Healthcare in North Staffordshire Debate

23rd October 2017

Philip Dunne responds to a debate on the provision of healthcare in north Staffordshire.

I congratulate the hon. Member for Stoke-on-Trent Central (Gareth Snell) on securing this debate, and on securing the support of neighbours and colleagues from both sides of the House, who clearly share his interest in ensuring that we have high-quality healthcare for the residents of north Staffordshire.

The hon. Gentleman gave a wide-ranging account of several of the challenges facing healthcare provision in Staffordshire, and I shall frame my remarks in the context of the NHS plan for resolving them. The hon. Gentleman did not mention it, but he will be aware that Staffordshire and Stoke-on-Trent’s sustainability and transformation partnership is the vehicle through which all these issues are being brought together, to try to provide a sustainable, financially viable future of high-quality healthcare for the residents of Staffordshire. It is a complex area, and the rating given to the STP by the NHS earlier this summer reflects an understanding of the challenges being faced across Staffordshire, because it was rated in the lowest category. A number of steps are being taken to try to help leaders in Staffordshire come to grips with the challenges that they face.

The area contains two local authorities, six clinical commissioning groups—as the hon. Gentleman mentioned—and five NHS trusts. Together, they provide services to more than 1.1 million people in Staffordshire. The hospital the hon. Gentleman invited me to visit, and on which he began his remarks, the Royal Stoke, also serves patients from Shropshire, including in my constituency, as it is one of the leading trauma centres for the area. I have yet to visit that hospital, and I would be delighted at some appropriate point to take up his invitation; so at the outset I can give him that reassurance in answer to one of his questions.

We in the Department, and the Secretary of State in particular, are acutely aware that some of the pattern of provision in Staffordshire is coloured by the tragic events of Mid Staffs, and the importance of eradicating the poor care that the people in Staffordshire experienced because of the problems in that hospital at that time. Much has already been done to address the challenges that arose earlier in this decade, and I pay tribute to the NHS staff across Staffordshire, who have been working tirelessly to improve the way care is delivered. Just one year after the Mid Staffs inquiry, we saw a real shift in priorities, with new inspection regimes, additional nurses and a stronger voice for patients, leading to tangible improvements in the way care is delivered, but it is right for me to acknowledge, as the hon. Gentleman has in this debate, that the NHS in Staffordshire remains under significant pressure. The acute hospitals have been, and still are, struggling to meet quality standards and demand.

The STP has publicly stated that if the way services are delivered is not transformed, the majority of organisations across Staffordshire and Stoke-on-Trent will be in deficit by 2020, and many of them already are. Clearly, Staffordshire has long-standing local issues that need addressing. None of the organisations in the area can do that by themselves. Instead, they need to work together to deliver wide-ranging transformation. The STP is the vehicle to do this. It brings together the local population, NHS organisations and local authority bodies to propose how, at a local level, they can improve the way that their local health and care is planned and delivered. The plan published in December last year set out the scale of the area’s ambition, identifying five particular areas that, if implemented, will help to achieve that.

The first area was a focus on shifting from reactive care to prevention. That means increasing the proportion of care delivered in the community, rather than in hospitals. Some £24 million has already been invested in community services by two CCGs in the STP area, including the CCG covering the hon. Gentleman’s constituency, through changing the way local services are delivered. Further investments are being made to increase the capacity of primary and community care, which will, in turn, significantly reduce the pressures on A&E.

I want to push the point about community care if I may. The 168 community care beds are not only in my constituency; they are in Bradwell in Newcastle, and in Leek in the Culture Secretary’s constituency. Will the Minister answer the point about referrals specifically?

I specifically will; I will come to that point very shortly.

It is important that we get the right balance between primary, community and secondary care. NHS leaders believe that they can significantly reduce the 30% of patients who are currently being treated in Staffordshire in the wrong setting. Clearly, patients sometimes have to go to our acute settings. We have recognised that the Royal Stoke, having reviewed its emergency department, is under-bedded. There is currently a plan for 46 beds to be added over the winter to help to relieve the pressure on the acute services. I will come to the question of the community beds in a second.

I want to raise the point about acute beds as well, because it is a significant issue. It particularly relates to the design of the hospital, which does not have enough acute beds. Does the Minister agree, however, that some of these issues predate this Government?

I am sure that my hon. Friend is right, but I am not going to get into a dispute about that just at the moment. I would like to deal with the question of community beds that the hon. Member for Stoke-on-Trent Central raised. He has referred to the request by two local authorities concerning the community bed closures, seeking a referral to the independent reconfiguration panel. He suggested that there had been no response to that request, unless I have misunderstood him. I think that the hon. Member for Stoke-on-Trent North, who is sitting next to him, received a letter in February. The local authority received a letter to confirm that the referral request had been received, and the referral has been transmitted to the independent reconfiguration panel. We are currently awaiting the results of that referral and the panel’s report and recommendations. The hon. Gentleman will therefore understand that it would be inappropriate for me to pre-empt the panel’s conclusions by commenting on this specific case.

I want to touch on the financial challenges that the hon. Gentleman has referred to. I recognise some of the figures that he has referenced and questioned. We believe that Staffordshire needs to get into a financially sustainable position. At the moment, some areas of Staffordshire receive significantly more funding per capita than the rest of the county and than England as a whole. The Stoke-on-Trent CCG receives an allocation that is some 9% greater than the average for England per capita, reflecting the needs and challenges of that community. The NHS recognises that parts of Staffordshire are more challenged and need more money, but equally, the hon. Gentleman needs to recognise that each area of England needs to live within the budget that it has been set.

One of the challenges that Staffordshire has at present is that, for historical reasons that have not been addressed over the years—going back to the point made by my hon. Friend the Member for Stoke-on-Trent South (Jack Brereton)—the pattern of provision and the models of care have not developed in the way that they have in some other areas. This has meant that the cost of providing care—in some cases, in settings that are no longer as relevant as they could be—is resulting in Staffordshire running unsustainable deficits. It is unfair that other parts of the UK should provide even more funding into Staffordshire, resulting in their not having sufficient funding to look after their own populations.

The hon. Member for Stoke-on-Trent Central referred in particular to the better care fund. I understand that concerns are shared across the House about the funding that was pledged in the Budget. It was made clear to local authorities that as a condition of that funding they would need to make progress in reducing the delayed transfers of care. North Staffordshire has made huge strides in doing that and it currently has roughly zero delayed transfers of care, which is one of the best performances in the country. We need to see that improvement across the county as a whole. I know that there was a meeting last week to discuss that, and we will see how that progresses in the future.

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