from the hon. Member for Easington (Grahame Morris). The inquiry by the all-party group for radiotherapy is on 18 January, but we have not had a response to our request for the Secretary of State, or indeed any of his ministerial team, to attend. Will at least one of them do so?
Steve Barclay
Let me check the diaries with the Department. These things are always dangerous because we need to know what the travel plans and various commitments are, but I hear the hon. Gentleman and the hon. Member for Easington, and we will absolutely look at what can be done.
Vicky Ford
As a declaration of interest, let me say that I am the daughter of two NHS doctors, the sister of a geriatrician and the wife of an oncologist. I hope that the shadow Secretary of State shows a bit more respect in the future for those of us who come from medical families. I thank my right hon. Friend the Secretary of State for giving way, given that the Opposition were not allowing me to ask my question.
We know that it takes a long time to train doctors. Before the last interventions, the Secretary of State mentioned the Chancellor. One excellent thing the Chancellor did when he was Health Secretary was to announce 10 new medical schools. We have always had a shortage of doctors in Essex and difficulty recruiting them, because we had never trained doctors there. The medical school in Chelmsford is brilliant. Its attrition rate is less than half the national average. The first students will qualify this year, and it is fantastic. Those students want to stay locally. This is a symbol of the Conservative party investing in the long-term future of the NHS where it is needed. Will the Secretary of State consider expanding these excellent medical schools?
Steve Barclay
My right hon. Friend raises an extremely important matter. I was in the Department when the current Chancellor was Secretary of State and when we made that commitment to a 25% expansion in medical undergraduate places. She is absolutely right in saying that it takes time for those cohorts to come through. She is also right that Chelmsford has been a huge success. I am sure that, in the context of the workforce strategy that NHS England colleagues are bringing forward, she will make the case for where any additional capacity should go, but we will, of course, look to that workforce strategy to map out what is needed.
Let me turn to elective care backlogs. A number of Members across the House have raised the issue of the 7.2 million people on the waiting list. I think that it is worth breaking that figure down between the 1 million who require surgery and the 6 million who are waiting for outpatient appointments—either for their first appointment or for their follow-up. The NHS is doing more than 94 million outpatient appointments a year, of which 30 million are for new patients and 64 million are follow-ups. The “did not attend” rate is about 6.5%. This relates to the question of my right hon. Friend the Member for Wokingham (John Redwood) about value for money and how we deliver the reform of which he spoke. If we halved the “did not attend” rate of about 6.5%, it would free up almost 4 million slots. I am very interested in looking at the data and at how we prioritise within that data the wider challenge around the elective care backlog. I hope that that provides him with some reassurance.
Margaret Greenwood (Wirral West) (Lab)
Will the Secretary of State give way?
Mr Deputy Speaker (Mr Nigel Evans)
Before the intervention is taken, I advise Members that there is a lot of interest in this debate, and each intervention is cutting into the contributions that can be made. We will be down to a three-minute limit very quickly, and some people still may not get in.
Margaret Greenwood
I wish to bring the Secretary of State back to the point raised by my hon. Friend the Member for Oldham East and Saddleworth (Debbie Abrahams), who pointed out that in the Health and Social Care Act 2012, the coalition Government legislated to allow NHS hospitals to make up to 49% of their money from private patients. She asked whether he regretted that, but we did not get a response, so I would like to hear the Secretary of State’s response. Will he also tell us what assessment he has made of the impact on waiting lists of non-NHS patients taking the place of NHS patients in our hospitals?
Steve Barclay
It is a good thing to be bringing more funding into healthcare rather than turning it away. However, conscious of your edict, Mr Deputy Speaker, I will truncate some of the areas that I was going to cover, because I am sure that right hon. and hon. Members will bring out some of those points in the wider debate.
Labour’s motion ignores the statement that I gave to the House on Monday. It ignores the extra funding that we provided in the autumn statement and the commitment reflected in the Downing Street summit on Saturday to publish recovery plans for urgent and emergency care and for primary care, which we will do in the weeks ahead. The motion ignores the very real health challenges being experienced across the United Kingdom in Wales, Scotland and Northern Ireland, which all face pressures. It ignores the fact that France, Germany and elsewhere in Europe also face significant pressure.
The Government recognise, as I set out to the House on Monday, that there are real challenges in the NHS and social care. That is why we set out a three-phase approach: first, taking immediate steps to reintroduce flow to relieve pressure in the emergency department and across the hospital estate; secondly, putting in more capacity to build greater resilience over the course of the year, mindful of the fact that summer is increasingly a busy period—more so than was traditionally the case; and thirdly, making investments in our life science industry, such as the deals with Moderna and BioNTech, to ensure that patients in the UK get the most innovative drugs at the earliest date. That shows the Government’s commitment to backing the NHS now and in the future, which is why I commend the amendment to the motion to the House.
Several hon. Members rose—
BioNTech Strategic Partnership
Steve Barclay Excerpts(3 years ago)
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The Secretary of State for Health and Social Care (Steve Barclay)
The UK’s response to the covid-19 pandemic demonstrated the power of Government collaborating with industry to accelerate life sciences innovation. We want to take this innovative approach to tackling the other major healthcare challenges we face, such as cancer.
The Government have signed a Memorandum of Understanding with the Germany-based company BioNTech. This MoU aims to build a strategic partnership which will bring innovative immunotherapy research to the UK, with the potential to transform cancer patient outcomes and develop new vaccines for infectious diseases. This agreement will pave the way for a multi-year partnership between the Government and BioNTech, accelerating trials into the company’s ground-breaking pipeline of products targeted at major global diseases such as breast, lung and pancreatic cancer, malaria and tuberculosis.
BioNTech is a biopharmaceutical company developing a pipeline of cutting-edge immunotherapies—including mRNA-based vaccines and therapies. The company became a household name in 2020 after developing a covid-19 vaccine in partnership with Pfizer, which went on to become the world’s first licensed vaccine to use novel mRNA technology.
Through this partnership with BioNTech, the Government aim to ensure trials into further promising vaccines and therapies are accelerated, to reach our patients faster. The agreement means cancer patients will get early access to trials exploring personalised mRNA therapies, like cancer vaccines. No two cancers are the same and mRNA vaccines will contain a genetic blueprint to stimulate the immune system to attack cancer cells. The collaboration will aim to deliver 10,000 personalised therapies to UK patients by 2030 through a new research and development hub, creating at least 70 jobs and strengthening the UK’s positions as a leader in global life sciences.
BioNTech will also be the first industry partner in the new cancer vaccine launch pad which is being developed by NHS England and Genomics England. The launch pad will help to rapidly identify large numbers of cancer patients who could be eligible for trials and explore potential vaccine across multiple types of cancer. The partnership will aim to help patients with early and late-stage cancers.
If successfully developed, cancer vaccines could become part of the standard of care.
[HCWS485]
NHS Winter Pressures
Steve Barclay Excerpts(3 years ago)
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The Secretary of State for Health and Social Care (Steve Barclay)
Mr Speaker, I wish to take this first opportunity to update the House on the severe pressures faced by the NHS since the House last met. I and the Government regret that the experience for some patients and staff in emergency care has not been acceptable in recent weeks. I am sure that the whole House will join me in thanking staff in the NHS and social care who have worked tirelessly throughout this intense period, including clinicians in this House who have worked on wards over Christmas. They include my hon. Friend the Member for Lewes (Maria Caulfield), the Minister for mental health, and the hon. Member for Tooting (Dr Allin-Khan), the shadow Minister for mental health.
There is no question but that it has been an extraordinarily difficult time for everyone in health and care. Flu has made this winter particularly tough: first, because we are facing the worst flu season for 10 years—the number of people in hospital with flu this time last year was 50; this year, it is over 5,100. Secondly, it came early and quickly, increasing sevenfold between November and December. It also came when GPs and primary and community care were at their most constrained. When flu affects the population, it affects the workforce too, leading to staff sickness absence that constrains supply just as it also increases demand.
These flu pressures came on top of covid. Over 9,000 people are in hospitals with covid, while exceptional levels of scarlet fever activity and an increase in strep A have created further pressure on A&E. All that comes on top of a historically high starting point. We did not have a quiet summer, with significant levels of covid, and delayed discharges were more than double what they were during the pandemic. I put that in context for the House: in June 2020, there were just 6,000 cases per day of delayed discharge—patients medically fit and ready to leave hospital—whereas throughout last year the figure was between 12,000 and 13,000 per day. The scale, speed and timing of our flu season have combined with ongoing high levels of covid admissions in hospital and the pandemic legacy of high delayed discharge to put real strain on frontline services.
Since the NHS began preparing for this winter, there was a recognition that this year had the potential to be the hardest ever. That is why there was a specific focus on vaccination. There were 9 million flu shots and 17 million autumn covid boosters. We extended eligibility more widely than in the past, to cover the over-50s, and became the first place in the world to have the bivalent covid vaccine, which tackles both the omicron and the original covid strain.
NHS England also put in place plans for the equivalent of 7,000 additional beds, including the introduction of virtual wards of a sort that one can see at Watford General Hospital. That innovation is still at an early stage of development, but has the potential to be significant in reducing pressure on bed occupancy in hospitals; in Watford alone, it has saved the equivalent of an extra hospital ward of patients. In addition, our plan for patients put £500 million specifically into delayed discharge, with a further £600 million next year and £1 billion the year after. Although the funds are already starting to make a difference, efforts have taken time to ramp up operationally with local authorities and the local NHS.
In addition, our 42 integrated care boards, recognising how bed occupancy in hospitals and social care are connected, will fully integrate health and care in the years to come. But likewise, they are at an early stage of maturity, with ICBs having become fully operationalised only in July 2022, less than six months ago.
Our plans involving the integration of hospital care and social care, additional funding for discharge, increased step-down capacity, the equivalent of 7,000 additional hospital beds and a vaccination programme at scale have provided the groundwork for the Government response, but it is clear we need to do more right now in light of the level of flu and covid rates and given that hospital occupancy remains far too high and emergency departments are too congested. Recognising that, we launched the elective recovery taskforce on 7 December, and in the coming weeks, we will publish our urgent and emergency care recovery plans. NHS England and the Department of Health and Social Care have been working intensively over Christmas on these plans, which were reviewed with health and care leaders at an NHS recovery forum in Downing Street on Saturday.
