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May I say what a joy it is to see you back in the Chair, Mr Deputy Speaker?
I am very pleased to have secured this Adjournment debate on Stepping Hill Hospital, which comes at an important time in its development. I wish to discuss with the Minister the current pressures the hospital is facing, its recent performance figures and especially the strain on its accident and emergency and urgent care services. I hope to explain some of the reasons behind those pressures and what needs to be done, in both the short and the long term, to ensure that the hospital improves. In particular, I want to hear what the Minister is able to do to help the hospital and its staff to deliver better care for patients.
Stepping Hill provides a vital service to local residents in both my constituency and, as evidenced by their attendance at this evening’s debate, the constituencies of right hon. and hon. Members across the region. I am a long-term supporter of the hospital, although I am bound to say that, given that it was the place of my birth. I was, of course, pleased that Stepping Hill Hospital was awarded specialist status as part of Greater Manchester’s Healthier Together programme. I backed that bid from the beginning, as a local councillor, parliamentary candidate and Member of Parliament. The hospital is also generally well regarded by local people for the services it provides, and it deserves special praise for the fantastic and difficult job it performed in treating victims of the terrible Manchester Arena bombing in 2017.
The hospital faces difficulties in its performance in a number of areas. Although the latest Care Quality Commission inspection report rates the hospital as good for the care it provides and for leadership, its overall rating is “requires improvement”. The pressures are most acutely felt in emergency care services and in meeting its four-hour target in accident and emergency. In recent years the trust has struggled to consistently achieve the national standard of 95% of patients in the emergency department being seen and treated within four hours. Sadly, the most recent figures published demonstrate that Stepping Hill’s year-to-date position against that standard was 68%.
Those headline figures in no way reflect the work of doctors, nurses and all the other hospital staff, who are working incredibly hard to see, treat and care for the unprecedented number of people currently accessing the emergency department. I place on record my personal thanks to all staff right across the hospital, who provide excellent care for patients, day in, day out.
The reasons for Stepping Hill’s current performance against the standard are multiple and complex. They include the large catchment area it serves, rising demand, local population demographics, the limitation of the current building, a lack of alternative options to the emergency department, and integration with the local health and care system.
First, may I congratulate the hon. Gentleman on what he is doing? I have read some of the background, as I have already told him, and I commend him for his energetic efforts on behalf of his constituents and the hospital. My hospital, like his, has a specialist stroke unit and we want to keep it open, too. Time is of the essence. Does he agree that the retainment and enhancement of specialist services must be a priority in the NHS, no matter what direction it takes?
Naturally, I agree with the hon. Gentleman and commend him for his work, particularly in maintaining the stroke services at his local hospital. Indeed, I commend the work of all those who perform such vital roles at Stepping Hill.
In other parts of the country, especially in large cities, people have a number of options for where they can receive care for a range conditions, including as a result of accidents and minor injuries. That means that emergency departments just care for the sickest patients who need resuscitation or emergency care.
I am grateful to my hon. Friend for securing this really important debate. Stepping Hill Hospital serves not only Hazel Grove but High Peak and other parts of Stockport, and I know that there is a lot of interest in this debate. From my point of view, as the MP for Cheadle and as a Stepping Hill Hospital MP, I want to see the hospital really thrive. One of the issues facing the hospital is that it was built to accommodate about 50,000 out-patients—people coming into A&E—a year, and now that figure is going up towards 100,000. That is clearly a pressure on it. Does my hon. Friend agree that the £30.6 million that is going into the new emergency care centre will really make a difference?
Absolutely. I congratulate my hon. Friend and constituency neighbour on the work that she has undertaken with me and others from across the region in securing additional funding. I will touch on that later. She is absolutely right, because Stepping Hills’ emergency department is overstretched and facing those rising demands. It was built to treat about 50,000 patients a year but is currently on track, as she says, to exceed 100,000 patients this year.
I congratulate the hon. Gentleman on securing this Adjournment debate. Is it not also important to impress on the Minister the demographic nature of the borough of Stockport, which we all represent? Stockport is a microcosm of the whole country in that it has its own north-south divide. There are real health inequalities between those living in the north of Stockport and those living in the south. In the south of Stockport, people tend to live longer and stay healthier longer, but when they do reach old age, they often have very complex needs.
The hon. Gentleman, my constituency neighbour to the north of my constituency, is entirely spot on. His remarks are incisive and to the point, because the demand for emergency care in our area has risen by about 5% in the past year, and in the three months to December alone it increased by 6%. It was previously rare for Stepping Hills’ emergency department to see more than 200 patients a day, but now it is not uncommon for over 300 people to seek treatment per day. Indeed, in Christmas week, over 1,700 patients were seen by the department.
