Roger Harris, Corporate Director of Adults Housing and Health, presented the report that updated Members on the New Models of Care innovation that had been launched in Tilbury and Chadwell as part of Phase 2 of the Thurrock transformation programme in collaboration with local health partners, the voluntary and community sector. Roger Harris referred Members to the four principles:
1. The development of a new Primary Care Workforce – to address the shortages of GP’s and improve the Primary Care offer.
2. Improved identification and early treatment of people with Long Term Conditions.
3. The redesign of the health and social care workforce and all community based solutions.
4. The development of four Integrated Medical Centres to ensure that we have 21st Century local facilities.
Tania Sitch, Integrated Care for Thurrock Council and North East London Foundation Trust, explained the development of this new exciting project to Members and how the new 12 new workers would support the 8 practices in Tilbury and Chadwell to ensure that GPs are used where most needed and to reduce waiting times. That the implementation of the integrated workforce will bring together health, mental health, social care and the voluntary sector to ensure more coordinated care and a more personal response. Those 13 programmes devised to improve the identification of treatment with evaluation being undertaken by Public Health England and the University of Birmingham to ensure that it was robust and that outcomes were focused.
Mandy Ansell stated that this project would involve and be joined up with Health, Social Care and the Health and Wellbeing Board Strategies.
Roger Harris stated the Integrated Medical Centres were being designed to support the Council and Clinical Commissioning Group for primary care services. The design of the Tilbury and Chadwell site had now been commissioned and that this would probably be the first of the 4 sites being developed with health partners. The second site being Stanford and Corringham based on a similar model as the Tilbury and Chadwell site, the third at Purfleet as part of the Purfleet Regeneration Programme which would soon be commissioning an architect and design team. The fourth site would be at Grays Thurrock Hospital which would concentrate on services covering the whole of Thurrock e.g. the Minor Injuries Unit (MIU). The development plan would be 3 years with lots of work including planning applications, business cases and signing of leases. That huge commitment had been made by Thurrock Council and Health providers.
The Chair thanked Officers for their very interesting presentation.
Councillor Rigby questioned would the Integrated Medical Centres reduce GP appointment times and had this model been undertaken elsewhere. Tania Sitch stated that similar trials had been undertaken but not to the extent that Thurrock are proposing with this being one of the first ever model of shared services.
Mandy Ansell stated that Thurrock had been identified as one of the worst under doctored areas in the country with the recruitment of doctors being one of the biggest challenges. Thurrock had relied on doctors and nurses from overseas as not enough GP graduates were coming through the process.
Councillor Allen stated with the shortage of GPs in Tilbury he welcomed the Integrated Medical Centres and questioned what services would they provide. Tania Sitch stated that more services would come out of Basildon Hospital, space had been committed at these Integrated Medical Centres to accommodate outpatients with those services from Orsett Hospital going into all 4 Integrated Medical centres with one off services going to just one specific centre. This would prevent residents having to go to 2 or more different places for appointments.
Councillor Allen stated that it was great that all services would be available closer together but had concerns how the Integrated Medical Centres would cope with the increase in population with the proposed 32,000 new homes to be built in Thurrock and would this not call for Thurrock to have its own hospital.
Roger Harris stated that the Integrated Medical Centre planning process had included some form of future proofing to ensure that the centres were used in the most effective way and had taken into account the proposed growth in population. Roger Harris stated that it was very unlikely that an acute hospital would be built in Thurrock but that this decision would fall to the National Health Service.
Councillor Holloway reiterated comments made previously that the Integrated Medical Centres should be up and running before any consideration to close Orsett Hospital was made. Councillor Holloway commented that in regards to a new hospital, Thurrock had an existing hospital and when proposals are made as to what happens there we need to look at the existing hospital before looking at a new one.
Councillor Akinbohun questioned how convinced were Officers that this model would work in the long run. Tania Sitch stated that there were community representatives on the group that would hopefully spread the good news on the work being undertaken. With a new employed full time Engagement Officer to work with Communications on promoting the services and proving the roles of the workforce. That the new workforce were trained staff to a level in how best a patient should be seen, undertaking tests and knowing when to refer patients for further appointment. Tania Sitch also stated that tougher measures would be put in place for appointment making.
Mandy Ansell briefed Members of a pilot of extended physiotherapist services where patient numbers were higher seeing the physiotherapist directly rather than waiting to see a doctor and then having to wait for an appointment to come through. That a PhD Pharmacist working on the medical review rather than GPs. Mandy Ansell stated that it was about patient experience and that the positivity out of this should be built on. It was ensuring that the patient was at the right place at the right time.
The Chair stated how excellent to see how primary care was improving and that Thurrock had received national recognition and was glad that Thurrock was leading the way.
The Chair questioned when changes to the timelines re referrals would be shown. Tania Sitch stated that recruitment to this skills mix was underway and that the role of the care navigators would be to navigate patients to the right service. That the model for Tilbury and Chadwell would be rolled out to the 3 other localities with funding from the Clinical Commissioning Group.
The Chair requested that a further report be added to the 2019/20 municipal calendar work programme for further updates.
Mandy Ansell stated that the Director of Public Health monitored progress closely and that the Quality and Outcome Framework focused on identifying each patient and that treatment was provided when needed.
Councillor Allen asked Officers to confirm that it was the ambition to have the Tilbury and Chadwell Hub opened by 2020. Roger Harris stated that this was the aim.
Councillor Allen questioned whether the new workforce had been recruited, when they would start and would the proposed model enable them to visit all practices. Tania Sitch stated that the recruitment process had begun with the intention that new workforce would support and spend time at all 8 practices based on the need.
The Chair thanked Officers for the report.
1. That the Health and Wellbeing Overview and Scrutiny Committee commented on the progress made with delivering the New Models of Care.
2. That the item be added to the 2019/20 municipal year work programme.