The recovery falls into three main areas of work: first, steps to support the system now, given the immediate pressures we face this winter; secondly, steps to support a whole-of-system response this year to give better resilience during the summer and autumn—as we have seen with the heatwave this summer and with the levels of covid, pressure is now sustained throughout the year, not just, as in the past, during autumn and winter; and, thirdly, our work alongside those two areas on prevention, on maximising the step change potential of proven technologies, such as virtual wards, and on the wider adoption of innovations such as operational control centres and machine reading software to treat more conditions in the community, away from someone reaching an emergency department in the first place.
Let me first set out the measures I can announce today to provide support to the NHS and local authorities now. First, we will block-book beds in residential homes to enable some 2,500 people to be released from hospitals when they are medically fit to be discharged. When that is combined with the ramping up of the £500 million discharge funding, which will unblock an estimated 1,000 to 2,000 delayed discharge cases, capacity on wards will be freed up, which will in turn enable patients admitted by emergency departments to move to wards, which in turn unblocks ambulance delays. It is important, however, that we learn from the deployment of a similar approach during the pandemic by ensuring that the right wraparound care is provided for patients released to residential care. I have asked NHS England to particularly focus on that, so that it is the shortest possible stay on patients’ journey home and into domiciliary care, and indeed it is in the NHS’s own interests for those stays to be as short as possible. Taken together, this is a £200 million investment over the next three months.
Next, our A&Es are also under particular strain. From my visits across the country I have seen and heard how they often need more space to enable same-day emergency care and short stays post emergency care. Our second investment is in more physical capacity in and around emergency departments. By using modular units, this capacity will be available in weeks, not months, and our £50 million investment will focus on modular support this year. We will apply funding from next year’s allocation to significantly expand the programme ahead of the summer. We are giving trusts discretion on how best to use these units to decompress their emergency departments. It might be for spaces for short stays post A&E care, where there is no need for a patient to go to a ward for further observation, or for discharge lounges that previously have not been able to take a patients in a bed—many of those are often simply chairs—or for additional capacity alongside the emergency department at the front end of the hospital.
The third action we are taking to support the system right now is to free up frontline staff from being diverted by Care Quality Commission inspections over the coming weeks, and the CQC has agreed to reduce inspections and to focus on high-risk providers in other settings, such as mental health. Those are the actions we are taking that will have an immediate effect.
I turn to the measures we are taking now that will give greater resilience into the summer and next winter. We now have 42 NHS system control centres in operation across England, staffed 24 hours a day, seven days a week, tracking patients on their journey through hospitals, helping us to identify blockages earlier and getting flow through the system. Where we have implemented these systems, such as the one I saw in operation in Maidstone, they have had a clear impact. We will therefore allocate funding in next year’s settlement to apply these systems more widely.
Similarly, we have also seen how the use of artificial intelligence and data can demonstrably reduce demand and release patients sooner. NHS England has been tasked with clarifying and simplifying the procurement landscape, taking on board best international practice, so that a small number of scalable interventions are taken forward where international experience shows they can deliver meaningful benefits to patients.
Next, we will capitalise on the incredible potential of virtual wards. Last week at Watford General Hospital, I saw how patients who would have been in hospital beds were treated at home through a combination of technology and wraparound care. Patients released sooner are often much happier, knowing that they are receiving clinical supervision and always have the safety net of being able to quickly return to hospital should their condition deteriorate. There is scope to expand these measures to many more conditions and many more hospitals in the months ahead.
We are also opening up more routes for NHS patients to get free treatment in the independent sector and offering even greater patient choice. The elective recovery taskforce is helping us to find spare operating theatres, hospital beds and out-patient capacity.
We must also take steps in primary care. We are clear that our community pharmacists can support many more things to ease pressure on general practice. From the end of March, community pharmacists will take referrals from urgent and emergency care settings; later this year, they will also start offering oral contraception services. But I want to do even more, as they do in Scotland, and work with community pharmacists to tackle barriers to offering more services, including how to better use digital services. The primary care recovery plan will set out a range of additional services that pharmacists can deliver.
Finally, notwithstanding very severe pressures, we know that to break the cycle of the NHS repeatedly coming under severe pressure, the best way to reduce the numbers coming through our front doors is to address problems away from the emergency department. On Friday, we signed a memorandum of understanding with BioNTech —a global leader in mRNA technology—to bring vaccine research to this country, which will give as many as 10,000 UK patients early access to trials for personalised cancer therapies by 2030. This builds on the 10-year partnership we struck with Moderna in December to also invest in mRNA research and development in the UK and build state-of-the-art vaccine manufacturing here.
We are also reviewing our wider care for frail, elderly patients in care homes long before they ever get to A&E or our hospitals. Take the brilliant work being done in Tees valley, where community teams are being used to help with falls to prevent unnecessary ambulance trips to hospitals. We have looked at what more support we can offer elderly patients further upstream. With an ageing population, and many more people with more than one condition, it is clear that we have to treat patients earlier in the community and go beyond individual specialties to better reflect patients with multiple conditions to give the right support to people where they are, which is often at home or in residential homes.
Today’s announcement provides a further £250 million of funding, which recognises the spike in flu on top of covid admissions and high delayed discharge numbers from the pandemic. The funding will provide immediate support to reduce hospital bed occupancy and decompress A&E pressures, and, in turn, unlock much-needed ambulance handovers. This funding builds on the £500 million announced in the autumn statement specifically for discharge, which is ramping up, and the additional funding for next year.
All this work ultimately builds on the much-needed greater integration of health and social care through the 42 integrated care boards, which we will strengthen through the Hewitt review, and through a step change in capability, including operational control centres.
This immediate and near-term action sits in parallel with our wider life science investment, such as the deals with BioNTech and Moderna, and underscores our commitment to recognising the immediate pressures on the NHS and investing in the science that will shift the dial on earlier, upstream treatment at scale, particularly for the frail elderly, long before a patient reaches an emergency department. This is a comprehensive package of measures, and I commend this statement to the House.
Wes Streeting (Ilford North) (Lab)
Happy new year to you, Mr Speaker, and to the rest of the House. I thank the Secretary of State for Health and Social Care for advance sight of his statement.
This winter has seen patients waiting hours on end for an ambulance, A&E departments overflowing with patients, and dedicated NHS staff driven to industrial action—in the case of nurses, for the first time in their history—because the Government have failed to listen and to lead. I notice that the Secretary of State did not talk about the abysmal failure of his talks with nurses and paramedic representatives today. Let me say to him: every cancelled operation and delayed appointment, and the ambulance disruption due to strikes, could have been avoided if he had just agreed to talk to NHS staff about pay. Today, he could have opened serious talks to avert further strikes. Instead, he offered nurses and paramedics 45 minutes of lip service. If patients suffer further strike action, they will know exactly who to blame.
Of course, the Prime Minister has already shown that he is not interested in solving problems; he resorts to the smokescreen of parliamentary game playing by bringing in legislation to sack NHS staff for going on strike. I ask the Secretary of State, in his sacking NHS staff Bill, how many nurses is he planning to sack? How many paramedics will he sack? How many junior doctors will he sack? The Government have the audacity to ask NHS staff for minimum service levels, but when will we see minimum service levels from Government Ministers and the entire Government?
After arriving at the Derriford Hospital in Plymouth, an 83-year-old dementia patient waited in the back of an ambulance outside A&E for 26 hours before being admitted. That was on 23 December, when no strikes were taking place; the Secretary of State should listen. The patient’s family found him in urine-soaked sheets, and since arriving in hospital, he has contracted flu. His daughter said of the hospital staff:
“They’re polite, they’re caring, and they are trying their best. It’s just impossible for them to do the work they want to do.”
Let me say what the Health Secretary and Prime Minister refuse to admit: the NHS is in crisis—the biggest crisis in its history. That is clear to the staff who have been slogging their guts out over Christmas and to everyone who uses it as a patient; the only people who cannot see it are the Government.
What has been announced today is yet another sticking plaster when the NHS needs fundamental reform. The front door to the NHS is blocked, the exit door is blocked, and there are simply not enough staff. Where is the Conservatives’ plan to fix primary care, so that patients can see the GP they want in the manner they choose? After 13 years of Conservative government, they do not have one. Where is the plan to recruit the care workers needed to care for patients once they have been discharged from hospitals, and to pay them fairly so that we do not lose them to other employers? After 13 years of Conservative government, they do not have one. Where is the plan to train the doctors, nurses and health professionals the NHS needs? After 13 years of Conservative government, they do not have one.
Well, we do. The Secretary of State is welcome to nick Labour’s plan to abolish non-dom tax status and train 7,500 more doctors and 10,000 more nurses and midwives every year; to double the number of district nurses; and to provide 5,000 more health visitors—a plan so good that the Chancellor admitted that the Conservative Government should nick it. After 13 years of mismanagement, underfunding and costly top-down reorganisations, however, all the Conservatives have to offer the NHS is a meeting and a photo op in Downing Street.
The collapse of the health service this winter could be seen coming a mile away—health and social care leaders were warning about it last summer—so why is the Secretary of State announcing these measures in the middle of January? Why have care homes and local authorities been made to wait until this month for the delayed discharge fund to reach them? It is simply too little, too late for many patients.
In fact, this Government are so last minute that, after announcing this plan last night, they found an extra £50 million and sent out another press release. I know most of us are happy to find a spare fiver lying around the house that we did not know was there, but this Prime Minister seems to have 50 million quid stuck down the back of the sofa. What on earth is going on? No wonder they cannot get money to the frontline: the left hand does not know what the right hand is doing.
It is intolerable that patients who are fit and ready to leave hospital are then stuck there for months because the care they need is not available in the community. They are not bed blockers, and they are not an inconvenience to be dropped off at a hotel and forgotten about. They need rehabilitation at home, rather than a bed in a care facility. Vulnerable patients deserve proper support suited to their needs, or they will fall ill again and go back to hospital. What about all these beds the NHS is procuring, and what about the capacity that families need? I will tell hon. Members what will happen: they will not get the care, and they will be coming right back through the front door of A&E, with the cycle of broken systems repeating itself again and again. Where is the choice and control for patients and their families who may not want to be discharged to a hotel?
I am afraid that, after 13 years, this just is not good enough. The Prime Minister might not rely on the NHS, but millions of ordinary people do. They are sick and they are tired of waiting. There have been 13 years of Conservative Government now—13 years—and look at what they have done to the NHS. Did the Health Secretary listen to himself as he described the situation in hospitals of people waiting on chairs for discharge, the trolleys in the corridors and people waiting longer than ever? Whose fault is it? It is not that of the NHS staff he is threatening to sack, but of the Conservative Ministers who have made disaster after disaster. After 13 years of Conservative Government it is clear that the longer they are in power, the longer patients will wait. Only Labour can give the NHS the fresh start and fresh ideas it needs.
