Health & care organisations consider proposals for consultation

Health and care organisations in partnership across mid and south Essex are considering proposals for public consultation at the end of this month on proposals for change in some hospital services.

Subject to the approval of the Joint Committee of clinical commissioning groups (CCGs) in mid and south Essex, the proposed changes would happen over the next two to five years. They form part of a plan to prepare for a continuing rise in the number of people who need health and care. These proposals build on the benefits from Southend, Broomfield and Basildon hospitals working together as one group to make the most of clinical talent, new treatments and technology and achieve better outcomes and quality of care for patients.

Feedback from the consultation will be considered by the Joint Committee in May 2018.

Proposed consultation to be approved by CCG Joint Committee
A Joint Committee of leading GPs that represents all five clinical commissioning groups (CCGs) in mid and south Essex is due to consider the final pre-consultation business case and proposed consultation at its public meeting on 29 November. If the Joint Committee approves the case, a consultation document and other background information will follow and local people will have a period of 14 weeks to give their views.

Mid and South Essex Sustainability and Transformation Partnership (STP)
The proposals come from the partnership between all NHS organisations and the three local authorities that provide social care in mid and south Essex. Known as the Mid and South Essex Sustainability and Transformation Partnership (STP), this is one of 44 STPs in England. The area involved covers Braintree, Maldon and Chelmsford in mid Essex; and Southend, Castle Point and Rochford, Basildon, Brentwood and Thurrock in south Essex.

Proposals developed with views from local people
The STP’s proposals have been developed by clinicians and discussed widely in public over the last 18 months.

The latest proposals, which were influenced by the views of local people, would mean that people would continue to have access to A&E, tests, outpatients, day case surgery and maternity services as they do now at their local hospital, alongside critical care and the vast majority of overnight emergency care. In a small number of cases some emergency and planned patients may be transferred to new specialist centres with greater consultant cover. These proposals are based on clinical evidence and best practice from elsewhere across the country.

• Just under 1,000 people a day currently attend the three A&E departments on average
• It is estimated that around 15 patients a day would transfer to another hospital for specialist emergency care as a result of the proposals for change.

Proposals for stroke care
One example of a specialist service is stroke care, where the proposal is to establish a specialist centre, known as a “hyper-acute stroke unit (HASU)” in addition to the existing stroke care services at all three hospitals.

CT scans and the start of treatment for a stroke would be available at the nearest hospital. If patients were diagnosed as having had a stroke they would be transferred to the proposed new specialist HASU for up to 72 hours of high dependency care and rehabilitation, before being transferred back to their local hospital, or home with further care and support.

A collaboration across the three hospitals would maximise skills to treat people in the crucial first 72 hours and create a strong network of stroke services across the three hospitals with links to other stroke specialists working in the community.

Evidence from other areas in the country that have already established a hyper-acute stroke unit (HASU) is that patients who are treated in the HASU benefit from higher chances of survival and good recovery.

Proposals to cover a range of specialist services
The proposals will emphasise that all three main hospitals in Southend, Chelmsford and Basildon are equally important for providing hospital care in the future for their local population.

Each hospital also has a range of different specialist expertise, such as the radiotherapy and cancer centre at Southend, the specialist centre for burns and plastic surgery at Broomfield Hospital near Chelmsford and the Essex Cardiothoracic Centre in Basildon.

Working together as one group, it is proposed that the hospitals build on their existing expertise and offer other specialist surgery and treatments that require a hospital stay.

The proposed new services would work across all three hospitals and guarantee a full team of specialist doctors, nurses and technicians available round the clock, which is not always the case currently at all three sites.

Dr Celia Skinner, Chief Medical Officer for all three hospitals said:
“Our proposals aim to bring together some specialist services, for the times where, once or twice in our lives, we need very specialist emergency care or a planned overnight operation.

“We estimate the proposed new arrangements would mean that around 15 emergency patients and 15 planned operations per day would be go to a different hospital for a few days; but the benefit is that a larger team would be able to provide immediate specialist treatment and help you to make a quick recovery.”

“All our A&Es would continue to receive ambulances and remain open to walk in patients. Patients would continue to have their tests, outpatient appointments, day case operations and maternity services at their local hospital, the same as they do today, alongside general emergency care beds and critical care facilities.”

Dr Caroline Dollery, local GP and Clinical Chair of Mid Essex CCG said:
“We all want the very best health and care for people. While there are examples of excellent care, it is very difficult to achieve ever-increasing standards with consistency across our three hospitals. It makes complete sense for the hospitals to work together in some of the very specialist types of services.

“At the same time, we are looking at how we can develop our GP, community services, mental health and social care to help people stay well and out of hospital.

“The CCG Joint Committee is keen to hear the views and ideas of local people on the wider picture as well as the specific proposals for hospital services.”

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