Healthcare in Essex is now the responsibility of six clinical commissioning groups: Basildon and Brentwood, Mid Essex, North East Essex, Southend, Thurrock and West Essex.
History
From 1947 to 1965 NHS services in Essex were managed by the East Anglian for Saffron Walden and North-East Metropolitan (the rest of the county) regional hospital boards. In 1974 the boards were abolished and replaced by regional health authorities. Essex came under the North East Thames RHA. Regions were reorganised in 1996 and Essex came under the North Thames Regional Health Authority. There were two area health authorities from 1974 until 1982: Barking and Havering and Essex. There were six district health authorities: Barking, Havering and Brentwood; Basildon and Thurrock; Mid Essex; North East Essex; Southend; and West Essex. in 1993 these were reorganised into North Essex and South Essex. Regional Health Authorities were reorganised and renamed strategic health authorities in 2002. Essex was under the Essex SHA. In 2006 regions were again reorganised and Essex came under NHS East of England until that was abolished in 2013. There were six primary care trusts for the area: South East Essex; South West Essex; North Essex; West Essex; North East Essex; and Mid-Essex PCT. Look up St Helena Hospice.
Sustainability and transformation plans
Suffolk and North East Essex formed a sustainability and transformation plan area in March 2016 with Nick Hulme, the Chief Executive of Ipswich Hospital NHS Trust, as its leader. Hertfordshire and West Essex formed an STP with Beverley Flowers, the Accountable Officer of East and North Hertfordshire Clinical Commissioning Group as its leader, and Mid and South Essex under the leadership of Dr Anita Donley the independent chair of the Mid and South Essex Success Regime.
There are two plans for the county, one for Hertfordshire and West Essex and one for Mid and South Essex. Both claim that they will reduce the use of the hospital sector and increase the use of community and primary care sector and reduce a projected 2020/21 deficit which totals £1,180 million. Neither give any clear account of how the problems with their local hospitals are to be tackled.
Ipswich and East Suffolk, West Suffolk and North East Essex CCGs propose to merge as part of local plans to establish an integrated care system.
Hertfordshire and West Essex is to become a shadow integrated care system, covering one and a half million people with effect from April 2020.
Commissioning
Castle Point and Rochford, Southend and Thurrock clinical commissioning groups were instructed by NHS England to pool functions and create a single plan in April 2017. Mid Essex, and Basildon and Brentwood CCGs are to join them in a joint committee which must produce a joint commissioning plan to be approved in advance by NHS England.
Service restrictions
In 2015 the spending allocation received by Mid-Essex Clinical Commissioning Group, was £81 less per head of population than the national average.
In September a survey by the Health Service Journal showed that 34 of 188 CCGs who responded to their survey had restricted access to some services. Restrictions were usually introduced by a number of CCGs acting together across an area. Essex CCGs were proposing restricted access to specialist fertility services, and non-urgent elective surgery for patients who were obese or smoked.
Basildon and Brentwood CCG decided to limit GP referrals for vasectomy in April 2015. The number of vasectomies each practice is permitted to refer in 2015/16 ranges from one to 11 per practice based on their list size. The decision was criticised by Dr Richard Vautrey of the British Medical Association who said: ‘This is a ridiculous short-term decision that could have huge long-term emotional and financial consequences to both families in the area that the CCG serves and to the wider NHS as other services have to pick up the pieces. For the sake of saving a few pounds the CCG is taking the risk of a rise in unwanted pregnancies and all that means for individuals and families and they should seriously consider reversing this decision.’