Steve Barclay
The hon. Member talks about a fresh start, but even his own shadow Cabinet colleagues do not seem to agree with his plans. His own deputy leader seemed to distance herself from his plans to use the private sector, and his own shadow Chancellor seems to have distanced herself from his plans for GPs. Perhaps he can share with the House exactly how much his unfunded plans for GPs will cost, because the chief executive of the Nuffield Trust has said:
“It will cost a fortune”,
and is
“based on an out of date view”.
The point is that he has no plans that his deputy and his own colleagues support, and he has not set out how he would fund those plans in a way that does not divert resource from other parts of the NHS.
The hon. Member talked about pressure, yet there was no mention of the fact that the NHS in Wales, the NHS in Scotland and, indeed, health systems across the globe have faced significant pressure as a result of the combination of covid spikes and flu spikes, particularly in recent weeks. This is not a phenomenon limited to England and the NHS; this is a pressure that has been reflected internationally, including for the NHS in Wales.
The hon. Member refers to talks with the trade unions, and it is right that we are engaging with the trade unions. I was pleased to meet the staff council of the NHS today. Indeed, the chair of the NHS staff council, Sara Gorton, said the discussions had made “progress”, notwithstanding one trade union leader who was not in the talks giving an interview outside the Department to comment on what had and had not been said in those talks. We want to work constructively with the trade unions on that.
The hon. Member says that we are only announcing measures today, but again, he seems to have written those comments before he got a copy of the statement. The integrated care boards took operational effect in July last year—[Interruption.] Because they are scaling up, we are putting control centres in place and we are integrating health and social care. In the autumn statement, we announced £500 million for discharge, a further £600 million next year and £1 billion the year after, recognising that there is significant pressure, and that is ramping up. NHS England set out its operational plans in the summer, including the 100-day discharge sprint. That, for example, set out the greater use of virtual wards, which is new technology being rolled out at scale. It also announced the extra 7,000 community beds. Indeed, we also set out the additional measures in our plan for patients.
What is clear when we have a sevenfold increase in flu in a month—50 cases admitted last year compared with 5,100 this year—is that there is a combination of a surge in demand on top of the existing high-level position, and the surge in demand corresponds with a constraint on supply as staff absences also increase because of flu, so during the Christmas period community services are more constrained. Those two things together have created significant pressure on our emergency departments. That is why in the engagement I have had with health leaders the two key messages they gave to me were the importance of getting flow into hospitals, which is constrained by the high bed occupancy—that is why getting people out of hospital is so central to relieving pressure—and, within the emergency departments specifically, the need to decompress those services with same-day emergency treatment and having short stay post-emergency departments. That is a better way to decompress those emergency departments—through the triaging and bringing other clinical specialties closer to the front door. We have listened to the NHS frontline and those were the two key requests made to me, alongside other issues such as care quality inspections and how to make them more flexible. However, alongside those immediate pressures, we need to recognise that we had pressures last summer during the heatwave and we had pressures in the autumn, which is why we have announced a wider set of measures today.
So we have listened and we have acted; we have taken measures to deal with the immediate pressure, but we have also set out how we will build further capacity that will go through into the autumn. Alongside that, we have signed deals, for example with Moderna and BioNTech, and we are bringing forward the life science investment so that that has a better impact on pressures on the frontline.
Steve Brine (Winchester) (Con)
There is no doubt that, in some places more than others, patient flow in acute hospitals is the issue gumming up the system, and the Secretary of State is right to say that demand far outstrips supply, in part because of the very high flu numbers. Today’s injection of funding is very welcome as is the additional surge capacity the Secretary of State spoke about in his statement. His mention of prevention is especially welcomed by me; let us do so much more on this. Another £250 million is a lot of the public’s money. What real-time oversight does he have to ensure that NHS England spends it wisely, and may I make a plea that domiciliary care is not overlooked, because the lack of care in people’s homes is every bit as much the enemy of patient flow as the lack of care home places that he has identified today?
Steve Barclay
My hon. Friend raises an important issue about getting flow into the system, not least because delays in ambulance handovers lead to the highest risk in what is a whole-of-system issue where the patient is not seen and treatment is delayed. That is why flow through discharge is so important, because, while that often concerns the back door of the hospital, it is actually the pressure at the front door that is most acute. The Government recognised that in the autumn statement and that is why there was additional funding with the £500 million for delayed discharge. That has taken some time to ramp up, but we recognise that because of the flu there is an immediacy in the pressure on A&E that we need to address.
My hon. Friend’s point speaks to one of the key lessons from the covid period. It is not simply about releasing patients from hospitals who are fit to discharge; it is also about the wraparound services provided for those patients so that they do not get stuck in residential care for longer, and they are still able to go home and get the domiciliary care packages. NHS England is focused on that so that they have the wraparound services alongside that discharge.
Dame Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)
We have seen this year in, year out: money thrown into the NHS at a winter crisis point, too late to spend it sensibly, yet this Government have been in power for nearly 13 years. I could not identify anything new in the Secretary of State’s speech. We have talked about discharge before, and picking up on the point made by the Select Committee Chair the hon. Member for Winchester (Steve Brine), without proper funding for local councils for domiciliary care and for funding care homes, this will never work.
Steve Barclay
In terms of what is different, there is the block booking that will enable residential care to put the workforce in place and release the delayed discharge of the 13,000 patients who are in hospital but medically fit to be discharged. The accelerated release of those patients will help those at the front door, where the spike in flu is so acute. That is what we are doing; we are responding to what health leaders have said is the key intervention we can take. Of course, that is not being done in isolation. The point is that that is coming on top of the £500 million announced during the autumn statement and is to provide further capacity, recognising the significant pressure that the system is under.
Chris Grayling (Epsom and Ewell) (Con)
My right hon. Friend is absolutely right to highlight the fact that this is not purely an English issue but one affecting whole systems across the western world. I welcome many aspects of what he said, and I am grateful to staff at Epsom Hospital and those in the ambulance service in my constituency. So much of the time of those paramedics is spent taking frail elderly people from care homes to A&E where, frankly, they probably should not be. What steps can he take to divert some of those frail and elderly people from A&E to take some of the pressure off and get them to an environment where they will be much better looked after?
Steve Barclay
My right hon. Friend is absolutely right. That is where virtual wards have potential significant benefits in both demand management—avoiding elderly, frail patients coming to emergency departments in the first place—and releasing capacity in hospitals. The virtual ward at Watford General Hospital, equivalent to an additional ward of the hospital, is able to release patients with the comfort of knowing that they are still under supervision. Their medical information is being tracked and monitored and they get a daily phone call from a nurse. They also know that, if they need to come back to the hospital, they can do so much more quickly. That gives patients the comfort and confidence to recover at home, which is often where they want to be. Indeed, patient satisfaction from that trial at Watford was over 90%.
Mr Ben Bradshaw (Exeter) (Lab)
Given that there are currently 165,000 vacancies in social care—a 51% increase in just a year—where will the Secretary of State magic up the people to look after those he wants to put in hotels?
Steve Barclay
The whole purpose of the £500 million is to put more support into local authorities’ funding for social care. About a quarter of that funding is going specifically on workforce interventions, but we are also using other measures. One of the other things we have been doing is boosting workforce recruitment through international recruitment, with care sector staff on the shortage occupation list.
James Morris (Halesowen and Rowley Regis) (Con)
I welcome the Secretary of State’s statement and in particular the additional money for discharge. Does he agree that, in regard to integrated care systems, we really need to accelerate the integration between health and social care? Notwithstanding what he said about maturity, that is the key to the future integration of health and social care, and that will solve many of the problems that we face at the moment.
Steve Barclay
My hon. Friend is right. That is why, in the run-up to Christmas, one of the ministerial priorities was to have a whole series of ministerial meetings with the chairs and chief executives of the integrated care boards, because, as the Government have recognised, it is through the integration of those 42 ICBs that we will bring health and social care together. The ICBs have been operationally in place since July and are ramping up at pace. One thing that is making a real difference to them is having control centres that allow patient flow to be tracked through the system—Maidstone is a good example—with the data allowing blockages, as a whole-of-system problem, to be gripped at a much earlier stage.
Rachael Maskell (York Central) (Lab/Co-op)
Staff retention in both the health sector and the social care sector is at the heart of this crisis, but staff cannot be retained if they are not paid and, if they are not paid this year, the issues will not be addressed. Will the Secretary of State recognise that when he set the remit for the pay review body, inflation was not where it is and we did not have a war in Ukraine, so factors have changed and the remit for pay must therefore change this year so that we can retain the staff to deliver what he proposes?
Steve Barclay
On delayed discharge, the key is having domiciliary care support. That is not about the NHS Agenda for Change contract; it is about funding for those in the social care sector. Around a quarter of delayed discharges are due to delays in what is known as pathway 1, the domiciliary care side. That is what the £500 million in particular recognised. We are putting in more money, but that is about the social care sector so we can get flow through delayed discharge.
Priti Patel (Witham) (Con)
The Secretary of State speaks about getting more people treated in the community, and I think we all support that. He will know that in my constituency we have a higher than national average patient-to-GP ratio. It is a major problem for us and has been for a long time. We are short of diagnostic facilities and Essex County Council needs more resources to deal with adult social care for the very reasons he has spoken about. Will he please write to me—he will not be able to do it from the Dispatch Box today—with specific details of when, on all three of those areas, the money he has announced today will come to the frontline in Essex? Our doctors and nurses need the money and resources to do what they joined the profession for: to provide the care they really believe in to members of the public.
Steve Barclay
First, I am very happy to write to my right hon. Friend with further details. For the benefit of the House, in relation to the £500 million announced in the autumn statement, local authorities gave the Department and NHS England their data returns on Friday. We will have that data, which I will be able to share more specifically in relation to the £500 million. The £250 million for NHS England announced today is for very urgent delivery into systems and that will be going out extremely quickly.
Daisy Cooper (St Albans) (LD)
NHS leaders have today told the Health Services Journal that the Government have just seven to 10 days to get the additional funding to discharge hospital patients to the frontline for it to make any difference whatever. The NHS Confederation has said that the next three months in the NHS will likely be defined by critical incidents being declared. Will the Secretary of State promise that the extra funding will reach the frontline in the next seven to 10 days? Will he please finally declare a national critical incident, so that we can mobilise every single bit of our NHS to save lives and save the NHS?
