Members received a NHS briefing note on the impact of the Southend on Sea Council’s referral to the Secretary of State on the STP.

 

Roger Harris, Corporate Director of Adults, Housing and Health updated Members with the following background information on the STP.

 

•           On 6 July 2018 the Joint Committee of the five Clinical Commissioning Groups across mid and south Essex agreed to 19 recommendations which included the recommendation to close Orsett Hospital.

•           It had been agreed that Orsett Hospital would not close until all integrated medical centres were up and running.

•           That no clinical services would be moved out of Thurrock.

•           On the 9 October 2018, Southend Council agreed to refer the STP to the Secretary of State with regard to the stroke services and the consultation process.

•           With this in effect not everything had stopped with the planning and preparation work would continue.

•           NHS would not agree to any decisions until the referral had been resolved.

•           It was unclear whether the Secretary of State would squash the consultation completely or agree otherwise.

•           Southend Council prepared a letter to the Secretary of State setting out the formal reasons why the consultation and stroke services were inadequate and demonstrate that a comprise had been made locally.

•           The Secretary of State would then send the referral to the Independent Reconfiguration Panel who would consider the matter together with evidence and to seek specialist advice.

•           The Independent Reconfiguration Panel would provide advice to the Secretary of State. There are no deadlines for the Secretary of State to make any decisions.

 

Councillor Holloway requested clarification on what services were going to which integrated medical centre and when these would be moved. Asked whether these services would be moved once an integrated medical centre was built or when all four centres were finished. Clarification on what Orsett Hospital would look like once services start to be moved out. Councillor Holloway requested to see clear plans.

 

Councillor Spillman asked Roger Harris whether he was concerned about the consultation process. Roger Harris stated that through meetings the Council had shown concern but broadly the process had been robust and the consultation had been extended to ensure everyone got an opportunity to have their say.

 

Councillor J Kent asked how many referrals had the Secretary of State upheld on. Roger Harris stated that he would have to check this information.

 

Councillor J Kent questioned Roger Harris on his understanding on what the impact of the referral would be. Roger Harris stated that was more of a question for the NHS to provide a response and stated this would be an opportunity to consolidate some clinical services, recruit primary care staff in centres of excellence and the clinical services provided would be more robust.

 

Councillor J Kent questioned whether there would be any problems with recruiting staff. Roger Harris stated that the new centres of excellence would provide an opportunity to recruit the specialist and associated staff.

 

Councillor Spillman asked for long term plans on the centres development. Roger Harris stated that it would be hard to sustain clinical specialisms at all the proposed centres therefore specialist centres of excellent would be built across the region.

 

Councillor Rigby questioned whether the referral to the Secretary of State made by Southend Council had an effect on the integrated medical centres. Roger Harris stated that potentially this could have an impact as the NHS were significant financial contributors and would be head lease holders for the centres. That the Council would not recommend going out to tender and would not be confirming any contracts.

 

Councillor Holloway questioned whether the opening of the integrated medical centres was dependent on the closure of Orsett Hospital and what would happen if Orsett Hospital did not close. Roger Harris stated the proposed integrated medical centres were dependent on primary care partnerships offering a wide scale and range of services. The integrated medical centres had been designed around the range of services and would still go ahead but would fundamentally be a different style of building. Roger Harris stated that it was unlikely that all four centres would be finished at the same time but phased over time.

 

Councillor Holloway stated until timescales were known Members and residents would not have the confidence and stated that NHS Partners should continue to treat patients and invest into services.

 

Roger Harris provided an update on the Integrated Medical Centres.

 

Tilbury and Chadwell was being led by the Council with plans well advanced with a design team in place providing architect drawings and application will be presented to the Planning Committee in the New Year. A consultation had taken place in October.

 

Thurrock Hospital owned by EPUT. This integrated medical centre would be slightly different as this site was seen as the most central area where fixed services such as minor injuries and renal dialysis would be located. A planning team had been established to look at reconfiguring the whole site which would address some of the parking concerns.

 

Corringham was being led by NELFT. Planning permission had been granted and a design team had been commissioned but would be on hold until the Secretary of State made by Southend Council had been confirmed.

