Healthcare Facilities: Royston

Royston’s growth as a town and its close relationship with its villages nearby is reflected in the fact that the two practices that have merged have patients not only in Royston but in nearby villages in Cambridgeshire, Essex and Hertfordshire; it is a wide catchment area, not just for retail and industry but for health. The opportunity to merge the two practices provides the opportunity for modern facilities and for the secondary sector to follow Government policy and delegate services such as diagnostics to the primary community setting by way of a community diagnostic centre. I understand that Addenbrooke’s Hospital is a keen advocate for that approach and believes that Royston could be a good centre for the CDC.

In Royston, local people have seen the idea of a refurbishment of Royston Hospital co-located with modern community services as the way ahead. There have been campaigns over time to save the hospital site, but that is not out of sentiment or dogmatism; it is simply because it is a six-acre site close to the town centre and already in the NHS fold. If another site were identified and its benefits outlined, I am sure that Royston people would give it a fair hearing, but we do not want to lose our hospital site and be left struggling in the existing GP practice buildings, which come from a time when the town was half its current size. Where would the advantages of the sort of modern state-of-the-art health centre that we want be? They would be absent. There would be no room for our diagnostics unit. A new modern building would mean that the patients reliant on Royston would have guaranteed long-term primary care services provided in a locally based setting, satisfying the ICB mission to think local. It would also be future-proofed.

Local primary care services are suffering from recruitment problems in our area. I am sure that both Government and the NHS want to show professionals a modern vision for the future. What local doctors are proposing satisfies the current national programme seeking to improve access to common diagnostic tests using community diagnostic centres. The combining of services from the two Granta practices plus utilising the opportunity to cascade services from Addenbrooke’s into primary care and diagnostics at Royston is both opportune and efficient, and it would help with solving the problem of staff shortages. This issue is addressed in Dr Morrow’s recent BMJ article with Dr Sinsky about how to retain GPs, the importance of the patient-doctor relationship and how CDCs can help with that by doing the diagnostics locally and enabling that relationship to flourish.

I would like to see constructive discussions between Granta Medical, the Cambridgeshire and Peterborough ICB and Addenbrooke’s Hospital, hopefully supported by the Hertfordshire authorities, to see how this vision can be realised. The Minister has kindly already had one meeting with me and the various stakeholders, and he has played a part in helping this to happen. I note that last week I received a letter from the Cambridgeshire and Peterborough ICB—I wonder if it was aware this debate was to take place—asking me to work with it on a programme of engagement with local people and communities about health and care services around Royston. It also made it clear that no decision has been made about the future of Royston Hospital. I welcome that, and I will be happy to take part, but I hope that the Minister will continue to help us by backing the vision of our local doctors and ensuring that Royston does not fall off the map again.

If we take the map of the ICB area for Cambridgeshire and Peterborough and place it next to the map for Hertfordshire and West Essex ICB, the significance of Royston emerges clearly. It is in the middle, it is one of the fastest growing towns, it is surrounded by burgeoning villages, and it is at the heart of the innovation and engineering corridors that are the future of the UK economy. I am certain that, if meaningful discussions were held between all the interested parties, a long-term solution could be found for Royston. I am hoping that today’s debate, with the support of the Department, will go a long way to persuading Cambridgeshire and Peterborough ICB to re-evaluate its options and to accept that a health centre and CDC in Royston is an eminently sensible way forward.

NHS England is currently undertaking a formal assessment of all general practice premises through a primary care data collection programme, and this will provide an overview of the current capacity, suitability and ownership of all premises, with the information made available to local commissioners to inform their planning. But the activity of my right hon. and learned Friend in pointing out the opportunities and the challenges will be very clearly in the minds of his local ICB as it thinks about its future plans.

From 2023, a substantial proportion of primary care business-as-usual estates and GP capital is included within overall integrated care system capital funding envelopes. That allows local systems to take a more cohesive and coherent approach to how they spend capital across that system, and to prioritise the primary care investment needs in their own local strategies.

As well as funding from specific national programmes, Cambridgeshire and Peterborough ICB—as we now know, it is responsible for commissioning health services in Royston; my right hon. and learned Friend was quite right about that—received £77 million in operational capital funding in 2022-23, totalling over £205 million during this spending review period. Cambridgeshire and Peterborough integrated care system has worked in partnership with NHS Property Services to develop the first estates strategy for the region. This was consulted on earlier in 2023 and approved by the ICB on 10 March.

The ICB has been working closely with primary care providers to try to stabilise primary care provision locally, and is now reviewing estates and local health care provision to make sure that they are also fit for the future. I know that the ICB is in conversation with the Hertfordshire Community NHS Trust, Granta Medical Services, and NHS Property Services—my right hon. and learned Friend has mentioned some of this—to review all the sites and consider options for a potential healthcare centre, co-located with primary care and diagnostic facilities.

In its decision-making capacity for estates and healthcare service commissioning, it is essential that the ICB is able to fully assesses capital and revenue costs, and service implications, that would arise from any decision. The ICB has noted that, while it recognises the community hospital is not currently functioning as it should, it is important that any future decisions on its use are not taken until it has fully considered and appraised all options, as my right hon. and learned Friend has quite rightly insisted on. That is why the ICB is about to begin a comprehensive listening and engagement exercise for an initial six weeks, encouraging local communities to take part in that conversation through a range of routes. The ICB will share more details in the coming weeks, on its website, on social media channels and through updates to key stakeholders, as well as via the printed materials in the community so that everyone knows that this conversation is ongoing.

Another approach and consideration that integrated care boards may take when they are shaping healthcare estates locally is the reconfiguration of services. This is a clinically-led local decision following appropriate engagement with patients and stakeholders. Responsibility for the delivery, implementation and funding decisions for services ultimately rests with the appropriate NHS commissioner. All substantial planned service change is subject to a full public consultation, and must meet Government and NHS England’s tests to ensure good decision making. As my right hon. and learned Friend has sometimes pointed out, community diagnostic centres are an important development to allow patients to access planned diagnostic care nearer to home, without the need to attend acute sites. That is only one of the ways we are doing that, including through virtual wards and a closer tie-up between primary and secondary care. Funding for community diagnostic centres has been allocated so that areas with unmet need receive more funding. That will help to tackle health inequalities.

My right hon. and learned Friend rightly raised the Priors Field surgery closure at Sutton. NHS Cambridgeshire and Peterborough ICB is pleased to conform that from 1 April, Malling Health took on an interim contract to provide primary care services to the patients of Priors Field surgery. While that interim solution is being secured, the ICB continues to work with key stakeholders in the local community to ensure that communities in Sutton and the surrounding areas continue to have access to primary care services that meet their needs, both now and in the future. Knowing my right hon. and learned Friend well, I know that he will not be backward in coming forward to make the case strongly for investment in his local community and constituency, and we will continue the useful and helpful conversation that we have been having.