Steve Barclay
The very purpose of today’s announcement—I have made it on the first day that Parliament is back—is to give that urgent uplift in funding to local authorities and ICBs so that they can act now, knowing that that funding is available. They have the additional £500 million, which is ramping up as well. That is part of a wider package of measures—NHS England putting in community support with 7,000 more beds—but the purpose is to recognise the very real immediate pressure the frontline has been under. It also needs to be viewed as something that other healthcare systems across the globe have faced: a very sudden and very significant spike in flu seven times higher than last month and 100 times what it was last year.
Sir Edward Leigh (Gainsborough) (Con)
Yes, but they also have covid and flu in France, Germany, Italy, Sweden and Holland. Winter after winter, they cope far better because they have much more integrated social insurance systems. Some people like me have been banging on about this for years, but now the former Health Secretary, my right hon. Friend the Member for Bromsgrove (Sajid Javid), is suggesting a social insurance system, as is newspaper editorial after newspaper editorial. What is our long-term plan? We cannot leave the Labour party to have a long-term plan while we do not. How are we going to reform this centrally controlled construct? People of my age have paid taxes all their life and their only right is to enjoy the back of a two-year queue! What is the Secretary of State’s plan?
Steve Barclay
First, integrating health and social care through the integrated care boards. That is what we put in place from July, recognising that actually the pressures on the NHS are often as much about pressure on social care as they are about pressures in the NHS itself. In particular, if we look at ambulances, we see that often it is the delay in domiciliary care that is driving the blockage on the wards, which in turn applies there. Secondly, it is recognising that there are workforce pressures, which is why NHS England has been working on the workforce plan that has been set up.
Thirdly, we have already set out our elective recovery plan. Over the summer, the longest waits—those of over two years—were largely cleared. [Interruption.] Opposition Front Benchers chunter, “How’s it going?” Let us look at how it is going, compared with the Labour Government’s two-year clearance in Wales. Before Christmas, there were about 60,000 people in Wales who had been waiting for more than two years; in England there were fewer than 2,000. We are making progress on the longest waits through the work of Jim Mackey, Professor Tim Briggs and Getting It Right First Time. We are innovating with the surgical hubs and the community diagnostic centres. That, in turn, gives greater resilience to the electives that used to be cancelled when there was winter pressure. With hot and cold sites, they are much more resilient.
Finally, I must take issue with what my right hon. Friend says. In France, Germany, Canada and many other countries, the massive spike in flu and covid pressure, combined with pressures from the pandemic, has placed similar strains on healthcare systems. It is simply not the case that the issue affects England alone.
Dame Diana Johnson (Kingston upon Hull North) (Lab)
I am really not clear how, despite all the warnings, the Government have got themselves into this position after the biggest crisis in the NHS. We all know that it is a no-brainer to invest in social care to reduce bed blocking, so what exactly is the purpose of the pilot that has been announced for Hull and the Humber? It will tell us what we already know: that what we need is investment in social care and reform of social care.
Steve Barclay
We recognised very early—in fact, NHS England recognised it in the summer—that this winter was likely to be extremely hard, both because population resilience to flu would be lower as a consequence of the pandemic and because of the combination of pandemic backlogs with the ongoing level of covid admissions. As I have said, we have more than 9,000 patients in hospital with covid and a further 5,000 with flu; that comes on top of the other strains from the pandemic that we have seen. The measures taken, such as boosting the vaccination programme, extending it to the over-50s and being the first place to have the bivalent vaccine, were part of the package in NHS England’s operational plan.
We also recognised—this point goes to the heart of the right hon. Lady’s question—that social care is central. That is why, notwithstanding the other economic pressures that the Government faced, health and education were prioritised in the autumn statement, with an extra £6.6 billion in funding for the NHS over the next two years and an extra £7.5 billion in funding for social care. That was recognised with a clear prioritisation in the autumn statement. The reality is that we have had a massive spike in flu cases, meaning that there have been 100 times as many hospital admissions for flu as there were last year.
Holly Mumby-Croft (Scunthorpe) (Con)
I welcome the measures that my right hon. Friend has set out for us today; it is absolutely right that we consider a wide suite of measures. With that in mind, may I draw his attention to my region? We have, I think, the second biggest ICB area by geography, but without the population to match. Will he consider giving us an additional community diagnostic hub? For everyone in the area to have access, we need two, not one. Will he look at that, please?
Steve Barclay
My hon. Friend is absolutely right to highlight the importance of diagnostic centres, which we have particularly prioritised. As she knows, I am extremely keen to accelerate the programme so that where we award community diagnostic centres, they open in 2023. In my view, too many plans were for 2024, so that is a particular challenge that I have been posing. My hon. Friend has campaigned strongly on behalf of her constituents; I know that the Minister of State, my hon. Friend the Member for Colchester (Will Quince), is looking at the proposal that she has shared and will be happy to discuss it with her in the days ahead.
Maria Eagle (Garston and Halewood) (Lab)
Hospitals used by my constituents in Liverpool and Knowsley have had queues at A&E of 33 hours, 41 hours and 30-plus hours. They have had dozens of ambulances queuing up outside for entire shifts, unable to transfer even one patient. These problems were predictable and—as the Secretary of State has just said—predicted, yet he disappeared over Christmas and the new year when they were going on, only emerging last week to blame them on flu and covid. When will he acknowledge that leaving it until January to deal with winter pressures is too little, too late? When will he take responsibility and apologise for the lamentable situation in which he has left my constituents and many others across this country? The fear, the pain, the worry—when will he say sorry for it?
Steve Barclay
That simply is not accurate. Let me give the hon. Lady some specific examples. Under the auxiliary contract with St John Ambulance, we invested an extra £150 million in the ambulance service, and we invested a further £50 million in additional capacity for call centres. Taxpayers spent £800 million on the new Royal Liverpool Hospital, and during 2018-19 a brand-new hospital was built at Aintree. However, this is not simply about investing in new hospitals; it is also about looking at the integration between health and care, and that was recognised in the autumn statement, which provided an additional £500 million. It is simply inaccurate to say that there were no measures in the summer. The St John Ambulance contract and the community first responders, and the service for frail and elderly people, will help with demand management and prevent people from going to emergency departments in the first place.
Sir Julian Lewis (New Forest East) (Con)
Do the Government recognise the danger of a major increase in pressure on the NHS as a result of any new variant of covid that may be imported from China? How quickly would we be able to identify such a variant and prepare a vaccine against it?
Steve Barclay
Let me first congratulate my right hon. Friend—along with the whole House, I am sure—on the knighthood that he received from His Majesty.
According to the analysis we have received, the variant in China is the same as the one in the United Kingdom. On the other hand, the data shared by China is often not as clear as we would like. That is why, over the Christmas period, my right hon. Friends the Prime Minister and the Secretary of State for Transport announced proportionate measures involving covid tests for travellers and, in particular, sequence variant testing for those coming into the UK, in order to identify any new variant quickly.
Liz Saville Roberts (Dwyfor Meirionnydd) (PC)
Strikes by nurses and ambulance workers are a last resort for overworked staff, who fear that patient safety is suffering as a result of increased demand and staff shortages. Instead of providing proper pay increases, the Labour Welsh Government have responded by offering Welsh health service staff tokenistic one-off payments, and, reportedly, the right hon. Gentleman’s Government are considering doing the same in England. Can he guarantee that if that approach is taken, one-off payments will be recognised as support with the cost of living crisis rather than proper pay increases, and will be treated as such for tax and benefit purposes?
Steve Barclay
As we have said previously, we have a process, through the independent pay review body, to look at these issues in the round and, when it comes to the needs of our NHS—my focus, obviously, is on the NHS in England; it is for the Welsh Government to conduct negotiation in Wales—to balance what constitutes the right level of funding for retention and recruitment against the wider issues of affordability for the economy as a whole. However, we are keen to engage with the trade unions, and we had a good discussion with them today. I am pleased that they recognised the progress made in that discussion, and I look forward to further discussions with them.
Siobhan Baillie (Stroud) (Con)
In recent weeks I have seen a few of my constituents in tears because they have been with loved ones in A&E and seen elderly residents stuck on trolleys. No Member of Parliament wants to deal with that. I know that my right hon. Friend is working hard, and I welcome his announcements, but the public are watching more and more money going into the NHS, and I think we need to hear, very clearly, his assessment of when the further money that has now been announced will lead to meaningful change in Gloucestershire’s A&E departments and elsewhere.
Steve Barclay
That is a fair challenge. Let me divide it into three sections. First, there is a recognition that the combination of the legacy from the pandemic, the ongoing covid issues and, in particular, the massive spike in flu create an immediate pressure in our A&E departments. The package announced today shows that we have listened to those on the frontline, and have responded.
Secondly, there is a recognition—this is relevant to some of the questions asked today—that the system has been under pressure for some time. Therefore, the second phase looks at innovation, technology, artificial intelligence, virtual wards and ways of doing things differently. To take the example of the frail and elderly, that will address their needs upstream in the care home before they get to the emergency department or release them from hospital quicker, provided they have the safety net of being part of a virtual ward, where they are subject to ongoing clinical supervision. If they need to come back to hospital, they can do so much more easily than would otherwise be the case. That stops the boomerang of patients being released early and then coming back. That second phase includes the modular capacity, because space is needed to streamline and to triage. That compression within the emergency department also drives inefficiency and poor care.
Thirdly, the Government have invested in the life sciences industry. R&D investment of £15 billion to £20 billion is a big marker of that. One of the priorities is to say that we can do certain things at scale with companies such as Moderna that will shift the dial in healthcare. That is a third but significant part of this, particularly in respect of the prevention work that we can do.
Emma Hardy (Kingston upon Hull West and Hessle) (Lab)
The failure to fix social care is having an impact on not only the acute service but the mental health service. I have raised directly with the Secretary of State the problems facing the Humber NHS trust, where 42% of adult learning difficulty beds have been taken by patients with delayed discharge and where 17% of adult mental health beds and 22% of child and adolescent mental health beds have been taken by patients waiting for discharge. What investment and support will be given to provide the right social care and support services, to enable beds to be freed up not just in the acute service but in the desperately needed mental health services?
Steve Barclay
The hon. Lady is right to highlight mental health, which is an extremely important part of the wider health landscape. That is why the Government are increasing funding for mental health by £2.3 billion. We must also consider how we get better value for money from that spending. The reform of the Mental Health Act 1983 that the Minister for mental health, my hon. Friend the Member for Lewes (Maria Caulfield), is taking forward will help us better target that funding in ways that deliver value for money.
