THURROCK is to get 12 fledging GPs in the near future to help offset the shortage across the borough.

That was revealed at last night's (Tuesday, 7 June) meeting of Thurrock Council's Health and Wellbeing Overview and Scrutiny Committee and was described by the consultant health planner brought in to sort out delays, frustrations and concerns with the council's plans to create four new integrated medial centres (IMCs) across the borough as - "a really good news story and exciting for the whole of Thurrock".

Tiffany Hemming is described as an innovative and entrepreneurial leader and manager, able to see 'woods and trees' and as well has her input she is to create a team of specialists and a project leader based in the borough to drive the blighted project forward.

Addressing the meeting for the first time Ms Hemming, somewhat embarrassingly introduced by acting committee chair Cllr Terry Piccolo as Timothy Hemmings, delivered a series of pledges – including an assurance that Orsett Hospital will not be closed until all the IMCs are complete and up and running.

Cllr Piccolo's slight faux pas aside, the presentation was well received by committee members who did raise some concerns but appeared satisfied to get concise and specific answers.

It was, as Ms Hemming herself acknowledged, a change from previous presentations where amorphous answers from council officers left the whole project clouded in mediocrity at best.

Now, according to Ms Hemming - who was 'parachuted in' to save the project in April this year – project is back on track and it is hoped all the IMCS will be delivered by the end of 2025 – at which time Orsett Hospital will finally close its doors.

She describes herself as on secondment with a substantive role on the executive and unitary board of an outstanding NHS Trust where she leads on development of integrated care partnerships (place-based care) with multiple stake holders in the community.

Ms Hemming outlined how she and her team will manage the project in Thurrock, before moving on to deal with each centre – and unveil the scheme for new doctors.

She said: "I am now moving sideways into an executive director role. I am bringing in three people who will be dedicated to work on this programme as a permanent project management office and I will be bringing in a dedicated project leader."

She promised informed and on time delivery on the project – adding: "I can't say that's true of what I have managed to find about what is in the past."

She said: "I have been working on the integrated medical centres for a couple of months, to try and get a programme up and running and back into things happening in a timely manner."

Corringham's new IMC was previewd by Ms Hemming.

She first spoke about the nearly complete Corringham IMC – and revealed the town's existing health centre will now stay open and not be demolished - saying: "At there is just over 1,200 square metres of space in the new building available for health and social care plus community use which we are encouraging community groups to come forward for using that space, particularly at weekends and out of hours, that's a really big part of the plan for the IMCs.

"There's a second site at Corringham Health Centre that's now going to be available for delivery of services, so we will have more of a campus approach across the two sites, which I think is really exciting.

"The site is due to open, probably late July, it's just going through its final commissioning period.

"We plan on moving services in over July and August, into September to try and make sure that we can get as much in there as quickly as we can. Community services are moving from other sites across Thurrock. We also have acute and out-patient services moving in there.

"Some of those are new, so the triple-A screening, which is abdominal, aortic aneurysms - which is essentially where a blood vessel becomes very unstable and is at risk of bursting in your abdomen. There is a high risk of that in Thurrock so we are putting a unit into each of the IMCs as a new service to try and pick that up before it becomes a problem.  

"There will also be the facility to take blood samples at every site, including Corringham which is again quite exciting. And also ultrasound.

"The primary care was originally going to be provided by two branch practices that are currently based in Corringham Health Centre and we were going to knock down Corringham Health Centre 

"We have now decided that we will keep Corringham Health Centre, so instead of just moving GPS from one site to another they will now stay on that site and we will have an additional five rooms for GPs to provide services inside the Corringham IMC.

"That will be provided by something called the GP Fellowship scheme and primary care network appointments.  

"The plan is to recruit an additional 12 newly-qualified GPs and they are going to be accommodated in the Corringham IMC from September of this year.

"Their training will be complete in August and we intend to start employing them in September. These GPs will spend about half their time providing extra GP appointments across the whole of Thurrock on behalf of local practices.

"The way that will work is we are working very closely with the GP practices now to work out which of those practices want one of those GPs, because they have to pay for them, for the time that they are with them

"We've already got significant interest, for example in the Corringham and Stanford-le-Hope primary care network (PCN), we have at least one practice that wants two of them  

"These GPS will do half their time in what you understand a GP does, the other half of their time, they will carry on studying essentially in an area of special interest. That could lead to them holding specialist clinics at Corringham IMC.

Corringham's IMC from the road.

