Sunday, June 16, 2024

Preventing avoidable deaths plan at level ‘never seen in decades’

A FOCUS on preventing avoidable deaths from cardiovascular disease, obesity and smoking across parts of Essex will be at a level never seen in 30 years, health chiefs say reports the Local Democracy Reporting Service.

The Mid and South Essex Integrated Care Board’s first Joint Forward Plan comes as it admits demand for complex care across all services is rising as the population ages. It says a key plank of its strategy will be preventing illness – with focus on heart disease, weight and smoking.

The Mid and South Essex Integrated Care Board plans the establishment of the Cardiology Programme Board to deliver blood pressure monitoring at home with an ambition to have over 75,000 residents monitoring their blood pressure by end of March 2024.

It also wants to maximize the use of mobile heart monitors that allows individuals to detect, monitor and manage heart arrhythmias with automatic analysis, located in GP surgeries, community centres and on outreach buses.

In 2020/21 nearly two thirds of adults in mid and south Essex were overweight or obese and are at increased risk of heart and circulatory diseases like heart attacks, strokes and vascular dementia. A recent study suggests that if everyone were a healthy weight the NHS would save nearly £14bn annually.

The ICB, which covers  aims over the next two years to improve weight management services and to make them more accessible to an increased proportion of the eligible population.

It also wants to increase identification and diagnosis of hypertension by doubling the number of individuals that have a blood pressure check at their community pharmacy by 2024/25.

Treating tobacco dependence is specifically identified as a key service that can improve the prevention of avoidable illness. The NHS long term plan commits to providing NHS-funded tobacco treatment to all patients admitted to hospital and pregnant women by 2023/24.

Ian Wake, partner member of the Mid and South Essex ICB, which met on May 18 to agree the plan, said: “It represents a significant shift. I have been around the NHS for 30 years and I never seen this level of prevention embedded in the system and that is incredible welcome.”

The Integrated Care Board’s Joint Forward Plan 2023/28 comes as it admits demand for complex care across all services is rising as the population ages – it often duplicates service offerings or fails to deliver joined-up, personalised care.

It adds it is not well resourced in terms of workforce – with particular shortfalls in primary care, and significant nurse, support worker, allied health professionals and in some clinical specialities, medicine vacancy rates. Both recruiting and retaining staff has been problematic in recent years.

It also faces serious financial challenges that threaten its budgetary independence if not addressed – it ended the 2022/23 financial year with a deficit of £46.4m. But without change that gap is forecasts to increase to around £500m by 25/26.

In 2023/24 additional workforce will be recruited to enable all those admitted to the mid and south Essex hospitals or specialist mental health services will be offered NHS funded tobacco treatment services.

It adds its £46.4m deficit has been driven largely by a failure to deliver efficiencies and an over-reliance on bank and agency staffing – underpinned by rising demand in certain areas of care, more complex treatment regimes in some specialties and a failure to prevent chronic disease exacerbation.

It adds that a key consequence of the deficit is that it has been limited in the investment it has been able to make in transforming health and care.

It says: “We do not wish to cede control over our operations that is a likely consequence of not resolving our deficit. We wish to retain our autonomy within the agreed NHS framework.”

Professor Michael Thorne, chairman of NHS Mid and South Essex Integrated Care Board, said: “As is the case for many newly established Integrated Care System, we face a number of challenges.

“The Covid pandemic has exacerbated health inequalities in our population, our primary care services are under extreme pressure, demand on our mental health, urgent and emergency services are significant, we have long waits for planned treatments and we are not meeting nationally set standards in relation to cancer care. Collectively, our providers are carrying significant vacancies and we over-rely on bank and agency staff to fill rotas – as a result the quality of care we offer can sometimes suffer.

“We have a significant underlying structural deficit, and we are not meeting our planned financial position. Within these many challenges, we are also a system that has high ambitions to improve the health and wellbeing of the population that we serve. We have delivered a number of impressive and long-lasting improvements and have had many successes.

“This plan will look to continue to build on those positives. It incorporates detailed operational and financial plans for the first year, 2023/24, in line with NHS England guidance, and outlines the ambitions and plans of NHS partners over the coming five  years in key areas.”


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