Richard Graham (Gloucester) (Con)
I join the Secretary of State for Health and Social Care in paying tribute to those working in hospitals, such as the Gloucestershire Royal Hospital in my constituency, so intensely and under such heavy pressure. I welcome the changes that he has announced, but will he confirm what progress his Department has made with the Home Office to prioritise tier 2 health visas and to provide a grace period for international GP trainees? Lastly, will my right hon. Friend consider helping staff with parking and out-of-hours food this winter, which has been described by so many as a perfect storm?
Steve Barclay
As I said at the outset, today’s announcement is part of the wider recovery programme that we discussed with health leaders at No. 10 on Saturday. That will have a number of components, one of which is the urgent and emergency care recovery. Work is ongoing with Home Office colleagues on the visa component. My hon. Friend raises an extremely important point that a number of clinicians on the frontline have raised with me, and I am discussing it with my right hon. and learned Friend the Home Secretary.
Stephanie Peacock (Barnsley East) (Lab)
More than 5,000 operations have been cancelled at Barnsley Hospital in the last year. What are the Government doing to reassure those in Barnsley who are waiting in pain for delayed operations? Will they ensure that any new staff are deployed first to the areas that need them most?
Steve Barclay
I share the hon. Lady’s desire to reduce the backlog in the electives programme, which is why the Government have invested a further £8 billion. To ensure that it delivers value for money, the key focus is on building greater resilience into that elective programme through surgical hubs and the better use of community diagnostic centres, in particular by having a distinction between hot and cold sites.
Too often in the past, as winter pressures have surged, elective operations have been cancelled to free up bed capacity. Having the surgical hubs and the hot and cold sites builds greater resilience. I pay tribute to the work of the Getting It Right First Time team, and to Professor Tim Briggs and Jim Mackey, who are leading that programme. We saw the progress that was made in the summer and we are very focused on the next stage, which is 78-week waits. We are working very actively on that.
Jason McCartney (Colne Valley) (Con)
Maple ward at Holme Valley Memorial Hospital used to provide much-needed community intermediate care for those leaving Huddersfield Royal Infirmary. Unfortunately, it closed temporarily around six years ago. Does the Secretary of State agree that this is exactly the kind of facility that we now need in the community, not only to give great intermediate care but to free up capacity in our main hospitals?
Steve Barclay
My hon. Friend makes an important point. Often the debate is about beds, but in reality it is as much the workforce that go with those beds that we need to consider. The point about step-down care is that it has a lighter patient-staff ratio compared with what is necessary for more serious patients at the acute stage. It is important that we look at the end-to-end capacity, and that includes step-down care. That is why NHS England set out 7,000 additional beds in its summer plans. We are also doing things differently using technology. Virtual wards allow some patients to be at home, which many patients prefer, but with wraparound clinical support. Virtual wards and step-down care in the community are part of that wider landscape.
Zarah Sultana (Coventry South) (Lab)
Iqbal fell seriously ill on Christmas eve. His family rang for an ambulance, calling 999 three times and pleading for help. They waited for three hours, but by the time an ambulance arrived, it was too late. Paramedics tried desperately to save his life, but the 58-year-old father tragically passed away. His daughter Minnie was clear about who was to blame, saying that it was not NHS staff but Tory Governments who have left the NHS in what she called a “disastrous state”. Will the Health Secretary heed Minnie’s words and undo 13 years of running down our NHS by giving NHS workers a proper pay rise, ending all forms of privatisation and giving the NHS the funding it desperately needs?
Steve Barclay
As I said in my opening remarks, I regret the fact that some patients in emergency care did not receive acceptable care in recent weeks, but I gently remind the hon. Lady that the pressure, particularly around flu and covid rates, is something that has put huge pressure on the NHS in Wales and Scotland, as well as across Europe and across the globe.
Andrew Jones (Harrogate and Knaresborough) (Con)
I thank my right hon. Friend for his statement and I welcome North Yorkshire’s involvement in the trials he has announced today. He has highlighted the increased bed occupancy that has come from the flu surge. NHS North Yorkshire briefed me earlier that flu vaccination take-up in North Yorkshire was 64%. That means that one in three people is not vaccinated. Does my right hon. Friend agree that putting more focus on encouraging vaccination take-up is one way in which we can all help to alleviate this crisis and reduce demand in our hospitals?
Steve Barclay
I very much agree with my hon. Friend about encouraging greater vaccine take-up. I think we can agree across the House that that is to be encouraged, and I hope all Members will reinforce the UK Health Security Agency’s messages on the take-up of the vaccine. We have expanded the scope to include over-50s, and we have the world-leading bivalent vaccine that targets both omicron and the original strain of covid, but it is important that as many people as possible get their flu jab as well, and I encourage all Members to support that.
Caroline Lucas (Brighton, Pavilion) (Green)
The NHS and social care are in unprecedented crisis, even if that is a word that the Secretary of State and the Prime Minister refuse to use. We know that resilience was stripped out of our NHS years before the covid pandemic, and I come back to the level of vacancies: there are 133,000 in our NHS and 165,000 in social care. Will the Minister admit that, as well as growing the workforce, we urgently need to keep the workforce that we have? If so, why are the Government not at least meeting the nurses halfway on pay, as the Royal College of Nursing has offered to do, and why, after 13 years of Tory Government, is the average care worker’s pay less than the pay at McDonald’s or Amazon?
Steve Barclay
It would have been welcome if, within that list, the hon. Lady had recognised the Government’s significant investment in Brighton’s new hospital. There are also more doctors and nurses in the NHS this year than there were last year.
The Chancellor announced the £500 million in his autumn statement partly in recognition of the pressure on the social care workforce, which is why the funding was prioritised, and Home Office colleagues have put social care workers on the shortage occupation list to enable us better to attract international talent.
Mr Robin Walker (Worcester) (Con)
My right hon. Friend made many sensible points in his statement, but he will forgive me for focusing on the local pressures in Worcestershire, which remain acute. Our two A&Es saw 14,000 attendances in December, up from 12,500 in December 2021 and 10,600 in December 2020. The hospital trust tells me that, on any given day in December, around 100 patients in hospital beds could have been cared for somewhere else.
Today, I read my right hon. Friend’s press release on extra funding for neighbouring Warwickshire. Will he ensure that a significant amount of this £200-million funding package reaches Worcestershire hospitals? There is an acute need to upgrade our A&Es, which I understand is due to happen this year.
Steve Barclay
As my hon. Friend knows, I signed off those A&E upgrade plans when I was Chief Secretary to the Treasury, but they have been delayed by contractual disputes on the ground. I share his desire to see them expedited. The Government made that investment, and we want to see a consequent improvement in operational performance.
My hon. Friend is right that today’s announcement will enable ICBs, including those in his area, to accelerate their discharge plans. Plans were already in place because of the funding in the autumn statement, but today’s announcement allows ICBs to go further and quicker in releasing patients, which will in turn take pressure off A&E departments.
Barbara Keeley (Worsley and Eccles South) (Lab)
It is one thing to talk about blocked beds but, as many Opposition Members have said, care is also about staff. How does the Secretary of State expect care homes to cope with this increased pressure when one in 10 social care posts remains empty and when staff feel overworked, underpaid and exhausted?
Last year, a report commissioned by the Department of Health and Social Care found that the rapid discharge of people from hospital to care homes during the first wave of the pandemic, without adequate covid testing, was “highly likely” to have caused some outbreaks. How will the Health Secretary avoid the fatal mistakes of the past by militating against the seeding of more infections in care homes and, as my hon. Friend the Member for Ilford North (Wes Streeting) said, the danger of unsuitable care leading to hospital readmissions?
Steve Barclay
The hon. Lady makes a good point about the risk of introducing infections into care homes, as happened in the past. It is worth the House reflecting on the fact that we are in a very different position from the start of the pandemic. First, we now have vaccines in place for care home residents and staff. Secondly, we now have antivirals. Thirdly, we now have huge knowledge about covid. From an infection point of view, the risk of releasing people into care homes is now in a very different place.
On the wider workforce, part of the reason for the £500 million announced in the autumn statement is to support measures for the workforce, but we are also looking to boost numbers through international recruitment.
Sir Robert Syms (Poole) (Con)
I welcome what the Secretary of State says about community pharmacists, who have always wanted to do more. They can take a lot of the burden off GPs and, if access to GPs were improved, fewer people would turn up at A&E. It seems to be a win-win-win situation, so let’s do it.
Steve Barclay
I could not agree more. There is a huge opportunity for pharmacists to do more, and I have asked the Department and NHS England to explore that at pace. I expect to say more on that when I announce our recovery plan at the end of the month.
I think we can go even further because, alongside pharmacists, there is much more scope to work with employers. Staff absences due to cardiovascular conditions are a significant cost to employers, so it is in their interest to work with us on prevention measures.
Much more can also be done through home testing. One of the lessons from covid is that the public will test at home. In looking at the challenge of excess deaths, there is a significant opportunity to do more home testing, employer testing and work in the community, particularly through pharmacists.
Wera Hobhouse (Bath) (LD)
When a constituent of mine fell seriously ill recently, his wife rang 999. It was a category 2 emergency that then escalated to category 1, but it still took the ambulance nearly two hours to arrive and, despite the paramedics’ heroic efforts, my constituent sadly died. There are now up to 500 avoidable deaths per week because of A&E delays, according to the Royal College of Emergency Medicine. Will the Government support the Ambulance Waiting Times (Local Reporting) Bill, introduced by my hon. Friend the Member for St Albans (Daisy Cooper), to identify hotspots with the largest waiting times and put support to where it is most needed?
Steve Barclay
I have seen a lot of speculation in the media about the excess mortality to which the hon. Lady refers. I have discussed the issue in detail with both the chief medical officer and the medical director for NHS England. The point to note is, first, that this is something that has happened internationally. It cannot be ascribed just to one issue, as is so often the case. Some of the excess mortality will be due directly to covid, albeit that that will be a diminishing proportion, and some of the non-covid excess mortality will also be driven by quite a wide combination of factors, so we have to be cautious when those sorts of numbers are bandied around.
Amanda Milling (Cannock Chase) (Con)
I have recently had alarming reports from constituents who have had to wait for more than 20 hours for an ambulance, so will my right hon. Friend set out in further detail how the measures outlined today will also support ambulances to reach patients more quickly?
Steve Barclay
The measures announced today speak to the heart of that issue: by putting in more capacity to decompress emergency departments, we allow, in particular, more same-day emergency care, where patients can be rapidly assessed, diagnosed and treated without being admitted to a ward. By unblocking capacity on wards, we enable emergency departments to release patients, which in turn creates the capacity for ambulances to hand over patients. The delay in handovers from ambulances is caused where the emergency department is already at capacity and there is an understandable reluctance from clinicians for additional patients to come in. Freeing up capacity within the emergency department is therefore about the operation of same-day emergency care at the front door of the hospital as well as what is happening at the back door with delayed discharge.
