Health bosses paint gloomy picture of access to care for Thurrock residents

By Local Democracy Reporter
Piers Meyler

ONE in two people across mid and south Essex will not be able to get an appointment with primary care in three years if changes are not implemented, according to a top health officer.

The Mid and South Essex Sustainability and Transformation Partnership (STP) says it is facing a “workforce crisis” in primary care – principally due to the significantly lower numbers of doctors and nurses per head than the national average.

The position is likely to get worse in the coming years due to an ageing primary care workforce.

It is expected that around 230 GPs, equivalent to about 30 per cent of the total, will be considering or will have already retired over the next few years.

Health Education England recently identified the retirement challenge in mid and south Essex as the “greatest in England”.

Caroline Rassell, accountability officer for mid Essex CCG told the CCG board meeting yesterday (June 28): “There is a very clear message that in order to have sustainable primary care going foward across the STP we are going to have to invest in staff, we are going to need to invest in facilities and we are going to need to invest in IT.

“Very much it is putting forward a case for change.

“If we did nothing in three years’ time one in two people across the STP would not be able to get an appointment with primary care.

“That is unsustainable.”

The STP is implementing a series of changes to address the lack of GPs –aiming to recruit 120 more across mid and south Essex to enable it to hit the national target of having 682 full time equivalent GPs in post by 2020.

It is also looking to develop new roles and recruit a wider set of skills and disciplines in to primary care, including pharmacists, GP assistants and mental health specialists, as well as looking to reduce workloads and make current roles more attractive.

The STP also wants to recruit 69 additional clinical practitioners to bring the total to 325.

Other health models include the development of integrated hubs – bringing together a number of services – whether based in physical buildings or even in a virtual collaboration.

Dan Doherty, director of clinical transformation, who is leading an alternative staffing model for health in mid and south Essex said: “What this strategy is saying beyond that for the next three years is what we need to do, not only to solidify primary care and GP practices in the here and now, but to actually deal with that demand that is coming.”

Mid and South Essex STP has fewer doctors and nurses than the national average.

There are 2,243 patients per GP in mid Essex, 2,433 in Basildon and Brentwood and 2,739 per GP in Thurrock, compared to a national average of 1,818 per GP.

There are 5,838 patients per nurse in Basildon and Brentwood CCG, 5,065 per nurse in Thurrock and 4,083 per nurse in Mid Essex, compared to a national average of 4,088.

In Mid Essex 54 GPs or 26 per cent of the total are over 55, while in Basildon and Brentwood 45 GPs or 33 per cent of the total are over 55.

In Castle Point and Rochford 34 GPs or 39 per cent of the total are over 55.

The partnership has added that as a result of the pressures, the STP is heavily reliant on locums, with the challenge most pronounced in the south of the patch.

As well as being expensive, this affects continuity of care for patients, the partnership adds.

So serious is the situation in mid and south Essex that NHS England is today (June 29) announcing Mid and South Essex will receive intensive support to retain local GPs.

The news follows one month on from the announcement of the Local GP Retention Fund to provide an additional £10 million as part of the General Practice Forward View initiative to support areas that are struggling most with GP retention.

Of this, £3 million will be used to establish seven intensive support sites in areas in England that have struggled most to retain GPs, including the Mid and South Essex Sustainability and Transformation Partnership area.

The remaining £7 million is being made available to support locally-based retention schemes across the country to help GPs to stay in the workforce.

Dr Alistair Lipp, Medical Director for NHS England (East), said: “The new Local GP Retention Fund will enable significant changes to be made in how GPs are supported, whether they are newly-qualified, feeling the strain mid-career, or considering retirement.

“All our STPs have the opportunity to benefit but naming Mid and South Essex STP as an intensive support site recognises the particular challenges they face in retaining GPs.

“It will enable them to get the help they need in consultation with local GPs and system leaders, and build on the additional GPs being recruited via the international recruitment pilot.”

It takes around ten years to train a GP.

A new medical centre in Chelmsford due to accept the first students in September has been welcomed by health bosses, but those undergraduates will not be fully qualified until 2028.

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