Bed capacity is also a problem at Stepping Hill. A hospital bed system should ideally run at about 85% occupancy to make way for new patients, but at Stepping Hill beds have been frequently running at over 99% occupancy. Having support in place to enable people to return home as quickly as possible once they no longer need acute hospital care is also key to achieving the national standard by improving the flow of patients through the hospital and its emergency departments. As Andrew Gwynne says, Stockport has the highest proportion of elderly people in Greater Manchester, with 19.5% of the population being 65 or older. While increasing longevity is of course to be celebrated, our local population is living longer, often with complex and multiple health conditions, and they place a particular demand on the emergency department that is not seen to the same degree elsewhere in the region.
The hospital has implemented a number of short-term initiatives to try to fix and improve the situation in A&E, particularly to address the extra winter pressures due to influenza and the cold weather. The trust recently spent £1.2 million provided by NHS England to expand the number of consulting and treatment rooms in the existing emergency departments. This winter, Stepping Hill implemented its winter plans two months early, opening an extra 30 beds in the hospital. Even so, concerns this year were so great that they were recognised by the Greater Manchester health and social care partnership. In December, the hospital received an extra £2 million of funding to enable it to open an additional 51 beds until after the end of March this year, increasing staffing and supporting seven-day working.
However, I want to ask a number of questions of my hon. Friend the Minister, for whose consideration this evening I am very grateful. First, despite all those steps and extra beds, in December, alarmingly, 200 people waited for 12 hours or more in the department before a bed could be found for them. I wish therefore to ask him what more can be done by the Government to help Stepping Hill to improve its A&E performance in the short term.
I congratulate my hon. Friend and constituency neighbour on securing this debate. I know he is a great advocate for the local NHS and for Stepping Hill Hospital, which many of my constituents use as their local hospital. He touched on the worrying performance figures. Does he agree that we need to get on with building the urgent care centre as soon as possible?
First, may I congratulate my hon. Friend on his election in High Peak, which is next door to me, and for working as closely as possible with me on this issue as soon as he was elected? Like him, I welcome the investment that is coming, as I am about to outline.
Opening more temporary beds is not the answer to the pressures on our health and care system. A radical long-term solution is needed if Stepping Hill is to improve its A&E performance. That is why I, the hospital and all Members across the House with an interest in it have called for greater investment. The new £30.6 million of funding will enable the organisation to construct a three-storey, purpose-built emergency care campus. It will include an urgent care treatment centre, a GP assessment unit and a planned investigation unit, as well as a new ambulance access road and improved waiting areas.
The emergency care campus will not be simply a new accident and emergency; it is intended instead to care for patients who require a slightly lower grade of emergency care, thus relieving the pressure on A&E by improving the flow of patients through the hospital from the emergency department. Patients who need resuscitation or emergency care will still be seen in A&E. This much-needed investment will relieve the pressures on accident and emergency by implementing a better triaging system for patients, meaning that they get the right care in the right place. Patients who do not require full A&E emergency care will be seen in one of the three new services at the urgent care campus.
The urgent care treatment centre will provide an alternative for those who do not need resuscitation or emergency care. It is expected to triage about 45 patients a day away from accident and emergency. The GP assessment unit will support patients who are referred by their GP for hospital care, ensuring that they have quick access to the acute and medical specialists they need to see without going through the emergency department, thereby reducing A&E admissions by a further 25 patients a day. The planned investigation unit will improve the time in which patients are returned home with a care plan when they no longer need to access acute care services.
The hon. Gentleman is being incredibly generous; I am very grateful. I associate myself and my hon. Friend Navendu Mishra with the proposals the hon. Gentleman has outlined.
May I offer the hon. Gentleman some reassurance from across the boundary in the neighbouring borough of Tameside, which my constituency also covers? Fifteen years ago, when I was first elected to this House, the reputations of Stepping Hill Hospital and Tameside Hospital were almost in mirror image. Tameside was not the best place it could be. With great focus and new management, that hospital has been transformed. Does he share my confidence that better days are ahead of Stepping Hill, and my trust in the staff and the management to take the hospital back to where it needs to be?
To follow up on the point made by Andrew Gwynne, it is great to see the progress that has been made at Tameside Hospital, which many of my constituents, particularly those in Glossop, Hadfield and Tintwistle, use as their local hospital. Does my hon. Friend agree that it is fantastic that the Government have committed to a new urgent care centre at Tameside Hospital as well?