Paula Barker (Liverpool, Wavertree) (Lab)
The Secretary of State has said that the Government will now block-book residential homes for hospital discharges, but social care is in crisis and has been for many, many years. Care workers are leaving the profession in droves, because of low pay and poor conditions. To prevent care workers from leaving to work for supermarkets or Amazon, what will he do to recognise their incredibly highly skilled work and pay them what they deserve? Unless we retain existing staff, the international recruitment drive is meaningless.
Steve Barclay
We need to both maximise international recruitment and retain existing staff. That is why the Chancellor, in the autumn statement, with all the other competing pressures that he faced, prioritised putting £7.5 billion into social care over the next two years—the biggest ever increase, under any Government. Alongside the announcement of a further £6.6 billion investment in the NHS over the next two years, that was about recognising the centrality of social care in the wider pressures on the NHS.
Mark Pawsey (Rugby) (Con)
Does the Secretary of State agree that many of those who will need to be admitted to hospital in the coming weeks will have reason to welcome the fact that this Government, unlike the Labour party, do not have a prejudice against making use of facilities from within the independent sector?
Steve Barclay
I agree; I think that it is important that we maximise capacity in the independent sector. That is what we are committed to doing, and I very much agree with my hon. Friend.
Jonathan Edwards (Carmarthen East and Dinefwr) (Ind)
Over recent years, I have received sporadic correspondence from consultants based in my constituency complaining about the tax liabilities that they face as a result of their pension contributions, which force them to reduce their hours or to leave public health altogether. I understand that the Government are consulting on this issue and that this is probably a matter for the Treasury, but how close does the Secretary of State think we are to an innovative solution?
Steve Barclay
The hon. Gentleman mentions a matter that is raised with him. As he can imagine, it is also raised with me by many senior clinicians. He is right that it is a question for the Chancellor, because, as he knows, tax is a Treasury matter. I am happy to share that point though, as I know that it is under consideration by my right hon. Friend the Chancellor.
Jack Brereton (Stoke-on-Trent South) (Con)
As the Secretary of State knows, there are serious pressures within the NHS in North Staffordshire. The chief executive of the Royal Stoke University Hospital said on Radio Stoke last week that the key issue to addressing these pressures is dealing with social care. Will my right hon. Friend assure me that the measures will deliver more social care places across North Staffordshire?
Steve Barclay
I am very happy to give that assurance to my hon. Friend, but it is important to see the measures in the context of the autumn statement and the announcements that were made earlier by the Government around integrating health and social care through the integrated care boards. That will not only provide additional funding, but improve significantly the data, which will address some of our interface challenges in relation to those patients who are medically fit to be discharged from hospital, so that we can better ensure that the different pathways—whether it be domiciliary care, intermediate care or residential care, pathways one, two and three—are operating in a better way.
Janet Daby (Lewisham East) (Lab)
During this winter period, my constituents took their two-year-old child with severe breathing difficulties to A&E. It soon became apparent that the child needed to be hospitalised, but no beds were made available. After some 34 hours spent in A&E, a bed was found. I am sure that hon. Members from across the House can imagine how scary and exhausting that experience was for the whole family. Does the Minister view this experience as acceptable, and is this the new norm that the public should now expect from our national health service under a Conservative Government?
Steve Barclay
I recognised the hon. Lady’s second point at the start of my statement. On the wider point around those specific very troubling cases, one purpose behind integrated care systems having control centres is to get much earlier sight of the issues and much clearer escalation, with the result that these issues will get more scrutiny than is currently the case.
Rob Butler (Aylesbury) (Con)
In addition to the substantial increase in the number of cases of flu that my right hon. Friend mentioned, the intense cold snap shortly before Christmas put further unforeseeable pressure on hospitals. Stoke Mandeville Hospital in my own constituency saw four times as many broken hips as it normally would in that period, so I pay tribute to all the staff at Buckinghamshire Healthcare NHS Trust for treating those additional patients. I warmly welcome the Health and Social Care Secretary’s announcement on freeing up thousands of beds. Does he agree that putting a real, great focus on intermediate care and intermediate step-down beds is key, so it will be very important for integrated care boards, including the one covering Buckinghamshire, to put an intense concentration on that and on working constructively and effectively with the local authority and the local NHS trust?
Steve Barclay
My hon. Friend raises an extremely important point, which is the role of step-down care in freeing up capacity in hospital. I was keen to emphasise, in my opening remarks, the right wrap-around support and care for patients when they are discharged from hospital. Over the next few weeks, it will not simply be a question of discharging those patients; there needs to be the wrap-around care as well. He is also right to point to the fact that there have been significant increases in demand—the fourfold increase that he highlights—which, combined with flu, covid and the pandemic legacy, resulted in very significant pressures. That demand pressure combined with an impact on supply—for example, from flu—also exacerbated staff absences during the Christmas period.
Mr Deputy Speaker
My apologies to the Secretary of State. I now call Clive Efford.
Clive Efford (Eltham) (Lab)
Thank you, Mr Deputy Speaker; I was as enthusiastic to make a contribution as you were for me to make it. What contingency did the Secretary of State put in place for a spike in flu cases? He speaks as if it took the Department by surprise, but it was widely predicted that there would be a spike in flu cases following on from the lockdowns during covid. He has announced 4,500 places to ease pressure, but in his statement he said that in 2020 there were just 6,000 cases of delayed discharge per day—“just” 6,000, as if that is not significant—whereas last year it was between 12,000 and 13,000 cases per day. What he has announced is roughly one third of what he said was the average per day for the last year. Is this not just too little, too late?
Steve Barclay
First, the central announcement at the autumn statement was the additional capacity to deal with domiciliary care and further support for social care. That £500 million announcement was part of the £2.8 billion next year and the £4.7 billion the year after. The autumn statement recognised the fact—I would have to go back and check the transcript, but there were many comments around that period pointing to it—that this was likely to be the worst-ever winter because of the combination of pandemic pressure, covid admissions and the risk of flu, which has transpired to be the worst for 10 years. That is why, for example, we expanded the cohort eligible for the flu and covid vaccine to the over-50s and invested in the bivalent vaccine. It is why NHS England put in place an additional 7,000 beds. It is why we have been rolling out virtual wards of the sort used at Watford General Hospital, which is able to address the equivalent of an extra ward. Additional measures have been taken but, over the Christmas period, in line with what happened in Wales, in Scotland and internationally, we saw a rapid spike in flu, with a sevenfold increase in cases over a short period, on top of the pressures already in the system.
Ruth Edwards (Rushcliffe) (Con)
I welcome the Secretary of State’s statement and the new funding announced. In Nottinghamshire, the Nottingham University Hospitals NHS trust had to declare a critical incident between 29 December and 6 January. It needs this new funding to help to discharge more patients now. Can the Secretary of State confirm when the money will arrive and start making a difference to my constituents in Nottinghamshire, and what his Department is doing not only to attract new people to work in social care, but to try to win back some of those who have recently left?
Steve Barclay
To address my hon. Friend’s two points, first, the NHS will take immediate action to start arranging additional step-down care; that is a clear message that she can take to her constituents to show that the Government have listened and acted on the very real pressures we have seen. On the wider social care system, an example from Hull—the hon. Member for Kingston upon Hull West and Hessle (Emma Hardy) is not in her place now—is the Jean Bishop Integrated Care Centre, which co-locates social care and NHS staff. The feedback I received from those staff was that that integrated model is extremely rewarding for staff and a much better way of operating than working in silos. The workforce themselves have said that that co-location and greater integration between social care and health is extremely beneficial.
Tim Farron (Westmorland and Lonsdale) (LD)
Patients living with cancer, their families and the outstanding cancer workforce will be staggered—as am I—that we have just had a statement on NHS pressures that put forward no serious plan to tackle the deadly cancer backlog. Some 17,000 cancer patients in the last three months have had their targets for cancer treatment delayed or missed; 43% of people diagnosed with cancer in south Cumbria waited more than two months for their first lifesaving treatment, and in north Cumbria that figure was 63%. Where is the urgent plan to tackle the cancer backlog? On a practical, cross-party level, will the Secretary of State or one of his Ministers attend the all-party parliamentary group for radiotherapy’s inquiry on 18 January, so that we can work together to come up with some quick technical solutions that will save lives?
Steve Barclay
It is worth pointing out to the House that 92% of new patients are starting their cancer treatment within four weeks. On the substance of the hon. Gentleman’s point, however, we are rolling out the programme of community diagnostic centres and the surgical hubs programme precisely in order to prioritise cancer treatments. Also, given that it was a central part of the statement, it is rather surprising that the major investment in bringing out the potential of world-leading cancer vaccines from our life sciences strategy, which could be absolutely transformational for cancer patients, was not even referred to by the hon. Gentleman. I hope that he supports it, because it has the potential to be game-changing.
Andrew Percy (Brigg and Goole) (Con)
The Secretary of State is absolutely right: nothing about this situation is unique to the UK. There have been record delays at Canadian hospitals, Canadian emergency rooms have been closed because of staff shortages, and some Canadian citizens have had no ambulance cover at certain times, so the role of paramedics has been expanded there to enable them to do more diagnostics and to prescribe.
As somebody who works in this service, I say that it is not just about the delays in getting into hospitals; the demand on the ambulance service is equally driven by the fact that we have more people living for longer with more conditions that sometimes require care at 1 or 2 in the morning, and the only NHS service that will turn up is the ambulance service. What is my right hon. Friend’s vision for the future of community paramedicine? How can we expand paramedic roles, employ more advanced paramedics and, of course, put the proper resources into that service?
Steve Barclay
My hon. Friend raises a brilliant point—one that I completely agree with—about how we upskill the existing workforce and get more people operating at what is referred to as the top of their licence. One of the key areas in the discussions we had at No. 10 on Saturday was how we can better utilise the existing workforce and their roles, and what regulatory changes we need to maximise that.
I pay tribute to my hon. Friend for the work that he did over the Christmas period as a community first responder. He is absolutely right: looking at how we better integrate the data available to paramedics, for example, and therefore enabling them to do more, is exactly the direction of travel that we want to take. I look forward to discussing that further with him.
