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King's College Hospital: Covid-19 Recovery

Volume 704: debated on Friday 3 December 2021

Motion made, and Question proposed, That this House do now adjourn.—(Rebecca Harris.)

I am grateful for the opportunity to hold this debate on King’s College Hospital and the post-covid recovery, in which I will make the case for the sustained investment that our local hospital needs to keep delivering for our communities and beyond. Let me start, however, by placing on record the immense gratitude of so many of my constituents to all the staff at King’s College Hospital for their incredible work during the covid-19 pandemic.

King’s College Hospital is on Denmark Hill in my constituency. The King’s College Hospital NHS Foundation Trust also includes the Princess Royal University Hospital in Bromley and Orpington Hospital. I will refer to some issues that impact the trust as a whole, and some that are specific to the Denmark Hill site in my constituency.

King’s College Hospital holds a very special place in the hearts of families across my constituency, who are grateful for the live-saving, life-enhancing treatment and care that it provides. My family is no exception: both my children were born at King’s; my mum worked at the hospital for a decade; I have been a surgical patient there; and paediatric A&E has been there to patch up our children on several occasions. The team at King’s is a proud expression of the diversity of our wider communities in south London, including significant numbers of staff from the Caribbean, the Philippines, India and west Africa in particular. As a local community, we are grateful to those who have travelled to the UK to serve in our NHS, and for whom the pandemic has created the added pain of long separation from their loved ones.

King’s is a centre of excellence in many different disciplines, including trauma care, neurosurgery, maxillofacial surgery, hepatology, neonatal care and many others. At the start of the pandemic, the trust’s finances were in a very precarious financial state. Absorbing the Princess Royal University Hospital and Orpington Hospital into the trust in 2014, following the closure of the South London Healthcare NHS Trust, without an adequate funding settlement, had resulted in the trust having the highest levels of debt of any hospital trust in the country. This was completely impossible for the trust to address, despite punishing control targets bearing down on every single department.

I had been making the case to Ministers for many years prior to the pandemic that the only viable solution to King’s finances was for the debt to be written off, and I was enormously relieved when the Government finally announced this at the start of the pandemic. It made all the difference, allowing the staff team at King’s to focus fully on doing what was necessary to get through the pandemic. And that work really was extraordinary.

Between the start of the pandemic and the end of November, King’s treated and discharged 6,871 patients who tested positive for covid-19. Sadly, during the same period 1,285 patients who had a positive covid-19 test passed away at King’s. The second covid-19 wave hit King’s particularly hard. For example, on 18 December 2020, the trust was treating 90 covid-19 positive patients in its hospitals, yet by 11 January 2021, this had risen to 776 patients—a nearly ninefold increase in just over three weeks. Despite the intense pressures, the care and commitment of the staff at King’s ensured some of the best covid-19 patient outcomes anywhere in the country. Between February 2020 and June 2021, 17.6% of patients admitted to our hospitals with covid-19 sadly died, compared to the national average of 21.5%.

The specialist care and treatment provided by King’s also improved as the pandemic progressed, as expertise and knowledge grew. At the start of the pandemic, 27.2% of covid-19 positive patients admitted to King’s hospitals sadly died. That figure reduced to 16% by the second wave and fewer than 5% now. King’s also continues to help support the wider national covid-19 response, including through research, with teams currently running more than 55 covid-19 active research studies, placing King’s in the top five sites in the UK for the number of research studies undertaken. More than 5,000 patients have participated in covid-19 research at King’s, and its teams have published 169 covid-19 research papers.

Amid all this work, there have been some particularly moving human examples. In April 2020, King’s staff celebrated patient Jose-Luis Fernandez, aged 80, who was discharged from King’s after recovering from covid-19. Jose-Luis, a grandfather of five from Sidcup, was admitted to hospital on 15 March 2020 and then tested positive for covid-19. Jose-Luis’s daughter Natasha said:

“Dad’s recovery has been nothing short of miraculous. At one point, we didn’t know if he’d be able to walk or talk again, yet he’s back on his feet. So many people at King’s were instrumental in my Dad’s recovery. We can never thank them enough”.

Emmanuel Boateng had an extraordinary start to life. Born three months premature, Emmanuel fought off life-threatening infection before becoming King’s youngest survivor of covid-19. Emmanuel was due on 27 April 2020 but arrived unexpectedly on 30 January, at King’s, after his mother Evelyn went into premature labour. He spent time in the neonatal intensive care unit before being discharged, but just a week later Emmanuel was back in King’s with covid-19, fighting for his life. Emmanuel is King’s youngest survivor of covid-19, so when it was time for him to finally go home on 27 April 2020 —his original due date—he received a round of applause from staff as he left the ward.

