Thank you for all the contact I have received recently regarding NHS funding.

I have spent much of my parliamentary time over the last thirty years supporting the NHS, and working, either with colleagues, or as a Minister, for steady improvements in health care. We can see results all around, from new buildings such as the improved Lister or new QE2 at Welwyn Garden City in our area, to significant changes to primary care facilities throughout North East Bedfordshire. Treatments, and access to medicines have also improved markedly over the years.

It is not news that the NHS faces pressures, mostly from an increasing and ageing population. To meet this the Government agreed with the NHS’s own assessment of its needs back in 2015 to supply over half a trillion pounds of investment this Parliament - an unprecedented level.

However it is not the level of funding alone which makes a difference to the NHS, but how and where it is spent. This is why the Sustainable Transformation Plans for local areas, which will now incorporate the Bedford and Milton Keynes hospitals review, are so important as they look at how to bring together community and acute services, and ensure that there are effective health treatments throughout the area as a whole. These reviews are clinically led, and may well recommend changes in where services are provided, as it is recognised now that for patient safety and best outcomes, specialisation is important, and that not every hospital can safely perform every procedure. As an example I attach an abstract from the British Medical Journal of 5th August 2014 which examined the reconfiguration and centralisation of stroke services in Manchester, and in London, where 30 hospitals providing stroke care were reduced to 8. The number of lives saved is detailed there.

I am aware of no current plans to close local A&E facilities.

What I am doing is regularly engaging with local hospitals, the Clinical Commissioning Group for the area, local authorities, clinicians and the NHS as these reviews go forward. I keep in pretty close contact with colleagues in the Department of Health here, all in all to ensure that my constituents’ health care and improvements in it, remain a priority.

I hope this is helpful and thank you again to those who contacted me about this most important issue.


Objective To investigate whether centralisation of acute stroke services in two metropolitan areas of England was associated with changes in mortality and length of hospital stay.

Design Analysis of difference-in-differences between regions with patient level data from the hospital episode statistics database linked to mortality data supplied by the Office for National Statistics.

Setting Acute stroke services in Greater Manchester and London, England.

Participants 258 915 patients with stroke living in urban areas and admitted to hospital in January 2008 to March 2012.

Interventions “Hub and spoke” model for acute stroke care. In London hyperacute care was provided to all patients with stroke. In Greater Manchester hyperacute care was provided to patients presenting within four hours of developing symptoms of stroke.

Main outcome measures Mortality from any cause and at any place at 3, 30, and 90 days after hospital admission; length of hospital stay.

Results In London there was a significant decline in risk adjusted mortality at 3, 30, and 90 days after admission. At 90 days the absolute reduction was −1.1% (95% confidence interval −2.1 to −0.1; relative reduction 5%), indicating 168 fewer deaths (95% confidence interval 19 to 316) during the 21 month period after reconfiguration in London. In both areas there was a significant decline in risk adjusted length of hospital stay: −2.0 days in Greater Manchester (95% confidence interval −2.8 to −1.2; 9%) and −1.4 days in London (−2.3 to −0.5; 7%). Reductions in mortality and length of hospital stay were largely seen among patients with ischaemic stroke.

Conclusions A centralised model of acute stroke care, in which hyperacute care is provided to all patients with stroke across an entire metropolitan area, can reduce mortality and length of hospital stay.