Suffolk & North East Essex Integrated Care System

Estates

Where services are located, the choice of services offered and the environment in which care is delivered can enhance or reduce people’s personal health and wellbeing. Creating an estate where more people can access services at the right time, in the right place and be seen by the right person therefore supports people to improve their lives;

  • Providing ease of access to services that maintain health and  wellbeing including acute, primary, community, mental  health, voluntary, and leisure
    as close to home as possible
  • Providing treatment in environments that ensure privacy and dignity are protected
  • Taking views into account when an estates scheme is being  developed
  • Being confident that as our population increases over time,  our estate can meet the population needs
  • Ensuring that our buildings are safe, efficient and well  maintained
  • Enabling appointments with health and care professionals in a timely manner using a method of their choice

The Suffolk and North East Essex ICS utilises a large and varied estate to deliver health services. The estate consists of buildings and land for GP surgeries, large hospitals delivering acute care, smaller community hospitals and centres where health and community services co-locate. The size of the estate comprises over 252 properties, covering an area equivalent to approximately 140 full sized football pitches at 85 hectares. In working together as a system and thinking differently, we have the opportunity to use this large estate to support the transformation of services, bringing health and social care together for the community in a more integrated way and at the same time make cost savings and efficiencies.

What progress has been made as a system so far?

Our ICS submitted the Estates Workbook (also known as an Estates Strategy) to NHS England in Summer 2018. The Workbook was graded ‘strong’ in November 2018 (one of only 3 in the country to achieve this top rating). We are also delighted to have been successful in achieving £128.5m in capital funding since 2017. Outlined below is a selection of our capital funded schemes which demonstrate how we will deliver our vision and support the ambitions of the NHS Long Term Plan.

Acutes

Estates Strategy

At Ipswich Hospital there will be a larger Emergency Department and a new Urgent Treatment Centre.

  • Additional MRI and CT scanners will increase capacity and support rapid diagnostics and treatment.
  • West Suffolk Hospital will upgrade its Emergency Department and provide a separate ambulance entrance, GP suite for minor illnesses, Acute Assessment Unit with Ambulatory Emergency Care, mental health facilities, and a frailty service. A Paediatric Emergency Care department will ensure better and quicker service for children.
  • At Colchester Hospital Emergency Department capacity will be increased for rapid assessment and treatment, resuscitation, paediatric emergencies, and frail patients; and urgent assessment facilities will be improved. Integrated health and care teams will be co-located.

These changes will improve integrated working, reduce waiting times, improve pathways to treatment and to mental health services, and improve patients’ experiences.

  • Newmarket Community Hospital is being extended to enable the co-location of primary care with existing community and mental health services. Oakfield Surgery will be relocated to the hospital as a first step, followed by a health and wellbeing hub for the community, as well as minor surgery, GP training, extended opening hours and better links with services offered at the hospital.
  • Kennedy House in Clacton will be developed to create a Primary Care Hub for North Clacton, incorporating a GP Admin and Care Navigation centre, a renal dialysis satellite site, and integration between primary care, community services and social care.
  • We will develop an ICS wide Primary Care strategy underpinned by the needs of our population and consultation with local people.
  • To support our Alliances, we will support public sector services to co-locate and integrate into purpose-built Health and Wellbeing Hubs, where people can access health, social, advice, leisure and wellbeing services alongside health and care services.

These changes will reduce travel to hospital and improve availability of appointments, enable people to access a wide range of services in one place, and improve links between local services to arrange and deliver care effectively.