In December 2020, King’s became one of the first 50 hubs to begin vaccinating people against covid-19, at the start of the biggest immunisation programme in history. Initially, people aged 80 and over, as well as care home workers, were the first to receive the jab, alongside NHS workers. It was then rolled out more widely to the general population. Collectively, the vaccination hub at King’s and its sister site, the Princess Royal University Hospital, will have administered a quarter of a million vaccines by the end of 2021.

We know that for far too many people the covid-19 infection leaves long-lasting health impacts known as long covid. Members of the occupational health team at King’s have worked with other NHS colleagues on training materials for people impacted by long covid-19. Alongside colleagues from NHS England, NHS Improvement and St George’s Hospital, members of the therapies team, who have experience of caring for patients with long covid, came together and led on the development of training materials and guidelines for staff who work with patients suffering from the condition. The team developed a package of materials, with contributions from GPs, frontline staff and individuals with lived experience of long covid. The rehabilitation guidance will roll out nationally to benefit patients throughout the country.

The work I have described represents the extraordinary commitment of our NHS staff to the communities they serve, and I want to say a heartfelt thank you to everyone who works at King’s—the nurses, doctors, porters, cleaners, reception staff, allied healthcare professionals, management and maintenance staff and all who have done so much to give hope to those afflicted by covid-19 and their families, and to offer comfort to those who have tragically lost loved ones by doing everything they possibly could to save them.

The staff are continuing to work under incredible pressure, so I also want to take this opportunity to urge all my constituents to get the booster jab as soon as possible, not only to protect themselves but to help to reduce the pressure on staff at our local hospital. Shockingly, staff at King’s are being subjected to increasing levels of abuse from patients and family members, so I want to state very clearly that however stressful someone’s situation, there is no excuse at all for violence or aggression or for the verbal abuse of our hard-working NHS staff.

Just writing off King’s College Hospital’s debt is not remotely sufficient to put the hospital on a sustainable long-term footing for the future, because prior to the pandemic King’s had been strapped for cash for far too long. The hospital sits on a comparatively small site for a large hospital in the middle of a densely populated urban area, with a mixture of ageing buildings, the newest of which was opened 18 years ago. Much of the work of the staff at King’s is all the more extraordinary because it is undertaken in facilities that are badly in need of upgrading. When people talk about the need for efficiencies in the NHS, it is often interpreted to be about the rate of work for individual staff, and it is often forgotten that a huge part of NHS efficiency is staff having access to the equipment they need, close to their patients.

In common with NHS staff throughout the country, the team at King’s are exhausted and burnt out by the pandemic. I have spoken to staff who are full of praise for the support they received during the pandemic from the hospital, their trade unions and members of the public—the hospital established a health and wellbeing hub, and local residents and businesses donated hot meals, snacks and care packages—but many are traumatised by what they have witnessed and in need of longer-term support.

Recruitment into NHS roles remains hard, even for one of the best and most popular hospitals in London. King’s urgently needs to be able to plan for and commit to a sustained programme of capital investment to renew out-of-date facilities and ensure that the hospital is fit for purpose for the 21st century. This is vital for sustaining good patient care, for dealing with the backlogs left by the pandemic and, importantly, for the retention of staff. Specialist clinicians at King’s are among the best in the world. They are committed to the NHS, but they are also committed to scientific advancement within their areas of specialism, and they can work anywhere in the world. To retain the best clinicians and scientists at King’s, they must be provided with the equipment, facilities and working environment to do their work to the best of their ability.

I know that the trust is grateful for the capital investment that it has received in the past two years, as well as for the announcement today of funding for the emergency department at Orpington Hospital and to bring the long-awaited and already built critical care unit fully into use. However, a decade of under-investment has left the trust with an £80 million maintenance backlog that the funding allocation is inadequate to address. The current funding will not enable the trust to invest in IT and digital infrastructure to match the excellent clinical care that staff provide, or to address the wider investment needs of the Denmark Hill site in my constituency in particular. Capital investment in King’s, including in diagnostic equipment such as scanners, would directly help to address the backlog caused by the pandemic and support the emergency department, which remains under immense pressure.

Will the Minister join me in thanking the staff across the King’s College Hospital NHS Foundation Trust for all that they have done during the pandemic and all that they continue to do for our communities while working under intense and sustained pressure? Will she commit to the sustained capital investment that King’s urgently needs to support its staff in continuing to deliver the best possible care and in working through the backlog created by the pandemic? What comfort can she offer the hard-pressed staff at King’s and every other NHS hospital across the country that the Government have a plan to address the staffing crisis and alleviate the pressures they will face this winter and beyond? We are immensely proud of our local hospital in south-east London, and I will keep speaking up for the resources that it needs.

I thank the hon. Member for Dulwich and West Norwood (Helen Hayes) for securing a debate on this important issue, which I know is one on which she campaigns regularly. I also thank her for all the work that she has done with the hospital as a member of the trust and for her work in encouraging everybody to come forward for boosters or first vaccinations. I am grateful to her for thanking us for writing off the debts—Government seldom get thanked, so that was wonderful to hear—which I know made a massive difference. At the start of the pandemic, we wrote off £13 billion of debt, supporting 110 hospitals and freeing them up to cope with the unbelievable circumstances they have faced without having to worry too much about the impacts of their debt.