"There will be other services provided at Corringham 'as space allows' including a full-time obesity clinic.

"And extended 'out of hours' services will be provided at Corringham for people across the borough later in the year."

She acknowledged there have been concerns in Corringham about parking around the new building, which has limited on site parking provision and said: "I understand there is concern about car parking around this site. We do have a policy for car parking and we have prioritised it for patients.

"Staff are encouraged to use alternative means of transport where they can and/or car share or to park in local car parks."

Going back to the sort of things that will happen at Corringham Ms Hemming added: "In terms of the primary care provision, what we are going to do is work towards integrating the GP care with the community services and the acute outpatient services.

"For example if you have got diabetes and you normally go to your GP and maybe see the community's diabetes nurse or maybe you also go for outpatient appointments, all in different places, in the future as we develop our service more fully, you will be able to have a single appointment and all of those clinicians will have talked to each other in what we call a multi-disciplinary team meeting so that they understand that patient and they can provide better care for that patient in a single setting."

She then gave an update on progress on the other planned centres, at Purfleet-on-Thames, Tilbury and Grays, saying: "For Purfleet IMC an outline business has been submitted to the health programme board. The full business case will follow and it is planned to open in 24/25

"Tilbury's outline business case is being drafted. The current planned building is a bit too expensive for our current plans but we will be seeking to apply for more money.

"A redesign didn't make the expected savings, so work is ongoing on design, there were flaws in the current design process ' so we are now looking to put forward a plan that works in terms of patient flow.

"The capital cost of the building is bring born by Thurrock Council and there are some shortfalls in operational planning."

That prompted Cllr Piccolo to as: "If NHS don't give us the additional funding, what's the fall-back position, - to be told "We don't have one currently! Hopefully it will be open in 24/25."

Ms Hemming then turned to the planned Grays IMC, saying it was 'a very different beast,' adding: "It is still under development. It is proposed to be on the site of the current community hospital on Long Lane, its business plan is hoped to be completed later this year and again it is planned to open by 2025.

Members of the committee posed questions, including Cllr Tony Fish who said: "Talking about Corringham IMC the report mentions the existing site at Corringham Health Centre, which already got problems, including parking and problems for wheelchair access.

"What arrangements are there going to be there?"

Ms Hemming responded: "At the moment we haven't done anything about parking at the site. It will continue but as services move out to the new IMC parking issues will decrease. We are looking at what the needs of that building are, previously we were going to knock it down."

Cllr Georgette Polley said: "Currently there is an absolute lack of awareness of the need for out of hours GP appointments, what is to happen? And she was assured this would be addressed by the provision of new GPS. 

Cllr Polley added: "We seem to have been talking for so long, we are still just talking about outline business cases and making financial justifications.  This committee repeatedly put that there is to be closure of Orsett until all these IMCS are up and running and all the services are running.

"That has been written in stone from the start. You cannot be talking about closing Orsett until everything is up and running."

Her concerns were echoed by Cllr Jane Pothecary, who said: "We can see the timelines on paper that these sites are due to be opening in 24/25. We are in June 22. I am looking at Grays we are only just looking beginning with an outline case

"This process so far has not inspired me with confidence that this can move quickly enough so the IMC will be operational by 24/25. What I need is a reassurance when or if these sites are not opening and running by that time.

"What is the guarantee that if we don't get these over the line by 2025, that Orsett Hospital will not close. Is it a case that Orsett will close and there will be a bridging process? If it stays open, where is the budget for it?"

Ms Hemming responded by saying: "In terms of Orsett Hospital, I am checking up the governance and explicitly bringing the closure of Orsett workstreams into the programme. It is completely linked to the opening of the new sites.

"In terms of budgeting as hospital draws down its services, there will be less and less on site. We are already paying for 5,000 m of void space we are not using. Paying for void space is in the budget. But what isn't in the budget is operational costs.

"I am working particularly hard to make sure we have a much tighter process so that this happens on time and that we deliver these buildings when they are supposed to be delivered. There is no explicit closure date for Orsett. There is no plan to close it before services have moved out.

"The plan is it will relocate its services and only then close. That is the plan, I can reassure you on that.

"It's a really good news story and it's exciting for the whole of Thurrock."

Ms Hemmings also revealed that there is no 'cost-=saving' element associated with the new IMC scheme, saying: "The new buildings are going to cost more per square foot that what we are paying for Orsett

"For instance, Corringham IMC is more expensive than the buildings it has replaced, but that's because it's is a nicer, more modern building."