Kerry McCarthy (Bristol East) (Lab)
Last month, I asked the Prime Minister about a constituent with dementia who waited three hours for an ambulance and then spent 10 hours in the back of the ambulance in the car park at A&E. We have heard much worse examples today. I have now been contacted by another constituent, who went into cardiac arrest at his GP’s surgery. He waited two hours for an ambulance, and the GP eventually ended up driving him to hospital and probably saved his life. Can the Secretary of State give us some confidence that everything he is talking about today will filter through quickly to ambulance response times? At the moment, my constituents are terrified that if they call for an ambulance, it will not come.
Steve Barclay
Looking at the media coverage, the hon. Lady raises a very fair challenge. To give her a sense of what underscores our approach, 15 trusts are responsible for 56% of ambulance handover delays, so the targeting of additional capacity—particularly how we target what we have announced on the areas where delays are most acute—is obviously one of the central things that we are doing at pace, and there is a significant concentration of that.
There are also opportunities to look at the variation in performance and what is working effectively in other trusts. That combination of control centres and better upstream demand management is absolutely core, particularly for cohorts such as dementia patients. There are significant opportunities to target interventions better—NHS England has been doing a lot of work on that as part of its 100-day sprint exercise—but we can do more and the funding announced today speaks to that.
Jonathan Gullis (Stoke-on-Trent North) (Con)
I put on the record my thanks to the incredible staff at the Royal Stoke University Hospital and the Haywood walk-in centre, who have faced unprecedented pressures. Tracy Bullock and Neil Carr deserve our full respect.
We have two problems in Staffordshire. One is that community first responders do not have blue-light ability, which was taken away by the West Midlands Ambulance Service. When will it be reinstated? The second is that community pharmacies can do more—I am delighted that we will see them do more—but their core funding needs to be increased, which it has not been since 2014. How will that be rectified?
Steve Barclay
On the blue-light ability, I am very happy to take that away and look at it. As is often the case, these things are slightly more nuanced, as I discovered when we were looking at Ministry of Defence ambulance drivers and their interaction with blue lights. I am very happy to look at that.
The Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Harborough (Neil O’Brien), is looking at community pharmacy and, in particular, how we better enable patients to get the right treatment in the right place. Given that community pharmacies are accessible and sometimes get higher numbers in more deprived communities, there are significant opportunities for us to do more with them, and I know that that is something the ministerial team is working on.
Justin Madders (Ellesmere Port and Neston) (Lab)
I listened with some incredulity to the Secretary of State’s explanation—that because the integrated care boards are only six months old they are still getting to grips with the link between health and social care. Who does he think was running health and social care before the ICBs were created? It was the very same people, who know exactly what the issues are; what they are lacking is a Government committed to dealing with the systemic issues facing both sectors.
As we have heard, one of those issues is workforce and social care. A quick internet search reveals that there are 200 social care vacancies within a 10-mile radius of Ellesmere Port; we have heard already that there are 165,000 social care vacancies nationwide. I have not heard anything from the Secretary of State today about what he is actually going to do to address those vacancies. In a year’s time, how many social care vacancies does he expect there to be across the country?
Steve Barclay
On the interaction between vacancies and workforce, NHS England is working on a workforce strategy, as has been said, and we will say more on that shortly.
In his wider point, the hon. Gentleman is ignoring examples such as the Jean Bishop Integrated Care Centre—the ability to bring health sector and social care staff to work together in a more integrated way. Yes, the integrated care boards were operational from July. That is a factual statement; I am slightly mystified about why he thinks that was in some way an unusual observation to make. It is just the factual position. The point is that when one looks at the issue, one sees opportunities, particularly around how the data are better integrated, to understand where the workforce pressures and bed capacity are.
One of the causes of delayed discharge is about the interfaces as well as what is domiciliary care, what is step down and what is residential. There are a number of issues. By bringing them together in more integrated way, integrated care boards will be one of the ways we improve the situation. Indeed, that is what the hon. Gentleman’s former colleague Patricia Hewitt is looking at through the Hewitt review.
Mr Peter Bone (Wellingborough) (Con)
I am grateful to the Secretary of State for getting to grips with delayed discharges. As he will know, only a third of such discharges are in social care; most are down to the fact that there needs to be an NHS medical discharge.
I have some good news for the Secretary of State. The bad news is that Spinneyfields in my constituency, a 51-bed social care step-down facility, is going to be closed. If the Secretary of State spent a small proportion of the £250 million, the NHS could take over Spinneyfields and tomorrow 51 beds would be released at the acute hospitals in Northampton and Kettering. Will he agree to that now?
Steve Barclay
One of the things that my hon. Friend agrees with is that more decisions should be devolved rather than every decision being made in Westminster. Part of the reason for integrated care boards is so that they can look at where best to allocate their funds locally. He raises an extremely important point. He is right that around a quarter of delayed discharges are on the social care side—a fifth actually, in the NHS; there are a number of factors within that, which we will need to disaggregate.
On my hon. Friend’s point about local capacity, the Government are allocating the funding to his local ICB. I am sure he will have a conversation with his ICB on where the spare capacity can be best identified and rolled out at pace.
Mr Toby Perkins (Chesterfield) (Lab)
Last week, I met Hal Spencer, the chief executive of Chesterfield Royal Hospital; the pressures that he and his staff had faced as the hospital went into a critical incident over Christmas were etched all over his face. He spoke about the pressures on A&E registrars, ambulance drivers and nurses and about coming face to face with people who had been waiting 24 hours in a corridor on a trolley or who had been waiting many hours for an ambulance to turn up.
Is not the reality that this is a system-wide failure 13 years in the making? Did the right hon. Member for Gainsborough (Sir Edward Leigh) not hit the nail on the head in saying that Labour has a long-term plan for our NHS and this Government do not?
Steve Barclay
On the hon. Gentleman’s first point, this is absolutely a system-wide challenge. That is why the use of innovations such as virtual wards in demand management upstream, in the care home or on the home, is important, just as discharge—getting patients to leave hospital who are fit to do so—is important. The focus has often been on ambulances being delayed at A&E or on the significant and real pressures in emergency departments themselves, but the challenge is much wider. That is what the funding in the autumn statement recognised.
In response to his second point about this being a longer-term issue in England specifically, I would just point him to the examples in Wales and the pressures in Scotland. This surge in flu combined with covid and the pandemic legacy that we have seen in England have created so much pressure over the festive period, and it is something with which many other health systems around the globe have also been grappling.
Anna Firth (Southend West) (Con)
I very much welcome this extra funding, and I look forward to hearing how much will be coming to Southend University Hospital, which has had to deal with not one but two critical incidents declared by the East of England Ambulance Service NHS Trust. It has already innovated with modular units and an active discharge lounge. These NHS workers deserve all our recognition, and what they need is £8 million of capital funding to reconfigure the hospital, which is fundamentally not big enough. In the short term, will the Secretary of State agree to encouraging care homes to take discharges after 5 pm? Every day, 15% of the people who need to be discharged cannot be discharged because the care homes will not take them after 5 pm. That is at least 70 people a week who could be out of hospital. This is an emergency—everyone must put their shoulder to the wheel.
Steve Barclay
My hon. Friend has raised the £8 million capital request with me previously, and it is something we are looking at. She is right about how capital needs to be looked at in the context of getting flow into a local system and of where triaging can be unlocked. In response to her point about 5 pm, there are two points. First, part of the reason for looking at discharge lounges is that if we have something that is 7 am to 7 pm, there is a cultural change for the patient in going into the discharge lounge in the morning and being off the ward. Looking at other health systems around the world, we see that that can be beneficial in accelerating discharge, rather than there being a point in the day after which suddenly it is easier to leave discharging the patient until the next day.
The second point on 5 pm is that we need to look at what support care homes need to have the confidence to take the patient. To be fair to them, it is not simply a question of whether they are refusing to take the patient after 5 pm; it is also about us looking at the wider wraparound care package, so that care homes are confident in taking that risk not just after 5 pm on weekdays, but at weekends, when there is often a significant drop in the number of patients taken.
Helen Morgan (North Shropshire) (LD)
One of the key issues in Shropshire is a shortage of staff across every discipline and at every level. It is one of the reasons for the horrifying ambulance wait times that I raised in this place on my first day, 5 January 2022—this is not a new issue for 2023. What is the Minister’s plan to improve staff retention, because staff recruitment on its own will not plug this gap? It has not plugged it in Shropshire, and there are no signs of it plugging the gap across the rest of the country either.
Steve Barclay
We are expanding staff numbers—that is why there are 3% more doctors and 2% more nurses than last year—but it is about more than simply looking at that. We also need to look at the fact that we have more elderly patients, who are presenting with multiple conditions, which in turn changes the demands from a system that has traditionally been more about individual specialties. Now we are looking at treating those patients with multiple conditions, and that then needs to be factored into the skills the workforce have. That is why the point from my hon. Friend the Member for Brigg and Goole (Andrew Percy) is so important. We need to think about what upskilling can be offered to particular roles and how they can take on a wider set of responsibilities. There is also the role of technology in that. For example, many nurses in hospitals currently take time looking for beds. Operational control centres with a different cohort of staff, as is already the case in some hospitals, not only automate much of that process, which is far quicker in getting beds back into use, but free up a lot of nursing time to be used for what nurses would prefer to be doing, which is focusing on the clinical side and taken away from some of those administrative roles.
James Wild (North West Norfolk) (Con)
Norfolk and Waveney has already received £11 million to tackle discharges, which is making a difference. However, today there are 128 patients in the Queen Elizabeth Hospital in King’s Lynn who do not need to be there. This additional funding is welcome, but do these pressures not also underline to the Treasury the long-term importance of investing in modern hospitals that are able to meet demand and the case for including the QEH in the new hospitals programme?
Steve Barclay
My hon. Friend skilfully combines the importance of discharge at King’s Lynn with the importance of addressing RAAC—reinforced autoclaved aerated concrete—hospitals, on which he has campaigned assiduously. As he will know from my speech at the NHS Providers conference, it is an issue that I very much recognise. I have visited the hospital and seen the challenges at first hand; indeed, my son was born in that hospital, so I know it very well. We are discussing that issue with the Treasury and I hope to be in a position to update the House shortly.
Richard Burgon (Leeds East) (Lab)
We will not solve the NHS crisis without solving the NHS staffing crisis, which means sorting out pay. However, in talks with the unions today, the Government refused to make a new offer on pay. The unions say that the Secretary of State is ludicrously calling for—demanding—efficiency savings from nurses and other NHS staff. Many nurses and NHS staff are already working 18-hour shifts. When will the Government get real? When will the Government get serious? When will the Government make a proper offer to NHS staff to avoid strikes?