As every Member of this House and the wider public know, covid-19 has had a monumental impact on the NHS, without which we would have all been lost. King’s College Hospital trust has seen an increase in the number of patients waiting for routine procedures and operations, with about 1,000 people waiting more than a year for treatment. That is similar to the national picture, with currently more than 303,000 people waiting more than 52 weeks for treatment and a total waiting list of 5.86 million people, up from 4.4 million before the pandemic. Further, we are seeing impacts on emergency services such as A&E caused by winter pressures and covid-19. King’s College Hospital Trust sees about 69% of people in A&E within four hours, which again reflects the national picture of about 74% of people being seen within four hours.

The trust is now making good, significant progress to reduce waiting lists, with the number of people waiting more than a year for treatment reducing significantly from a high in February 2021 of almost 7,000 patients to about 1,000 now, as I stated. We thank all the teams working on that. The trust has found new and innovative ways of working, including a weekend operating list and greater partnership across local systems. To support that, £3 million has been provided to build an additional modular theatre at Orpington Hospital, which is due to open in the new year. That will certainly help.

Amazing work has also been carried out at the trust on diagnostics. It has seen a reduction in the number of people waiting more than six weeks for a test from 40% in January to 7% in November. Again, our thanks to all the teams involved in that effort. Ministers often read out numbers, but behind those numbers and achievements there is a lot of hard work. We recognise that.

To support the work of King’s College Hospital Trust, since the start of the pandemic it has received £64 million in additional revenue funding to support its covid-19 response, as well as an additional £18.5 million in elective recovery funding. The trust will also receive an additional £18 million of capital funding to complete its critical care unit and increase its overall critical care capacity by 59 beds.

I thank all the staff who work at King’s College Hospital for the work that they have done over the pandemic and since, not just in the areas that I have covered, but in the delivery of the national vaccination programme, during which they have administered more than 250,000 covid-19 vaccines, with I am sure more to come. I add my condemnation of anyone who abuses our wonderful health and social care staff who work so hard to do their best. The last thing they need is abuse from members of the public.

Staff members, led by their chief executive Professor Clive Kay, have given their all during the pandemic. They are at the heart of the effort to build our NHS back better. As such, I am pleased that staff have access to comprehensive staff support programmes, which focus on supporting and building the resilience of teams and provide psychological interventions to staff at high risk of developing mental ill health.

Further, the trust has established a psychological support team and a specific occupational health team to help staff who may be experiencing symptoms of burnout or poor mental health, including bespoke support for staff coping with the symptoms of long covid. We know that the staff have been through an awful lot and we need to provide that support to ensure that we take good care of their mental health.

We are also supporting trusts through national work such as community diagnostic hubs. We have allocated £2.3 billion to increase the volume of diagnostic activity and to roll out at least 100 diagnostic hubs by 2024-25 to clear the backlogs. Those hubs will provide a one-stop shop for diagnostic tests, which will mean that people can have multiple tests in the same place rather than returning for multiple appointments, so it will be much more convenient and efficient. That increase is expected to allow the NHS to carry out an additional 4.5 million scans.

Further, we have given £8 billion over the next three years to step up elective activity and transform elective services. That supports our aim for the NHS to deliver about 30% more elective activity by 2024-25 compared with pre-pandemic levels.

This winter, NHS England and Improvement has led work with NHS providers, regions and stakeholders to ensure that robust operational plans are in place, including plans to meet increases in the demand for emergency care driven by seasonal flu and/or covid-19. We have given it an extra £55 million to boost staff numbers ahead of winter to help to recruit more 999 call handlers and clinicians to work in control rooms and to bolster frontline staffing capacity. We have also invested an extra £98 million in NHS 111 to help to meet increased demand and to boost capacity.

“The health and social care approach to winter” has been published today; we heard the statement earlier from the Minister for Health, my hon. Friend the Member for Charnwood (Edward Argar). That is a joint publication from the Department of Health and Social Care and NHS England and Improvement, which sets out the wide range of preparations that we have made to ensure that health and social care services remain resilient, joined up and available to patients over the coming months. It also announces the allocation of the £700 million targeted investment fund.

I thank the hon. Member for Dulwich and West Norwood for the points she made in the debate, which we take on board. We are doing everything we can to support our NHS. I also thank our wonderful NHS staff, and while I am here, our social care staff as well, who continue to work so hard to overcome the problems that the pandemic has created and to look after vulnerable people in their time of need. We remain committed to supporting the NHS, so that we can reduce waiting times and ensure that everybody gets the care that they need.

Question put and agreed to.

House adjourned.