Andy Vowles, the Programme Director for the Sustainability and Transformation (STP) Partnership, presented the report to Members that covered a small range of services that formed part of the large STP and stated that the consultation was half way through with more discussion event focus groups being organised. Andy Vowles went through the five principles for the future hospital services which included:
1. The majority of hospital care will remain local.
2. Certain more specialist services which need a hospital stay are concentrated in one place.
3. Access to specialist emergency services, such as stroke care, should be via your local (or nearest) Accident & Emergency.
4. Planned operations should, where possible, be separate from patients who are coming into hospital in an emergency.
5. Some hospital services should be provided closer to residents.
The figure of those that would be affected in emergency were based on currently 960 attendees per day on average across the three Accident & Emergency departments, around 300 patients per day on average are currently admitted to hospital from Accident & Emergency; under the proposals for reorganising some specialist emergency services, an estimate of around 15 people per day would require a transfer from their local Accident & Emergency to a specialist team in another hospital.
The figure of those that would be affected in planned treatment were based on around 3,300 patients per day on average visiting the three hospital for an outpatient appointment, around 380 patients per day on average visiting the three hospitals for a planned operation; under the proposals for separating planned operations from emergency care, it would be estimated around 14 people per day would be referred to a hospital that was not their local hospital for a planned operation.
A summary of the proposed changes at Basildon Hospital was presented to Members and that the following services would remain the same: Accident and Emergency and urgent care, maternity services, intensive care, short stays in hospital, children’s care, care for older people, day case treatments and operations, tests, scans and outpatient appointments. The proposed service changes to emergency services could include: specialist stroke unit, improve stroke care and rehabilitation; specialist teams for complex lung problems, complex vascular problems, complex heart problems, more complex orthopaedic trauma surgery and specialist team for complex kidney problems.
The proposed changes that would affect Thurrock population were:
• All outpatients and majority of operations will stay local.
• Transfer of services from Orsett to the four new Integrated Medical Centres.
• Specialist stroke unit proposed in Basildon.
• Specialist teams in Basildon proposed for complex lung, vascular, heart and kidney problems.
• Planned orthopaedic operations proposed in Braintree and Southend.
• Specialist teams in Chelmsford proposed for complex urology, abdominal surgery and gastroenterology.
• Specialist gynaecology including cancer proposed in Southend.
Those views from the consultation on the proposed transfer of services from Orsett into the Integrated Medical Centres would be considered.
Andy Vowles updated Members on the proposed clinical transfer of patients between hospitals to ensure that discussions between clinical teams and patient/families were undertaken and clinical support was available throughout any transfer. That a free bus service between hospitals would be provided.
Andy Vowles finished the presentation by providing Members with an update on the next steps of the consultation with implementation planned for autumn 2018 and onwards. That implementation would not be imminent after this date as this was reliant on successful bids for funding to make infrastructure changes to hospitals.
Tom Abell, Chief Transformation Officer, Basildon & Thurrock University Hospitals, stated that conversations with Orsett Hospital were ongoing looking around the configuration of services into the Integrated Medical Centres and that input from local communities was vital to ensure a good service and the right accessibilities were provided.
That focus would be put on community services and where these services should be located to ensure they were fit for purpose and would work well for residents.
That the process may take up to five to seven years to be implemented to ensure that lessons can be learnt and those changes can be adopted.
Tom Abell reiterated the commitment that the relocation of services from Orsett Hospital would not be made until those services were available in the Integrated Medical Centres.
Councillor Snell thanked Andy Vowles and Tom Abell for the report.
Councillor Redsell stated that the proposed five to seven year implementation plan seemed a long way off and questioned where the Dialysis Unit, currently at Orsett hospital, would be located and who would provide and pay for the proposed bus services. Tom Abell stated that the implementation would be carried out as fast as possible but time would clearly need to be made to undertake the proposed infrastructure to the hospitals. That plans were in place to specifically engage with dialysis users on where services would be best located and arrange suitable dates with HealthWatch. Tom Abell confirmed that allowances had been made for operating the bus services but no decision had been made as to who the supplier would be yet.