 

Purfleet would be built as a commitment made between Thurrock Council and Purfleet Regeneration Limited, for a health centre to be provided in the heart of the development and would be included in Phase 1 of the development.

 

Councillor Holloway stated that if Orsett Hospital did not close whether a medical facility on Orsett Hospital site be built to consider population growth and need for services. Roger Harris stated that was a question for NHS but that a need for general practitioners would always be needed but would be offered on a different scale to what was already being proposed.

 

Roger Harris stated that the development of the integrated medical centres was happening at different stages and being led differently but all would have a common element.

 

Members agreed that a list of questions be prepared and presented to the NHS representative for responses to which these would then be presented at the next Task and Finish Group.

 

Councillor Spillman stated the integrated medical centre process had to be more tangible for residents to understand what services are going where and when.

 

Councillor Spillman requested clarification that services would allocated before Orsett Hospital was knocked down. Councillor Spillman stated there had been no details of such service allocation.

 

Councillor Redsell stated it was vital that all services were located together and in the right place.

 

Councillor Holloway requested more information on the plans for service allocation and asked whether the People’s Panel had engaged with residents on service needs. These details were vital to ensure that Members can keep residents informed.

 

Councillor J Kent questioned how the broad range of services currently available at Orsett Hospital would work when they are broken down into pieces and spread far and wide.

 

Councillor Holloway stated there was a fundamental need on the transformation of services being offered. Although in agreement with the vision but practical terms had failed and should be carried out more practically which Members should need to feed into. Councillor Holloway questioned what the process was in deciding to close Orsett Hospital rather than invest and what were the decisions were to close rather than to provide more transport routes. Councillor Holloway questioned what models had been looked at in making these decisions. Councillor Holloway stated that residents felt that the decision to keep Orsett Hospital had been snatched away from them and that communication had been poor. Councillor Holloway asked had the NHS partners thought about how residents would get to the new integrated medical centres and what the thought process was. Councillor Holloway questioned whether consideration had been made to keep a hub on the Orsett Hospital site and if not, why not.

 

Councillor Spillman stated that were so many unanswered questions with insufficient details and expressed again his disappointment that no NHS representative was not present to answer questions and make clear the final delivery model.

 

Councillor Redsell stated that Thurrock Hospital undertakes a lot of services and that reconfiguration of the site would address residents parking concerns. Councillor Redsell stated that Orsett Hospital was an old building which was only half occupied.

 

Councillor Spillman questioned Thurrock Council’s health responsibility to residents and at what stage would the Council have concerns over the services being offered and where. Roger Harris gave Members the reassurance that services would definitely be going into the integrated medical centres. Information such as the number of patient volumes, the design of the services and that some clinics would be going into more than one of the centres.

 

Councillor Holloway questioned the transition period of transferring services from Orsett Hospital to the integrated medical centres and where services would be available. Councillor Holloway asked for reassurance that once one integrated medical centre was built what would happen with the services remaining at Orsett Hospital. Councillor Holloway stated that it could take years for further integrated medical centres to be built and that the Council should be planning for every eventuality.

 

Councillor Rigby questioned whether one of the integrated medical centres could replicate the services being offered by Orsett Hospital as it would make sense to have a central unit. Roger Harris stated that only a small number of services would be replicated in one centre such as minor injuries and dialysis.

 

Councillor Redsell stated that Orsett Hospital would not be able to cope with the potential increase to the borough and that the integrated medical centres were required which could also potentially take some of the services out of Basildon Hospital.

 

Councillor Rigby stated that the integrated medical centres plans should be basic with the flexibility to change once development in the borough increased.

 

Roger Harris stated that a vigorous commitment had been made to keep all the services in Thurrock within the four integrated medical centres and to be clear that it was about the service delivery and not about the building.

 

Councillor J Kent stated it was not about the building but the service delivery to ensure that residents had confidence and faith that the services would be delivered. Councillor K Kent asked where the general practitioners planned to go into the Tilbury site were coming from. Roger Harris stated that general practitioner services had already been commissioned with the Clinical Commissioning Group and NHS England that two practices would be sited within the Tilbury site with patient lists of over 12,000.

 

Councillor J Kent stated that general practitioner services should be moving closer to residents and not further away. Roger Harris confirmed that not all general practitioners were moving into the integrated medical centres.