There is mutual praise and admiration all around in this debate, so I entirely agree with my hon. Friend. It is wonderful that we find such consensus on this issue. Stepping Hill unites us all, and that is something of which we can be proud.
I intend to work closely with the Government, Stockport Council and the hospital trust to support the planning process, so that the new emergency care campus can be built and be up and running, treating patients as soon as possible. That leads to my second question for my hon. Friend the Minister. What timescale does he envisage for the completion of the new urgent care campus, and how confident is he that it can be met? How many more winters will the hospital go through before that new facility is up and running?
No debate on hospitals would be complete without at least a brief discussion of parking, which is often the bane of patients, visitors and staff alike. It is an issue that affects not only those using the hospital but local neighbours. A lack of car-parking capacity, or the desire to avoid charges, often means that cars spill out to use kerbside parking on nearby residential streets, which can prove to be a significant inconvenience. I therefore welcome the Government’s commitment to provide free hospital parking for those who need it most, including disabled patients, parents and carers of sick children staying overnight, and hospital staff working night shifts, who are less able to rely on public transport. That change is long overdue and will make the NHS as accessible as possible for those who need it most.
In addition, I am extremely encouraged that the Government plan to provide more than £200 million of capital funding for new car parks, to support several hospitals across England that need extra car-parking capacity. Does the Minister know which hospitals have been earmarked for that funding and whether Stepping Hill is among them? If he cannot give me a firm answer today, will he meet me following the debate, so that I can make the case again for increasing parking capacity at Stepping Hill?
I look forward to hearing the Minister’s reply, and I hope that he can provide me with the answers to these important questions. I especially hope that he has some ideas on short-term solutions that can be found to help the hospital and its patients while construction work on the emergency campus is carried out. I would also like to take this opportunity to extend an open invitation to him to visit the hospital—I am sure that he would be very welcome—to see at first hand the pressures it faces and what can be done to improve the situation for the hospital and its patients.
Finally, I wish to reiterate my thanks to the dedicated doctors, nurses and staff across the hospital for their tireless work, day and night, in these very challenging circumstances.
I thank my hon. Friend Mr Wragg for securing a debate on this extremely important topic. I know well of his commitment to pursuing the subject of Stepping Hill on behalf of his constituents and ensuring that it continues to be focused on by Ministers and the House more broadly. He is a forceful but always courteous local champion for Hazel Grove, and his constituents are lucky to have him. He ensures that their voice is heard loud and clear in this place. I have recently discussed Stepping Hill with him, as well as with my hon. Friend Mary Robinson. I pay tribute to her for her work on this issue and to other Members across the House. As has been evidenced by the interventions in the debate, Stepping Hill Hospital is important not only to one or two constituencies but across the region.
My hon. Friend the Member for Hazel Grove is right to highlight how well-regarded Stepping Hill Hospital is by those it serves and its key role in treating some of the victims of the dreadful Manchester Arena attack in 2017. He is also right to raise the challenging performance at Stockport NHS Foundation Trust, of which Stepping Hill Hospital is a part. It is right that I echo his comments in paying tribute to the hard work and dedication of all who work in our NHS and in Stepping Hill, as we should whenever we speak about healthcare in this House. Day in, day out, our amazing NHS workforce deliver world-class care. My hon. Friend highlighted the challenges in the recent A&E performance statistics, but Stepping Hill does perform very well in a number of other areas. For example, in the statistics for some of its cancer treatments it performs well. There is a challenge, which he mentioned, particularly in but not limited to A&E.
Winter is the most challenging time of the year for the NHS, when a number of environmental and external issues, such as cold weather and an increase in flu and other viruses, place additional demands on the service. Of the short-term actions that have been taken and will be taken, and in recognition of recent challenges, oversight and additional input for Stockport and Stepping Hill have been ongoing via NHS England’s national oversight model, which brings national resource and expertise to bear in supporting them. The Trust has also been working with the emergency care intensive support team—commonly known as ECIST—a clinically led national NHS team, to help health and care systems deliver high-quality emergency care. Its intervention has improved the flow of the patient journey through the hospital and achieved a reduction in the number of long length of stay patients.
As my hon. Friend mentioned, the Stockport trust received the largest additional amount in funding given to any trust in the north-west this winter. This has enabled it to open additional beds and to employ additional senior medical staff. Specifically, there is £1.68 million to staff two additional wards; £453,000 to provide consistent medical staffing to additional beds to reduce length of stay; and just over £100,000 to provide additional seven-day acute medical cover, which is also to reduce the length of stay.
