Letter to Simon Stevens, NHS England Chief Executive

Copeland MP and Shadow Health Minister Jamie Reed has written to Simon Stevens, NHS Chief Executive, calling for an investigation into the Cumbrian health economy with a view to producing a comprehensive recovery plan following publication of today’s report into UHMBFT by Dr Bill Kirkup CBE:

The Cumbrian Health Economy

Dear Simon,

The Cumbrian health economy is experiencing the most prolonged period of intense pressure it has ever faced. Many working within it believe that it is on the verge of collapse.  Over recent years in particular, the system within the county as a whole has moved from one crisis to another. Inevitably, this is compromising patient care. I have repeatedly raised these issues with the Department of Health over a number of years. The time to act is long overdue and today’s publication of the report into the failings of University Hospitals of Morecambe Bay NHS Foundation Trust by Dr Bill Kirkup CBE makes action unavoidable.

Before outlining the issues facing the area, I want to place on record my support for those people working tirelessly within the Cumbrian health economy to provide high quality patient care in increasingly difficult circumstances.  Despite these pressures, it is the efforts of these people – above and beyond what they are paid for or which should ordinarily be expected – who are preventing systemic collapse from taking place.

Cumbria is England’s second largest county. The population of the county – less than 500,000 people – is disparate. The terrain is difficult and the infrastructure inadequate. The county is home to startling social and economic inequalities and is served by two acute hospital trusts. These inequalities typically manifest themselves in health outcomes. North Cumbria University Hospitals Trust provides services at the Cumberland Infirmary (Carlisle) and the West Cumberland Hospital (Whitehaven) and the University Hospitals of Morecambe Bay provides services at the Furness General (Barrow-in –Furness) and at the Westmorland General (Kendal). These four DGHs serve Cumbria’s major centres of population. All are in ‘special measures’ and have been for some time. In addition to this, Primary Care across Cumbria is also subject to growing difficulties and there is a clear crisis with regard to the recruitment of General Practitioners.

 The issues in relation to these hospitals – raised by Professor Sir Bruce Keogh and others – are clear: 
  • Staff recruitment and retention
  • Locum expenditure
  • Maintenance of clinical standards whilst retaining accessibility to services

Primary care is also under incredible pressure.  The most recent GP Patient Survey shows that over 60,000 people in Cumbria had to wait more than a week to see a GP the last time they tried. This is likely to be a conservative figure.

None of these issues are new, but progress has stalled in recent years and the situation is worsening.  I believe that an urgent investigation into the entire Cumbrian health economy is now essential. Only by understanding the interconnected issues relating to the local health economy as a whole – rather than treating individual manifestations of failure – will Cumbria’s health services become sustainable for the long term. This is particularly relevant given the likely influx of thousands of people into the area in the near future due to the construction of three new nuclear reactors, new submarine building programmes and other investments that are larger than the Olympics in scale.

Improving patient care and fundamentally resolving the systemic failures of the Cumbrian health economy is absolutely imperative.  We can only do this by understanding the whole health economy rather than approaching the issues in a piecemeal fashion.  To do this, we need to adopt a comprehensive approach involving NHS England, the Department of Health, the Cumbria CCG and the relevant hospital trusts (including Northumbria as an acquiring trust). I hope that you will agree to convene such an investigation without delay so that progress can be made. This investigation should inform the development of a recovery plan for the entire Cumbrian health economy.

I look forward to your reply and am available to meet to discuss these issues at any time.

Yours sincerely, 
Jamie Reed MP
Shadow Health Minister

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