  • We are reducing our unoccupied space and at the same time maximising our utilisation of existing space to provide more flexible working arrangements, expand co-location, and centralisation of administration functions.
  • Disposal of NHS surplus land and property will enable reinvestment in services.
  • We are focusing on meeting the future demand from an increasing population. West Suffolk Hospital NHS Trust has been ‘green-lighted’ to proceed to the next level of its development plan; it may take 5-10 years for any new hospital plans to come to fruition, and engagement with the local community and care partners will be essential to progress.
  • We have developed strong links with the local authority planning departments, and CCGs are currently coordinating the development of a system wide response to planning applications to ensure that existing patients are not disadvantaged though population growth, and that the increased population have adequate access to a fit-for-purpose health system.
  • We are reducing our unoccupied space and at the same time maximising our utilisation of existing space to provide more flexible working arrangements, expand co-location, and centralisation of administration functions.
  • Disposal of NHS surplus land and property will enable reinvestment in services.
  • We are focusing on meeting the future demand from an increasing population. West Suffolk Hospital NHS Trust has been ‘green-lighted’ to proceed to the next level of its development plan; it may take 5-10 years for any new hospital plans to come to fruition, and engagement with the local community and care partners will be essential to progress.
  • We have developed strong links with the local authority planning departments, and CCGs are currently coordinating the development of a system wide response to planning applications to ensure that existing patients are not disadvantaged though population growth, and that the increased population have adequate access to a fit-for-purpose health system.
  • As part of plans to ensure that health infrastructure is fit-for-purpose for decades to come, West Suffolk Hospital NHS Trust has been ‘green-lighted’ to proceed to the next level of its development plan.
  • The current site was built in the 1970s with a limited lifespan, and while the Trust makes the best of the resources, continuing increases in demand mean that space is a challenge and the current site as it stands is not sustainable in the long-term.
  • A total pot of £100m of seed money is being made available to help kick start the next stage of developing these plans.
  • It may take 5-10 years for any new hospital plans to come to fruition, and engagement with the local community and care partners will be essential to progress.
  • We have developed strong links with the local authority planning departments. This has allowed for a collaborative working relationship to be developed.
  • This will ensure that sufficiently detailed and developed plans are in place to mitigate the effects of housing growth on the local health infrastructure.
  • As a system we have identified that it is important that developers’ contributions support the whole healthy economy and therefore the CCGs are currently coordinating the development of a system wide response to planning applications.
  • The development of this approach looks to ensure that existing patients are not disadvantaged though population growth. Whilst also making sure the increased population have adequate access to a fit for purpose health system which is able to provide the right care, at the right time in the optimal care setting
  • A fit for purpose estate provides an improved working environment for the workforce as well as the patients. West Suffolk Hospital for example has just completed a residential development of 160 units for NHS students and staff. The planned improvements of the Emergency Departments in both East Suffolk and North Essex NHS Foundation Trust and West Suffolk NHS Foundation Trust will offer improved facilities for staff to work in which is hoped will help support longer term retention.

    Our system is working to ensure the estate is fit for purpose for the future as well as today. Incorporating digital systems into estate planning enables rooms and facilities to be repurposed easily should the need for service delivery change, and helps practitioners to work in alternative ways, accessing systems and records wherever they need to. This enables patients to have greater choice and flexibility around how, where and when they interact with health and care services, ultimately leading to better support for their individual needs.

    Each NHS trust will have a Sustainability and Development Management Plan detailing how they will reduce their carbon footprint and environmental impact. Government interest-free loans will continue to be used to fund transformation of electrical and carbon based fuel usage. Refurbishments of buildings will result in an improvement in energy efficiencies, with all new buildings meeting the BREEAM excellent standard as required by NHS England and Improvement. Renewable energy sources will be maximised where appropriate, including photovoltaic cells. LED lighting is being rolled out across the estate, and CCGs are sharing some office buildings with public sector partners to share running costs. Plans will include a waste management policy including targets for reduction in single use plastics and improving recycling opportunities.

    Due to the innovative design of a lightweight modular box on a platform cab base vehicle, the Trust’s new vehicles are 200kg lighter than the current National Specification equivalent, and provide a 20% greater working space within the patient salon providing a better patient centric environment and increasing crew safety by design. The modular box design further allows the option to re-mount or re-use the box for a second life of 5 years on a new chassis or base vehicle, and so potentially reducing future material cost an enabling a high recyclability of vehicles and parts. The significant reduction in weight provides the trust with a vehicle that is forecast to improve fuel efficiency from the current 16.7mpg, to a minimum of 19.5mpg, against the National specification of 18.4mpg. This equates to a forecast fuel saving £3.9 million, and a reduction of CO2 3,900 tonnes per year.

    Recent national policy changes mean that NHS Trusts are now able to acquire and take control of assets currently owned and managed by the national NHS Property Services for the benefit of patient care. We now have the opportunity to ensure local NHS estates meet our local community needs, transforming local community care. Our NHS provider partners have agreed to work together to identify opportunities to enable transformation of services, and their work on this will be underpinned by an agreed set of common principles, value and objectives.

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