I should say that Stepping Hill should be commended for the tremendous achievements it has secured. Its stroke centre in Stockport has been rated the best in England, Wales and Northern Ireland for the third time in five years, and a new service has been launched at Stepping Hill Hospital to provide extra support for mums and dads-to-be who have previously experienced stillbirth, late miscarriage or early neonatal death in previous pregnancies.
At local level, in addition to those broader achievements, additional clinical resources are being sought at Stepping Hill to help discharge patients more safely and more swiftly back into the community. Additionally, GP streaming, a process designed to ensure that less acutely ill patients can be seen more quickly, has moved to a seven-day model to provide enhanced levels of support over the winter period. As part of the wider round of capital work within the Stockport trust, a new frailty unit will be open in Stepping Hill from February, as an important short-term addition to its facilities and capabilities. By moving the existing unit, more space and capacity will be created in the acute medical unit so that more patients can be seen in a timely manner.
While all these interventions are beneficial in the short term, it is crucial that this is matched with investment in the infrastructure of the system for Stepping Hill, as my hon. Friend said, for the longer term. He and other hon. Members, including Andrew Gwynne, have highlighted some of the broader factors that continue to challenge the trust and hospital, such as the local demographics and the broader economic and societal factors affecting the health of the local population.
As my hon. Friend the Member for Hazel Grove said, the Government, through our new health infrastructure plan, are supporting more than 40 new hospital-building projects across the country, backed by £2.8 billion. We have also provided an extra £1.8 billion, including £850 million for 20 hospital upgrades. From this funding, Stockport NHS Foundation Trust has been awarded £30.6 million to build an emergency care campus at Stepping Hill. I must say that my hon. Friend and my hon. Friend the Member for Cheadle have both played key roles in securing this funding, but it would be right to say that hon. Members from both sides of the House and from the wider region have also played their part in making the case for this investment, and it is right that I pay tribute to all of them as well.
This funding will provide a three-storey, purpose-built campus, including an urgent treatment centre, a GP assessment unit, a planned investigation unit, a new ambulance access road and improved waiting areas. As with any improvements on a scale such as these, I am sure my hon. Friend the Member for Hazel Grove, and indeed all hon. Members, will recognise the importance of getting them right. This is why the development will be subject to a public consultation.
My hon. Friend, and other hon. Members, are right to be ambitious about getting on with this. I am pleased to see my hon. Friend Robert Largan in his place. He is a welcome addition to the Green Benches, and I know he will be a strong voice for High Peak in the House of Commons. His constituents are lucky to have him. He highlighted timescales, as did my hon. Friend the Member for Hazel Grove, and subject to public consultation and the development of plans, we hope that the business case and appropriate sign-offs and planning will take place this year, with construction beginning next year. I know my hon. Friend will wish us to go further and faster, and I am happy to take up his offer of a meeting. We will work together to see whether we can speed things up, but that is the timescale as it currently stands. More broadly, as well as investing in capital funding, the Government are also investing £33.9 billion more in our NHS, to ensure that its running costs, and day-to-day costs, are fully invested in.
My hon. Friend would not forgive me if I did not touch on his remarks about car parking. He has previously raised concerns about the lack of available parking at Stepping Hill, and the Government have listened. As he said, and as per our manifesto commitment, with the roll-out beginning in April this year, all 206 hospital trusts will move towards providing free car parking for disabled blue badge holders, parents of sick children who are staying overnight, and staff who are working nightshifts. Alongside improving access and cutting costs for those individuals, my hon. Friend is right to highlight the issue of capacity. As he said, we have earmarked a significant pot of capital for that, but we do not yet have a list of hospitals that will receive that funding. We are currently undertaking a data exercise to understand capacity versus demand in hospital trusts, and I know he will make a strong case for his hospital.
Taken together, the initiatives outlined this evening reflect the desire to excel at Stepping Hill, and they bode well for the ambition to turn around performance in other areas. I look forward to visiting, and I am happy to take up my hon. Friend’s kind invitation—I suspect that invitation may also attract Members from other constituencies, if it works with their diaries, and I look forward to working with him to find a date for that visit.
In conclusion, the nation’s health is our biggest asset. The NHS is the people’s priority, and it is our priority. We will continue to work with my hon. Friend and other hon. Members across the House, and with Stepping Hill and Stockport Foundation NHS Trust, to drive the improvements in performance that my hon. Friend’s constituents rightly expect, and that I know all who work at Stepping Hill are determined to deliver.
Question put and agreed to.