To receive additional items that the Chair is of the opinion should be considered as a matter of urgency, in accordance with Section 100B (4) (b) of the Local Government Act 1972. To agree any relevant briefing notes submitted to the Committee.

No urgent items were received.

Members discussed the Integrated Medical Centre briefing note sent to Members on the 17 December 2021 and all Members agreed the briefing note had raised some concerns. The Chair had invited Councillor Alan Mayes, Portfolio Holder for Health and Air Quality to the meeting to update members on the current position. Councillor Holloway questioned why Councillor Mayes was presenting this item and this was not appropriate at this scrutiny meeting. Councillor Ralph welcomed Councillor Mayes to the meeting and asked him to read out his statement from Cabinet this week. Councillor Mayes took this opportunity to thank members for inviting him this evening to talk about this issue as he knew it was very important to everyone on this committee.

“On Tuesday I met with Anthony McKeever who is the Chief Executive Designate for Mid and South Essex Alliance, Thurrock CCG, Alliance Director, Chief Finance Officers of the five CCGs and Mid and South Essex ICS along with Councillor Coxshall and Council officers to discuss the current issues with the IMC programme. All present at this meeting reaffirmed their commitment to delivering the four IMCs in Corringham, Tilbury, Purfleet and Grays with all services relocating from the old Orsett Hospital site before its closure in 2025. There was no cold feet from all sides on delivering this plan and although issues could arrive with a project that was ambitious and complex we, the chief executives designate of MSE ICS had said he will remove every barrier on the NHS side to get the outline business cases for Tilbury and Purfleet IMC signed off by the 31 March 2022. This will allow the IMC to progress to the next stage of full business case and then delivering them by 2025. The current IMC is due to open in the second quarter of 2022 and the Grays IMC is due to open in 2025. Everybody in the meeting on Tuesday acknowledged that Thurrock health needs were growing and integrated medical centres had a vital role in improving health care for our residents”

Councillor Holloway referred to the three specific areas the SFLG committee have asked for and that the work would be led by the CCG, questioned how far forward were they on points 1, 2 and 3 of information gathering. Mark Tebbs introduced Kerry Harding, MSE Estates Director who had undertaken an enormous amount of work on the medical centres. Mark Tebbs stated that as part of the internal process before it went to NHS England and England HSI we had taken the financial elements to the system finance leaders group who had asked for further clarification on a number of issues relating to affordability. It was agreed to go back to SFLG in January for the Purfleet OBC and then in February for the Tilbury OBC. By splitting them out enabled the focus on the specifics of each case to be undertaken to look at the commercial aspect. Whether there could be any other cultural related services that could be part of the IMCs and to quantify the impact of the integrated IMC delivery model on wider systems particularly acute needs and looking at the ultimate disposal of other premises that were no longer required as the IMCs came on board. Mark Tebbs stated the alarm caused from the briefing note had not been intended and should have said there was absolute commitment in moving forward with the IMCs and Orsett closure as this was part of the normal scrutiny process expected to justify the affordability and value for money of those centres.

Councillor Ralph thanked Mark Tebbs for the update and questioned whether it was known yet where services from Orsett Hospital would be allocated such as the eye department. Mark Tebbs stated there was an overarching plan for the four integrated medical centres which included the relocation of all of the services from Orsett Hospital. The Grays IMC was the least developed of the other business cases and did not have the same level of detail as the project was at a less mature stage. Kerry Harding stated services were being looked at as part of a wider project but buildings would be designed around the services and would not be squeezing services into buildings. Councillor Ralph questioned whether any new buildings were being built as part of the Grays IMC to which Kerry Harding stated we would use what we had first and what was practical and suitable for use. When it had been established that buildings would not be practical or suitable then new locations would be looked into, but this did not necessarily mean a new building. Services were being looked into as to where they needed to be and was the buildings fit for purpose.

Councillor Fish referred to the questions in the briefing note around affordability but this evening it was being said this was part of the ongoing process to look at what was affordable to which Mark Tebbs stated the reasons should have been more about value rather than affordability. The assistance finance leaders groups were making sure there was a strong commercial case for buildings, maximising the disposal of older estates which were no longer useful, described the impact model on demand and maximising use of space. The questions were around the business cases and the phrase “affordability” had caused alarm in that there had been a change of commitment from the NHS but as the chair had said following meetings with finance director and chief executive designate the message was absolutely clear that the NHS were fully committed.

Councillor Fish thanked Mark Tebbs for the response in that IMCs would be based on services and not the other way round then questioned what other medical services might be involved in the IMCs to which Mark Tebbs stated this could be a pharmacist or a dentist.

Councillor Holloway stated the briefing note had covered what had actually happened and there must have been concerns around affordability issues for these to have been flagged and had concerns that after the 31 March what was the timeline. Questioned when the timeline would be available to show what services will go where and when the medical centres would actually be open and needed some reassurances. Mark Tebbs stated the Corringham IMC would be open and seeing patients in the next financial year so progress had been made but agreed with Councillor Holloway’s comment it had been a long time in the planning. Councillor Holloway requested for Anthony McKeever to be invited to the next meeting to hear those reassurances from him before the 31 March.

Councillor Holloway stated the briefing notes had to detail what was actually happening and officers should be honest with Members and appreciated and acknowledged the amount work that was being undertaken and stated again for this report to be formally returned to committee in March so that Members can make sure it was on track before the 31 March.

Councillor Ralph stated as chair of this committee he felt a compromise could be found to ensure he received more regular updates via telephone call or by more detailed briefing notes. He felt this was essential between now and the next committee and agreed with Members that a full report be presented at the March committee.

Councillor Polley stated there was a sense of nervousness on the timings of the IMCs and had always been under the impression the IMCs were additional facilities or an increase in capacity of services. In Purfleet this had been promoted as additional doctor surgeries. Councillor Polley had concerns on who deemed where affordability allowed a clinic to run and questioned whether this would be based on need, statistics or footfall through clinics. Mark Tebbs stated factoring growth in general practitioner list sizes would be taken into consideration especially in the Purfleet IMC and would be reflected in the size of the practice needed to support the local population. The IMCs were more than just primary care, not just serving the list size they offered a wider service offer and delivered integrated care and this was some of the complexities being modelled.

Councillor Ralph stated he had his concerns eased about what and how the services going into the Corringham IMC would work and stated this was a flag-ship opportunity to identify any flaws for the rollout of the rest of the programme.

Kerry Harding left the meeting at 7.35pm.