Steve Barclay
The hon. Gentleman seems to be quoting Onay Kasab, the lead national officer of Unite, who spoke to Sky News outside the Department of Health and Social Care just a few minutes after my discussions with the trade unions. The slightly odd thing was that Mr Kasab was not actually in the meeting on which he was commenting.
Ben Bradley (Mansfield) (Con)
It is pleasing to hear from across the House a focus on capacity in domiciliary care, which is a huge priority. Ultimately, that is where we want people to end up: independent in their own homes, as far as possible. I wonder if the Secretary of State could reassure me about some elements of the plan for the NHS to procure care beds. Where does he envisage staff coming from? If it is from the NHS, how will we ensure that more people do not leave domiciliary care for what are often better-paid roles in the NHS? In the same vein, on capacity, how will we ensure that people are able to move on from residential care beds into domiciliary care when there is that shortage of capacity?
Steve Barclay
As befits the leader of his own county council, my hon. Friend rightly recognises the importance of the integration of health and care. I have pointed to examples where that is already being done extremely effectively in an integrated way. As I recognised in my remarks, the medical director of NHS England has said that helping people to leave hospital with the right support when they are ready to do so is not just clinically the best option for those individuals, but one of the safest options for expanding capacity for everyone who needs care. It is the right thing to do clinically, but his point—one that we are extremely focused on—is about how we then ensure that wraparound service for patients who are released into residential care so that they can move into domiciliary care.
Jim Shannon (Strangford) (DUP)
I know that the Secretary of State appreciates that the winter pressures are only exacerbated by the looming strikes. I joined the picket line at Newtownards hospital back in early December. Just before Christmas, I had the opportunity to meet Pat Cullen, the leader of the nurses’ union at St Thomas’s Hospital, just across Westminster bridge, as the protest was ongoing, and we heard in the news that she referred to a glimmer of hope over today’s talks between the Government and nurses. Does the Secretary of State believe that there can be real engagement with not only nurses and midwives, but junior doctors, who are also threatening strikes? Does he agree that it is about not just a pay increase, but an increase in the numbers of staff to secure safety and accountability on shifts in hospitals tonight and every night from today on?
Steve Barclay
I agree that a combination of pay and wider conditions have an impact on recruitment and retention. That is why we have been keen to engage constructively with the trade unions; we had a good discussion earlier today. We recognise that there is a range of factors. To take the example of paramedics, the feedback from my discussions with a number of paramedics was that their frustration about handover times and the delays that they were experiencing was more important to them than pay. It is important to have discussions through the independent pay review bodies about pay, what is affordable and what is the right balance, but a range of non-pay factors are also extremely important to staff.
Mr Philip Hollobone (Kettering) (Con)
The biggest flu outbreak in 10 years has seen Kettering General Hospital become the 28th busiest hospital in the country, with a bed occupancy rate of 96.5% in the week leading up to the new year. The Secretary of State was kind enough to visit it last year and stood in the busy and overcrowded A&E. He was also good enough to visit Thorndale care home, where he was briefed on the fact that the rate of increase in the number of over-80s in Northamptonshire gives it one of the fastest-growing elderly populations in the country. In thanking the Secretary of State for the measures that he has outlined today and the extra funding, I ask whether he will ensure that Northamptonshire, North Northamptonshire Council, the Northamptonshire ICB and, crucially, Kettering General Hospital get their fair share of the funding that he has announced, so that we can tackle these winter pressures quickly and successfully?
Steve Barclay
My hon. Friend is right to point to the real pressures at Kettering which, as he says, I have visited. Not only am I keen to see it get its fair share, but I know that he will absolutely champion it through his good offices to ensure that that is the case, as he always does. He also raises an important point that the pressure of an ageing population is not universally distributed but is more intense in certain areas than others. Again, in our scrutiny of the data, I am keen to look at how that plays out in the variation in performance between trusts because, as I said, 15 trusts account for 56% of ambulance handover delays and there is significant variation across the NHS. Understanding what is driving that, such as different ageing profiles between different areas, is a key part of our recovery plans.
Andy Carter (Warrington South) (Con)
I spent Friday morning at Warrington Hospital to see the challenges that A&E department staff are facing. One senior clinician said to me that it was the busiest he had seen it in 30 years. The entire hospital was full—there were no beds—and last Monday, 90 people were waiting in A&E to be admitted to a bed. The Secretary of State knows that I am waiting for an announcement on whether a new hospital can be funded in Warrington, and I am keen to hear when that announcement will come, but can he reassure my constituents that the funding announced today will support the staff in Warrington Hospital and the social care staff in Warrington and ensure that the pressures that they are facing will be addressed immediately?
Steve Barclay
Yes, I can; that is the whole purpose of the announcement. Although my hon. Friend campaigns assiduously for the new hospital, he will concede that, regardless of the decision, that would take time. To his point about the hospital being full, there is an immediate challenge about how we get additional capacity into the emergency department so that it can operate more effectively, because if there are too many people, that impedes an emergency department’s ability to operate effectively. There is also a challenge about how we address the wider occupancy in the hospital as a whole, because that is at the core of getting flow into the system. That is the essence of the feedback that we have listened to and taken on board from the clinical community —as he did on Friday—particularly within emergency departments. Today’s announcement speaks to the exact issue that he raises.
Mr Deputy Speaker (Sir Roger Gale)
Finally, with the prize for patience, I call Shaun Bailey.
Shaun Bailey (West Bromwich West) (Con)
Thank you, Mr Deputy Speaker—I am last but I hope I am certainly not least. Some 700 beds are due to come online thanks to the Midland Metropolitan University Hospital and there is a new primary care centre in Wednesbury, so when my right hon. Friend’s Department delivers, we see the benefit. Clearly, however, that means nothing if we cannot get the processes right. The most pressing issue for my constituents during the winter has still been access to their GPs, as I am sure hon. Members on both sides of the House will agree. I welcome what he has said about the use of technology to ensure that people are seen, but fundamentally, people still want face-to-face appointments, because if they are digitally disconnected, they cannot access that technology. It is as simple as that. I ask him to commit—just after he commits to come to Wednesbury to see our new primary care centre—to work through his good offices with GP practices where there is best practice, particularly in the Black Country ICB, to ensure that we enable people who are digitally disconnected to access GPs.
Steve Barclay
We are working actively with the primary care community. Indeed, that was a key focus of the Prime Minister’s summit in No. 10 on Saturday and it is part of the work that the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Harborough (Neil O’Brien) is leading through the primary care recovery plan. Last year’s GP patient survey suggested that continuity of care and face-to-face appointments were extremely important for two fifths of patients, but that suggests that for three fifths—often younger patients—speed of access is more pertinent. Continuity of care is important for those with multiple conditions, particularly elderly patients.
Alongside that, my hon. Friend is right to raise the Midland Metropolitan University Hospital. Four years ago, when I visited as a Minister of State in the Department, it was near completion. As he knows, it has taken a significant amount of time since then to get to its opening, which is why we need to look at doing things differently when it comes to value for money. Looking at the hospital estate programme, nine of the last 10 hospitals were built over time and over spec, so we need to look at modular design, modern methods of construction, and standardisation, which deliver a 35% unit-on-unit reduction in cost and much quicker operational performance, and would enable us to get hospitals up and running earlier.
It is important to do things differently and the new hospital building programme is part of that. We have listened to the concerns of those on the frontline and today’s statement addresses the immediate issue of bed occupancy in hospitals and the pressure on emergency departments.
Mr Deputy Speaker (Sir Roger Gale)
My thanks to all hon. Members—Front Benchers and others—who have taken part in an important discussion.
Moderna Strategic Partnership
Steve Barclay Excerpts(3 years ago)
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The Secretary of State for Health and Social Care (Steve Barclay)
The covid-19 pandemic has shown the importance of having the ability to develop and deploy vaccines rapidly to respond to a health emergency, as well as to mitigate the potential economic and health costs such an emergency can cause. It also demonstrated the need to establish resilience on UK shores to avoid supply chain disruptions which could have severe public health and economic consequences. While the future trajectory of the covid-19 virus is uncertain, delivering a consistent and resilient supply of covid-19 vaccines is critical in ensuring safe and effective vaccines are provided on at least an annual basis over the next decade, to protect those who are most vulnerable to covid-19.
With these challenges in mind, in June 2022 Ministers signed non-binding heads of terms and a single tender case for a strategic partnership between HMG and Moderna. Since then, the Vaccine Taskforce and the UK Health Security Agency (UKHSA), has worked to negotiate a definitive agreement with Moderna. The execution of our contractual agreement for a 10-year partnership with Moderna was announced on 22 December 2022. The partnership will bring vaccine development onto UK shores, boosting our messenger RNA (mRNA) capability, strengthen our ability to scale up production rapidly in the event of a health emergency, and better equip the UK to respond to covid-19 and future health emergencies.
Through this deal, Moderna will, at its own cost, establish a UK based manufacturing facility and global research and development (R&D) centre, as well as commit substantial investment into UK-based R&D activities over the 10-year period, bringing the UK a step closer to becoming the leading global hub for life sciences. The manufacturing facility will be capable of supplying up to 100 million doses of respiratory vaccine per year in normal circumstances, increasing to up to 250 million doses in the event of a health emergency. The UK will have priority access to these vaccines where they are demonstrated to be safe, effective, and authorised by the MHRA. These include both Moderna’s proven and highly effective covid-19 vaccine and others in its pipeline, including against flu and RSV, providing health resilience.
Moderna has demonstrated expertise in mRNA development which has the potential to be a transformative breakthrough technology in several disease areas, including cancer, respiratory illnesses and heart disease. Also, mRNA vaccines have the potential to treat multiple pathogens in a single shot and be delivered in rapid timeframes.
The new Innovation and Technology Research Centre will look to unlock this potential by developing revolutionary treatments in the UK, which will benefit NHS patients and people worldwide. This will include running a significant number of clinical trials in the UK. Moderna has also pledged to fund grants for UK universities, including PhD places, research programmes and wider vaccine ecosystem engagement. The industry-leading, future-proof design of the plant will permit the addition of capability to manufacture a wide range of medicines and will be a massive boost to the UK’s R&D capability, as well as creating more than 150 highly skilled jobs.
The partnership, secured by the Vaccine Taskforce, will be taken forward by the Covid Vaccines Unit in the UKHSA. This will see the UKHSA working with Moderna to ensure early vaccine development, supporting the G7 mission to get from variant to vaccine in 100 days. Construction is expected to commence in early 2023, with the first mRNA vaccine expected to be produced in the UK in 2025.
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