• Mid and South Essex commissioners rubber stamp acute reconfiguration
  • Basildon to become major emergency, stroke and vascular centre
  • Patient transport system to be set up with Southend, Basildon and Mid Essex sites

Mid and South Essex commissioners have approved a controversial acute reorganisation, which will involve major changes to where and how emergency, specialist and elective services across the patch.

The joint committee of the five local clinical commissioning groups, which cover the success regime area rubber stamped the proposals, to be implemented between this year and up to 2022, at a meeting on 6 July.

The strategy would require recurrent investment of £30m a year by 2020-21 to fund increased investment in its workforce, estate and digital systems, the Mid and South Essex STP Decision Making Business Case said.

Basildon and Thurrock Hospitals Foundation Trust is the biggest winner of the acute trusts in terms of service acquisition. It will be designated the specialist emergency hospital and also undertake other major specialist activity, such as stroke and vascular services.

However, local bosses plan to merge Basildon with the other two trusts involved, Southend University Hospital FT and Mid Essex Hospital Services Trust in April 2019, as exclusively revealed by HSJ in January.

The reconfiguration plans have been constructed around five core principles, including retaining 24/7 type one emergency departments at Southend and Chelmsford, which will receive blue light ambulances as well (see box).

This was agreed as a concession after politicans and the public protested against the two hospitals being downgraded.

This has resulted in the requirement for a substantial new clinical transport service to be established to convey the more serious emergency stroke and other specialist cases to Basildon.

The service, for stroke patients in particular, has previously prompted safety concerns from clinicians and lobby groups.

The business case said: “Patients showing symptoms of a stroke [will] continue to [access treatment] via the local A&E department, where patients would be assessed, stabilised and, if indicated, treated with thrombolysis.

“After the patient [is] stabilised, and after discussion between the patient/family and clinicians, the patient would be transferred to Basildon Hospital for a short (approximately 72 hour) period of intensive nursing and therapy support.”

All follow-up outpatient appointments, tests and scans will continue to be offered at all three hospital sites. Patients in the most serious cases, such as a bleed on the brain, would be transferred to a specialised designated centre at Queen’s Hospital, Romford, or Cambridge University Hospitals FT, as is the case now.

The five principles underpinning the plans

1. The majority of hospital care will remain local and each hospital will continue to have a 24 hour type one accident and emergency department that receives ambulances.

2. Certain, more specialist, services which require an inpatient stay should be concentrated in one place, where this would improve care and chances of a good recovery.

3. Access to specialist emergency services, such as stroke care, should be via the nearest A&E department, where patients would be assessed, treated, stabilised, and if needed, transferred to a specialist team, which may be in a different hospital.

4. Planned operations should, where possible, be separate from patients arriving at hospital in an emergency.

5. Some hospital services should be provided closer to home (with specific changes to the services currently provided from Orsett Hospital).

The committee also approved a recommendation to carry out long awaited plans to relocate services currently provided at Orsett Hospital to a range of locations within Thurrock, Basildon and Brentwood, enabling the closure of a community site.

Services currently provided at Orsett include a minor injuries unit, sexual health services, and a range of blood tests.