NHS Major Incidents — House of Commons, 2015-01-28
Topic: Health
Andrew Murray Burnham (Labour, Centre-left): In the first week of January, at least 14 trusts across England declared major incidents, including three in the west midlands. Official figures show that pressure continued into the second and third weeks of January, with only seven A and Es out of 140 meeting the Government’s target. There were ambulance diverts, and even an A and E closure, but no further major incidents were declared. On 7 January, when the Health Secretary was called to the House to answer an urgent question, he said: "The decision to declare a major incident is taken locally—there is no national definition"—[Official Report, 7 January 2015; Vol. 590, c. 273.] He has just repeated that now, and called this a "local operational issue", but that does not appear to be entirely accurate. Let me quote from the guidance that was sent in the middle of January. It is headed "NHS England" and it states: "Major incidents should be agreed with…the Director on call for NHS England". Will the Secretary of State now withdraw his earlier statement to the House and confirm that this decision is not purely local, in that it has to be approved by NHS England Let me turn to the impact that this has had on trusts. There are 17 enhanced criteria set out, including requirements that may cause serious time delays for trusts in an emergency. For instance, there is a requirement on the on-call CCG manager to visit the trust and undertake a review. Let me tell the Secretary of State how those new rules were perceived by senior managers. I shall quote from an e-mail sent by the head of operations at one trust, who said that the requirement had been "introduced by NHS England to effectively stop trusts from calling a major incident…Our hands will be tied in most cases if they wish to call a major incident for capacity reasons" Is the Secretary of State confident that the new enhanced criteria are not unduly burdensome and will not cause unnecessary delays for a trust in an emergency situation? Is he satisfied that this guidance is consistent with good practice at national level and safe to be left in place The Secretary of State has used the word "local" many times today, and spoken of the only consideration being relieving pressure on hospitals facing severe demand. However, his claim that this matter is purely local is called into serious question right now by this 86-page document headed "NHS England"—[Interruption.] He says it is from the local team, but this is a regional function of the national body, NHS England. The local claim will not wash, I am afraid I will tell the Secretary of State what the guidance tells trusts to take into account. He says that it concerns only operational matters, but section 7.2.3 is headed "Politics", and subsection (a) asks: "Is there increasing involvement of senior command and control tiers, political involvement or excessive media coverage?" Subsection (c) asks: "Is there a risk of reputational damage?" Does not this muddy the waters hugely? Will it not distract doctors whose sole focus should be on the emergency situation, and not on media and political considerations that should form no part of their judgment? If the Secretary of State agrees with me on that, will he today instruct NHS England to withdraw this guidance and issue more appropriate instructions to the NHS in the region? The NHS remains under serious pressure, and it needs the clearest of instructions based on what is best for patients. Will he act today, so as to leave the NHS in no doubt that that must be its paramount and only concern at all times?