Wendy Smith the Interim Communications Lead, Mid and South Essex Success Regime for NHS England presented the report which informed Members of the considerable amount of the work that had been undertaken since this item was raised at the 9 June 2016, Health and Wellbeing Overview and Scrutiny Committee which included:

•           Developed localities where General Practitioners (GPs) services, community, mental health, social care and other public services worked closer together.

•           Thurrock Clinical Commissioning Groups (CCG) led on the development of the new model of care for frailty looking after older and frail people in the community.

•           Working groups looking at emergency and acute care, surgery, women and children services.

Wendy Smith stated that the work currently being undertaken on the mid and south Essex Success Regime had tended to be the main focus which was attracting the most attention, although not necessarily the most important. Any potential changes in the hospitals would require detailed public consultations and a particular National Health Service (NHS) process would need to be followed.

A group of around 70-80 doctors and nurses from across the three hospitals involved had come up with their thoughts on a single Specialised Emergency Hospital. All three sites would have accident and emergency care and also separate out the planned operations from emergency care which would give an opportunity to use the capacity at the specialised hospital to develop a centre of excellence. Wendy Smith stated that discussions and workshops had taken place supported by Thurrock Healthwatch.

It had been anticipated that a business case would have been ready for national assurance at this point but Wendy Smith stated that agreement had been sought to extend the period for developing the business care for further engagement. The Options Appraisal Process had been extended until early February 2017 with the Business Case being ready by the beginning of March 2017.

Councillor Watkins thanked Wendy Smith for the report but asked what the timescales were for pushing this work forward to ensure that the level of general practitioners was as it should be in Thurrock. Wendy Smith stated that it was difficult to put a detailed timescale to this as this was still a developing process but stated that the further engagement required would not put a halt to any of the work already undertaken on the primary care services in Thurrock.

Councillor Watkins asked for assurance that the engagement and consultation process should include those elderly residents that could not necessarily travel to the proposed hospital destinations. Wendy Smith stated that from the 20 workshops held travel distances was one of the biggest topic discussed.

The Chair and Members agreed that a Success Regime Update be added to the work programme.

The Chair asked for assurance for residents who had concerns on the quality and capacity of the ambulance services. Wendy Smith stated that this information would form part of further discussion and consultation documents but there were downsides which included the consideration of carers and families of patients who may have to travel distances to visit which could prove stressful.

Councillor Collins thanked Wendy Smith for her report and asked what the challenges they were facing. Wendy Smith stated one of the main challenges was recruitment with London attracting the more talented doctors and nurses with a higher rate of pay. Anglia Ruskin University are looking to create the first medical school in Essex. One challenge was that all three hospitals were looking for the same type of professionals. Although this was the opportunity to development the hospitals to make them more attractive to the workforce, provide training and rotational postings.

Councillors Collins asked could nursing accommodation be provided. Wendy Smith agreed to take this back as a suggestion.

Roger Harris stated that the Portfolio Holder for Health and Education was looking at key worker housing schemes for nursing staff in Thurrock which could help with renting accommodation or helping with deposits. The Portfolio Holder will take the report and proposal to Cabinet at some point.

Councillor Collins asked could council flats be made available for nursing staff. Roger Harris stated that arrangements could be made with private landlords and new builds and that the key worker housing scheme would be potentially available for social care workers, teachers and nursing staff.

Councillor Fish asked what, in further discussions, would the overriding factors be. Wendy Smith stated that potentially any of the three hospitals could be a specialised emergency hospital so further detailed discussions would still need to be held.

Councillor Snell stated that the downside to this proposal was when patients may need to spend longer in hospital and what plans would be in place to bring patients back to their local area for continued care. Wendy Smith stated that this was the plan; patients would attend the specialist hospital for treatment but be transferred back to a local hospital once the specialist care had finished.

Councillor Snell stated that Thurrock had health hubs which took pressure of hospitals but Thurrock was not quite there and could the proposal wait for Thurrock to catch up. Wendy Smith stated that there would be no point in making changes unless they were confident that it would not work. Work needed to be done to separate the planned work from the emergency work and this took time to develop.

Ian Wake asked Wendy Smith how this proposal would assist the £100 million deficit as agency staff were being used, the demand for unplanned care for emergency care was going through the ceiling and how the redesigning of new hospitals was being addressed. Wendy Smith stated that the redesigning of the hospitals was not about saving all that money but reinvest in the prevention and work with people who had higher risks of illness to ensure that more can be done to plan the care required.

Ian Wake asked Wendy Smith to clarify that part of the redesigning of the hospitals was to release money into primary and community care. Wendy Smith stated that was the plan that by reducing the amount to be spent by buying hospital care would release investment into the community.

RESOLVED

That the Health and Wellbeing Overview and Scrutiny Committee note the update and to give views on the emerging thinking in terms of potential hospital reconfiguration and the future plans for public consultation.