For heart attack patients suffering from cardiogenic shock, every 10-minute delay in treatment equates to a 3.3% increase in the risk of death. That startling fact not only emphasises that every minute matters when it comes to emergency patients receiving treatment, but highlights the importance of locating our new hospitals strategically. After all, a hospital’s reason to be is to save lives, and we must use the most up-to-date clinical evidence to ensure they do that whenever possible.
Last year, the then Secretary of State for Health and Social Care confirmed the biggest infrastructure investment in my constituency’s history: £700 million to £900 million for a new north Hampshire hospital at the Hampshire Hospitals NHS Foundation Trust. We have just completed an extensive public consultation on how the new hospital will evolve, and on the provision of services at two of the hospitals in the HHFT—the Basingstoke and North Hampshire Hospital and the Royal Hampshire County Hospital in Winchester. The results of the consultation are due to be released in the coming weeks. Although I very much look forward to seeing the views of residents on those important plans, I also believe it is essential that hospital services are configured so that they can best deliver treatment to patients, and that must be done by listening to how clinical experts feel we ought to locate services on a hospital and departmental level.
Although funding was confirmed last year, work to identify potential sites for the new acute hospital began in 2019. A comprehensive search for the right location spanned north Hampshire, including Alton, Andover, Basingstoke, Eastleigh, Winchester and the surrounding areas, as well as practical considerations such as price, availability and size. Fundamental to HHFT’s criteria were a series of clinical considerations on how to improve patient outcomes and increase accessibility. In the end, two viable sites were identified, one of which is the trust’s preferred option, between Basingstoke and Winchester near junction 7 of the M3. The other is on the existing Basingstoke hospital site. During assessments, the current Winchester hospital site was also considered as an option. However, it was deemed too small to accommodate all of the services needed at our new acute specialist hospital and, besides, there is no adjacent land that could facilitate future expansion.
A key reason why junction 7 is the preferred site is that the ambulance service has argued in the past that it would enable the sickest patients to access care more quickly. Locating a hospital in the centre of a town or city may be convenient for patients attending elective surgery, but it is increasingly awkward for ambulances in a race against time. As the statistic about heart attacks demonstrates, ambulances are often in a race against time, and junction 7 is a convenient location between Winchester and Basingstoke with easy access to the M3.
Combined with the important access considerations, building a new hospital at junction 7 would also not disrupt existing services while construction takes place. These proposals are rooted in science and clinical experience, and they will save lives. It is clear to me that residents from across north Hampshire should follow the expert opinion and throw their weight behind supporting the junction 7 approach.
Not only is clinical guidance essential to the siting of the new hospital; so too is the location of specific services. The new HHFT hospital consultation introduced the trust’s new model of care, which centralises crucial services. That approach is underpinned by mountains of clinical evidence and research. Medical evidence suggests that centralising services in this way reduces duplication, increases the quality of care and is best for patients.
This model has already been rolled out in some departments, such as cardiology. A person who has a heart attack in north or mid-Hampshire will be sent to an amazing new heart centre in Basingstoke, where they are assured of top-quality care at all hours of the day. The results have shown that this approach saves lives. Members do not have to take my word for it, because seven of Hampshire’s top clinicians, including the chief medical officer, published an open letter in support of this approach:
“Bringing together more specialist services for the most seriously ill patients onto one site would mean we are able to bring services in line with best practice and national guidelines.
This means if you are critically unwell, you will be seen by experienced senior doctors and nurses who are experts in their field. This would have significant benefits for patients, both in terms of improvements to their care and their clinical outcomes.”
To bring the benefits of the new model into even greater focus, I will touch on two particular areas of service: maternity and emergency care. Neonatal care units are graded on a three-tier scale, ranging from level 1, which can treat unwell babies, to level 3, which can care for the most premature or unwell babies. The trust previously had a level 2 rating, which was temporarily changed to level 1-plus in November 2023 following an unannounced Care Quality Commission visit after a series of complaints.
Although the trust’s overall rating remained good, it was concerned that the neonatal units did not see enough seriously unwell babies for the staff to maintain the specialist skills needed for level 2 status. This relegation now means that, each year, around 100 very sick or premature babies have to travel to Southampton or Frimley Park hospitals for treatment. This is clearly not easy for families, but we have been gifted a golden opportunity to make sure the decision is reversed so that more babies can be looked after closer to their families.
Good practice and standards suggest that there should be 98 hours a week of on-site consultant cover, with 60 hours being the minimum requirement. At the moment, both maternity sites in Winchester and Basingstoke are able to provide only the minimum requirement. Were services not duplicated across two sites, the hospital could provide one unit with more hours of consultant cover, thereby reaching the recommended number of cases necessary to regain level 2 status.
The current level 1-plus status of our maternity service shows that the status quo is not an option. North and mid-Hampshire need a better service, and the surest way to secure it is by following the medical advice and centralising the services of the maternity units into one hub at the new junction 7 site.
Another area where the new model of care will have an enormous impact is emergency care, which is set to be reconfigured to reduce waiting times and streamline patients’ treatment. A large emergency department, complete with trauma unit and children’s emergency department, will be centralised at the new junction 7 site. It will specialise in treating the most serious cases. However, both Basingstoke and Winchester will have an urgent treatment centre, and each will be led and supported by advanced nurse practitioners, doctors and other health professionals. Both will be open 24 hours a day, seven days a week, and have been designed to provide quick treatment. It has been estimated that two thirds of cases currently being treated in A&E could be seen at an UTC, including all but the most serious illnesses and injuries. Restructuring facilities in this way will free up staff in A&E to focus on the most unwell patients, while simultaneously reducing the waiting times for patients with less serious ailments. Plans have been rigorously drawn up in a way that ensures patients are rapidly assessed, diagnosed and treated.
Both those cases, of maternity and emergency services, underline the importance of listening to and following clinical guidance when determining not only the location but the configuration of our new hospital services. The Government have made it very clear that they wish to see both Basingstoke and North Hampshire Hospital and Royal Hampshire County Hospital, Winchester continue to provide services. That has been reiterated by the hospital trust itself. The plans are about a significant reconfiguration of where and how those services are provided. The recommendations are based on expert clinical advice, because clinicians are best placed to identify the best way to treat patients. We would do well to listen carefully to their advice and, as far as possible, to follow the plans informed by their methodological research.
The Hampshire and Isle of Wight integrated care board is due to publish the findings of the consultation that has been carried out imminently. We are all looking forward to seeing those results, but the Hampshire Hospitals NHS Foundation Trust must ensure, on behalf of residents and its patients, that the clinical evidence, best practice and expert experience of clinicians remains at the forefront of its mind throughout.
The £900 million investment in our health service in north and mid Hampshire is a once-in-a-lifetime opportunity to improve what is on offer to residents throughout those communities, but we only have one opportunity to get it right. I hope the Minister, in her reply, can confirm to me her intention to support Hampshire Hospitals NHS Foundation Trust to make sure that it follows clinical advice, while also ensuring that it has listened to residents.