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Hospital Trusts: Special Measures

Volume 605: debated on Tuesday 9 February 2016

2. What progress his Department has made on improving the performance of hospital trusts in special measures. (903535)

9. What progress his Department has made on improving the performance of hospital trusts in special measures. (903542)

12. What progress his Department has made on improving the performance of hospital trusts in special measures. (903545)

Eleven out of 27 hospitals have now exited special measures, having demonstrated sustainable improvements in the quality of care. Overall, trusts put into special measures have recruited 1,389 more doctors and 4,402 more nurses, with one estimate saying this has reduced mortality rates by 450 lives a year.

Following the recent Care Quality Commission report on the Medway hospital, the staff and new chief executive are working hard to turn around long, historic and deep problems. What further support can the Secretary of State and the Government offer the hospital to help turn it around and get it out of special measures? I thank the Secretary of State and his Department for the support they have given to the hospital so far.

I thank my hon. Friend for his enormous support for that hospital, which has been through a very difficult patch. I had a long meeting with the chief inspector of hospitals about the Medway yesterday. My hon. Friend will be pleased to know that, over the past five years, we got 106 more doctors and 26 more nurses into the trust. We now have a link with Guy’s and St Thomas’s that is beginning to bear fruit. There is a lot more to do, but we are determined to ensure that we do not sweep these problems under the carpet and that we deal with them quickly and deliver safer care for my hon. Friend’s constituents.

My right hon. Friend will know of some of the terrible problems experienced in Shropshire with respect to clinical commissioning groups and the trust, particularly over the future fit programme and A&E services in the county. The Royal Shrewsbury hospital covers a huge area—not just Shropshire, but the whole of mid-Wales. Will my right hon. Friend give me an assurance that he will do everything possible to support me and the residents of Shrewsbury to guarantee that A&E services remain at the Royal Shrewsbury hospital?

First, I thank my hon. Friend for his campaigning on behalf of the Royal Shrewsbury; no one could do more than he has over many years. I encourage him to engage carefully with the future fit programme. In the end, it is incredibly important to get the right answer for patients. My hon. Friend has been supportive of the process, but like him, I would like to see it concluded sooner rather than later.

Will the Secretary of State set out for my Worcestershire constituents what impact the putting of trusts into special measures is likely to have this year and what improvements can be expected when the trust exits special measures?

The advantage of the special measures programme is that we tend to make much faster progress in turning round hospitals in difficulty than used to happen in previous years. My hon. Friend will know that, in the past five years, his local trust gained nearly 50 more doctors and more than 100 more nurses. We are making progress, but we need to do it much faster. The hospital will have my full support in getting these problems dealt with quickly.

Walsall NHS trust has been placed into special measures, so what immediate action can the Secretary of State take to ensure that the Manor hospital can recruit the vital staff in paediatrics and A&E that it now needs—not agency staff, but long-term fully employed staff?

The hon. Lady is absolutely right that one thing that can tip hospitals into special measures is having too high a proportion of staff from agencies so that a trust cannot offer the continuity of care that other trusts can. There have been an extra 83 full-time doctors at Walsall Healthcare NHS Trust over the past five years, along with 422 full-time nurses. An improvement director started this week and we are looking to find a buddy hospital, which is what I think will help most. When it comes to turning hospitals round the fastest, we have found that having a partner hospital can have the biggest effect, as with Guy’s and St Thomas’s for the Medway.

Despite having a football team at the top of the premier league, the hospitals of Leicester are in need of urgent assistance. The worry for Leicester is that they will slip into special measures, particularly regarding A&E. What steps can the right hon. Gentleman take to ensure that our hospitals perform as well as Leicester City football club?

We want to them to be as outstanding as Leicester City football club, but we recognise that there is some way to go. There is pressure on A&E departments, as the Under-Secretary of State for Health, my hon. Friend the Member for Ipswich (Ben Gummer), has acknowledged in the House, and we are giving careful thought to what we can do to support them. Leicester will be one of the first trusts in the country to offer full seven-day services from March or April 2017 onwards, so important improvements are being made, but we will do all that we can to ensure that they happen quickly.

