Current population estimate: 387,000
Number of GP practices: 45
Local authority partners:
Essex County Council (provides social care)
Braintree District Council
Chelmsford City Council
Maldon District Council
Current annual budget:
£443 million for community, mental health, ambulance, hospital services, continuing healthcare and prescribed medicines.
Working together to enable residents in mid-Essex to enjoy a healthy, safe and fulfilling life
The mid Essex CCG Live Well programme has been progressing now for two years. This document confirms what Live Well means to you, the citizens of mid Essex. It breaks down our clear commitments to you, and gives firm timescales for achievement. It is a contract if you will between the local health and care system of mid Essex and its citizens.
What does Live Well mean for me?
Through our ongoing conversations with our public, we understand that people want high quality emergency and hospital services if the need arises. However, we know that the vast majority of healthcare, over 90% in fact, takes place outside of a hospital setting. The lion’s share of this is either delivered by, or coordinated by, your General Practice. Our public have told us that General Practice is the foundation of high quality community based healthcare. Our General Practices are fixed points that our public trust and know how to access. However, you will know from experience that General Practices are under pressure. You might not always be able to get an appointment when you want it or you might find it hard to get through on the phone. Our Live well foundations programme aims to relieve some of the pressure on General Practice resulting in real concrete improvements for our public. Following the successful implementation of Live Well foundations you should find that:
- It is easier to book an appointment at your General Practice with more appointments available and wide range of times to book, including weekends for some practices.
- You will have access to a wider range of clinicians within General Practice. For example, if you have a bad knee you will be able book an appointment with an expert physiotherapist.
- You will have online access to your practice. In its most basic form this might mean you can arrange your appointments online like many restaurants and hairdressers now offer. However, as the technology evolves you may find for some conditions you can interact with your Doctor or health professional online.
- In freeing up the time of our GPs, those patients that need it will find that they can have longer appointments with their Doctor. This means the Doctor can really get to grips with managing the more complex conditions affecting some of our population.
- Finally, our practices won’t just be places to go when you are ill. You will start to see that some practices become places to go to access a wider range of services within our communities. These might be lifestyle related, like fitness classes, stop smoking support or dietary advice, or other services such as counselling, carers support or help following bereavement.
Our public have told us that strengthening the foundations of General Practice is essential in helping them to Live well.
How are you going to do all this? Aren’t we short on GPs?
You’ve probably read in the papers that there aren’t enough GPs? It’s true that GPs are in short supply but we are able to recruit some into mid Essex, including helping some from overseas meet our high UK standards. Even with these additional GPs, we know we still need to do more to help our practices. We know there are other means to ease the pressure on our General Practices. We are aiming to recruit over 80 other professionals into our practices over the next two years to assist our GPs in managing the health of their populations. These professionals might be nurses, physiotherapists, paramedics, pharmacists and others but they will all have one thing in common. They will all be highly trained and capable of assisting our GPs in managing the health of our population. In doing this they will give our GPs the time they need to spend with the most unwell people in our communities.
In addition, over the next two years, we are planning on ensuring that every practice in mid Essex has a highly specialised nurse capable of prescribing medications independently and managing a range of complex medical conditions to help our GPs keep you well.
We can help in other ways too. We are planning on investing in different technologies within General Practice to ensure our practices can carry out their work as efficiently as possible. We are improving communication between our practices and other services such as hospitals and social services. In doing this we can ease the administrative burden on our practices freeing up their time for patient care.
And finally, we will connect our practices to you online. By allowing those of you who choose to, to manage more of your healthcare online, we can free up more time for our practice staff to provide care. If you are not a fan of online or smart phones, not to worry, the tried and tested ways of communication will still be there.
That sounds great but isn’t my practice busting at the seams?
It is true that not all of our General Practices have a lot of space available. However, a number of practices do have free space and many have an excess of space into the evenings and at weekends. Our practices are starting to work together to understand exactly how much space is available and it is likely that you will see many practices starting to offer appointments outside of traditional hours and into the weekends. In some cases, you may find that whilst you are registered with one practice, you are offered an appointment at a convenient time in a practice nearby. This is just one way our practices can maximise the space available to them.
However, in some cases, there is simply too little space available for a given population. Plans are already in place to create new General Practice facilities in several of our communities. South Woodham Ferrers, Maldon, Heybridge, Witham, Braintree and Chelmsford will all see new General Practice premises built within the next 5 years. This space will be modern and state of the art allowing these practices to become hubs in the heart of our communities. These modern hubs will provide an even stronger foundation for General Practices to care for their populations. Many of these hubs will offer additional services such as diagnostic tests like X-rays, outpatient appointments with hospital Doctors and several other services.
What about other local services like District Nursing?
We have plans in place to improve several other community services, including district nursing. However, we know that all these services are dependent upon the strong foundation of general practice described above. We have plans to improve services in each of the five domains of our Live Well wheel and these are described briefly below:
We firmly believe our children should have a healthy start to life. We are planning on continuing our work with local schools on childhood health. Our ambition is to offer all schools in mid Essex the opportunity to hold one of our childhood health workshops to ensure that our children, our parents and our teachers know what it takes to give a child a healthy start in life and how to effectively manage common childhood illnesses and injuries.
Even with the foundations in place to deliver excellent services in our General Practices we know some of our population will become sick or unwell, or experience an accident or emergency. We want to make sure that the services required for those who are sick or injured are the best they can be.
We want to improve our local cancer pathways to ensure everyone can be seen by a cancer specialist within 2 weeks of seeing a GP, and that those who need treatment start it within a month of diagnosis.
Similarly, we want to eliminate long waits for our emergency services including ambulances and at A&E.
Thankfully, very few people will ever need to use these type of services and for those who are fit and healthy we want to keep them that way. By ensuring the General Practice hubs described earlier have a range of healthy living services available to them, we can connect our population to the right services to ensure they can remain fit and healthy and live well.
Some of our population already have a long-term health condition. This might be a physical health problem like diabetes or arthritis, or a mental health problem like anxiety or depression. Either way, we want to support people with long-term conditions to stay well. Our General Practice hubs will be the first port of call for all forms of support but we want to go a little bit further where we can. There is increasing medical evidence that some patients with long-term physical or mental health problems can benefit from using technology. By prescribing appropriate apps certain patients can improve the way they manage their own long-term condition without having to leave their own home. We have already started using the myCOPD app to support some patients with COPD and a number of our population with a mild mental health problem use the Big White Wall website as a means of ongoing peer support.
We have a growing population of older frail individuals in mid Essex and this population need additional support to Age well. Once again, our general practices will be the centre of a patient’s care. However, we are starting a number of additional services to give more support to our older population.
We have recently started a Dementia Intensive Support Service. This service provides joined up physical and mental health support, along with social care support for those people living with dementia in mid Essex. The service is already available and accessible via General Practice.
In addition, we have recently launched our Home First initiative designed to ensure anyone from mid Essex spends the least amount of time necessary in a hospital bed. Medical evidence demonstrates that people recover more quickly and more effectively in their own home. This is true for both physical and mental recovery. The Home First service provides people with the same care they would receive in a hospital bed within their own home, giving them the best chance of a good recovery.
We still firmly believe that everyone in mid Essex should experience a dignified death in a place of their choosing. We have a new support service provided in partnership with Farleigh Hospice to ensure that patients and clinicians can access timely advice to support people to Die well. We have increased the capacity of our palliative support services to ensure that all patients who wish to die at home are given the care and support they need to enable them to do so.
More information is available at www.midessexccg.nhs.uk