Councillor V Holloway pressed Tom Abell on the funding of the transportation proposal following pressures from elderly residents. Tom Abell confirmed that residents should now take part in the consultation stating what transport would be good for them, to get local views on the best configuration and asked Members to encourage their constituents to feedback on this item. That many more services are already provided and would remain local for the frail and elderly.
Councillor Snell stated that it was really important that patient information was kept updated so that relatives and visitors were aware of any ward or hospital transfers. Tom Abell stated that investments to IT infrastructure were being pushed forward to use the TeleTracking system that would be used for patient flow logistics across the three hospitals with implementation into Southend in June 2018. The system would then be rolled out into the other two hospitals. Tom Abell stated that good quality conservations would be undertaken with patients and relatives about what hospital would be best to treat that person.
Councillor Redsell stated that the consultation had not covered residents over the age of 65. Andy Vowles stated that the wider agenda of the STP would cover this to look at right locations that had the right integrated services available. Roger Harris stated that the local authority would play a part in this process and was being addressed with Integrated Medical Centres becoming community hubs with local resources being made available.
Councillor V Holloway thanked Andy Vowles for the report and stated that it was readable for residents. Councillor V Holloway stated that the summary of the STP consultation was vague on certain services such as mental health and social care and where could details of the wider range of care and funding be found. Andy Vowles thanked Councillor V Holloway for her comments and questions and stated that a wider story and information on the STP were available through a range of different documents on the web site. Mandy Ansell, Accountable Officer, Thurrock NHS Clinical Commissioning Group, stated that the consultation relied on resident’s preferences and this would be undertaken by talking to local people. Mandy Ansell referred Members to “For Thurrock, In Thurrock” where the commitment between the NHS, Thurrock Clinical Commissioning Group, Thurrock Council and HealthWatch Thurrock to radically change the way health and social care services are commissioned and provided for within Thurrock.
Councillor V Holloway asked that following consultation with the right groups would a further consultation be required. Tom Abell hoped that no further consultation would be required following the events being organised by the Clinical Commissioning Group which would highlight to residents the timescales involved.
Councillor V Holloway asked whether some services would be relocated outside of Thurrock or would these be moved to the Integrated Medical Centres for Thurrock residents. Tom Abell stated that services would not be relocated outside of Thurrock unless feedback received stated otherwise. Tom Abell stated that getting the balance would be crucial where feedback might identify that residents would prefer all services under one roof rather than having to travel to different locations for different services.
Councillor V Holloway asked would the Capital Receipts for Orsett Hospital once sold be reinvested into Thurrock for Thurrock residents. Tom Abell stated that the selling of Orsett Hospital was some way off but the plan would be to reinvest into Thurrock with the purchase of equipment or other facilities for the Integrated Medical Centres.
Councillor Redsell stated her concerns over parking at Thurrock Hospital. Mandy Ansell stated that this was being addressed as part of the planning application.
Councillor Snell asked whether staff at Orsett hospital would transfer to the Integrated Medical Centres. Tom Abell stated that yes this would be the case apart from two principles areas, the sterile service unit and the medical record office, where this would be a good opportunity to bring services together and work differently.
Roger Harris stated that the Integrated Medical Centres were absolutely fundamental in delivering the STP Project and provided Members with the following updates:
• The Tilbury Integrated Medical Centre was most advanced with a design team being commissioned and that a business case would be taken to Cabinet in late summer/early autumn.
• A site had been identified for the location of the Purfleet Integrated Medical Centre.
• North East London NHS Foundation Trust (NELFT) had purchased the building for Corringham Integrated Medical Centre and a business case will go through the board in the summer.
• The Grays site would be slightly different as some components were already in place.
• That no contracts have been signed as yet with an enormous amount of work still had to be done to make this happen.
Councillor Snell stated that the travel of the STP was going in the right direction and that communication had possibly not been clear enough in the early stages. Councillor Snell stated that the Thurrock Plan was a good one and awaited the consultation responses.