Calderdale and Huddersfield trust is not in special measures, but it is in trouble, and we are likely to lose our A&E service—in one of the biggest towns in Britain—if we follow the recommendations of the CCG. Does the Secretary of State agree that when hospitals and trusts get into trouble, it is usually because of poor management? What can we do to improve the management of hospitals, and, in particular, what can we do about people who, because they are GPs, think that they are managers?

The hon. Gentleman has made an important point. I think that there are some things that we just need to do differently. For instance, we should allow managers to remain in their posts for longer. If the average tenure of NHS chief executives is only about two years, their horizons will inevitably be very short-term, so we need to give them enough time to turn their organisations around. The chief executive of the latest trust to be given an “outstanding” measure, Frimley Park Hospital NHS Foundation Trust, has been there for 26 years, and I think there is a connection. We can ensure that managers have the necessary resources. I think we can also make sure that we identify their problems quickly, and give them support before those problems turn into a crisis.

Barking, Havering and Redbridge University Hospitals NHS Trust is working extremely hard to improve its services and has already achieved considerable success, but although there are 250 spare home beds in the London borough of Havering, there are still a great many frail elderly patients in hospital who are no longer clinically ill. Has any research been done on the reasons for delayed discharge, and to what extent does patient choice play a part in it?

Unfortunately, it sometimes plays a part, but the main way to tackle the problem is to establish better co-ordination between what local authorities do, what the CCGs do and what the trusts do. That applies not just to my hon. Friend’s local trust, but to trusts throughout the NHS. I do, however, commend her local trust. At its last inspection, the CQC found that it had made significant progress. It has more doctors, more nurses and, in my view, an excellent chief executive, and I am very confident about its future.

Sixteen trusts across the country are currently in special measures, nine out of 10 hospitals are failing to fulfil their own safe staffing plans and waiting time targets are being missed so often that failure is becoming the norm. Does the Secretary of State think that that might explain why, as we learned yesterday, a King’s Fund survey has found that dissatisfaction with the NHS increased by eight percentage points in 2015? That is the largest single-year increase since the surveys began in 1983.

The hon. Lady might want to look more closely at that King’s Fund report before turning it into a political football. According to page 6, satisfaction rates in Wales—run by her party—are six percentage points lower than those in England.

Let me tell the hon. Lady exactly what is happening with the special measures regime. We are being honest about the problems and sorting them out, rather than sweeping them under the carpet, which is what caused the problems that we experienced with Mid Staffs, Morecambe Bay and a range of other hospitals. At the same time, we are putting more money into the NHS and helping it to deal with its deficits, we are treating more people, and public confidence in the safety and dignity of the care that people are given is at record levels.

It is clear that the Secretary of State does not want to talk about his record in England. His own Back Benchers are queueing up to tell him about the problems in their NHS areas of Medway, Shropshire and Worcestershire, but he seems not to understand the extent of those problems.

Let us return to what the public think. Satisfaction with the NHS has fallen by five percentage points; dissatisfaction has risen by eight percentage points; satisfaction with GP services is at the lowest rate ever recorded; and satisfaction with A&E stands at just 53%. We know that the Secretary of State has lost the confidence of doctors, but is that not the clearest sign yet that he has lost the confidence of patients, too?

What my Back Benches are queueing up to say is, “Thank you for sorting out the problems that Labour swept under the carpet for years and years.” What did Professor Brian Jarman of Imperial College say about the Department of Health under the last Labour Government? He said that it was a “denial machine”, with all the problems in hospitals being swept under the carpet and not dealt with. What is happening under this Government? Every day, 100 more people are being treated for cancer, 2,000 more people are being seen within four hours at A&E departments and 4,400 more operations are being carried out. There are record numbers of doctors and nurses, and the NHS is safer than ever in its history. We are proud to be the party of the NHS.