AFTER several years of planning, the first of Thurrock's new integrated medical centres looks set to be opened later this year – though it remains a source of some contention and confusion.

In 2017 plans were first mooted to close Orsett Hospital and replace it with four centres across Thurrock in Corringham, Tilbury, Purfleet and Grays – a proposal which met with much public opposition and a degree of scepticism.

However, health service providers including Basildon & Thurrock Hospital Trust and Thurrock's Clinical Care Commissioning Group (CCG) reassured residents that the scheme was fully planned, funded and would roll out within a couple of years.

Only when all the services had been relocated, residents were promised, would Orsett Hospital Close.

In 2018 Mandy Ansell, the accountable officer at Thurrock CCG said: "There has been much speculation over the services provided at Orsett Hospital and where they will go.

"We are in the planning stages for where these services will go. Our first point is that all Thurrock services will be re-positioned within the Integrated Medical Centres and no services for Thurrock people will be lost.

"This will not happen overnight, and we now want to work with people who use the service so that they can oversee the plans. There will be at least another two to three years to ensure the Integrated Medical Centres are built to the right specifications."

Ms Ansell's time frame has proved widely optimistic and the latest report to Thurrock Council's Health and Wellbeing Overview and Scrutiny committee has been given an update on the sites. You can read the full report via this link.

The only place where significant progress has been made is Corringham, which is set to open the doors in April and it is hoped it will be 'operational' by July.

However, there remains significant concern locally about what services it will be able to offer. And initial hopes that it would increase the number of GPs available to serve the Corringham community appear to remain unfulfilled.

The Corringham Centre will be run by the North East London Foundation Trust (NEFLT), an organisation that provides a range of community health and mental health services across the north east London boroughs of Barking and Dagenham, Havering, Redbridge and Waltham Forest, Essex and Kent and Medway and Barnet.

Work began on its construction in February last year when NELFT said: "The new IMC will be home to a range of health and social care services including adults and children's mental health services, GP services, blood testing and general outpatient services."

And Mark Tebbs, NHS Alliance Director, Thurrock Clinical Commissioning Group, added: "We know changing how and where health and social care services are provided can be worrying but, now more than ever, we need to look at different - and better - ways of delivering care.

"Health, social care and community teams will be able to provide better, more joined up care to local people in these new, 21st century facilities."

A further statement at the time said: "These new centres will not only transform health and social care services in the area, but will improve GP waiting times, reduce the number of people needing to be admitted to hospital, and future proof these services for a growing population."

However, in October last year Nub News reported that it is unlikely there will be any new GP provision in Corringham, simply that two existing surgeries will move into the new building.

We were told by a spokesperson from the Integrated Medical Centre Programme Board: "The Integrated Medical Centre will include two existing GP practices and additional primary care services including, advanced healthcare practitioners, clinical pharmacist, mental health practitioners and nurses. Patients will also have access to a wider range of services, including blood tests and other diagnostic opportunities as part of our commitment to provide better healthcare services closer to home."

Concern about the failure to deliver promises at Corringham has become deep-seated in Corringham and last year local ward councillor Shane Ralph, who chairs the O&S Health committee slammed it new centre as 'not fit for purpose' – as reported on Thurrock Nub News. .

Cllr Ralph was particularly irate about the lack of new doctors and said: "The IMC is not fit for purpose in Corringham.

"We need new doctors and a new surgery not just switching existing surgeries to it. When we looked at how many houses we are building in Thurrock we were given promises. If we can't get enough doctors we shouldn't build the houses. We were promised those doctors."

However, at last week's meeting it was Cllr Ralph who found himself in the line of fire from critics for not allowing more debate on what is happening at Corringham.

Debate and the ability to question officers was severely curtailed and after the meeting the committee vice chair, Cllr Victoria Holloway, said: "Councillors were given just four minutes to question health representatives. Because of a chair who loves the sound of his own voice and can't keep an eye on the time, we couldn't get to the bottom of why we don't have our medical centres after many long years. I'm appalled the chair didn't do a good enough job and allow proper questioning."

Cllr Holloway was angered because in the presentation to committee, aside from a lack of operational detail about Corringham, members learned that the three other centres are running well behind the planned sequence of events – though Orsett Hospital is still earmarked for closure in 2025.

While buildings that were on the site of the planned new centre in Tilbury have been demolished and it has been surrounded by hoardings boasting of the new facilities to come – the Tilbury scheme appears in some disarray and needs significant redesign.

With no sign of a spade in the ground after almost four years of planning members were given a 'bullet-point' list of issues.

They were told:

• The nature of the site (flood plain, contamination) means that the build is very expensive.
• It is our duty to ensure that every pound invested needs to be justified. Every pound spent on the estates is money that could be spent on frontline services.
• The current design of the building has a lot of shared space. The amount of shared space suggests that the design of the building could be more efficient to maximise value for money.
• The pandemic has changed the way we work, and we need to review the amount of hot desking space.
• The work on the adult place-based strategy is nearing completion. This is a key document for Thurrock and will help us to drive the locality-based service model.
• The current IMCs do not provide provision for a children's resource centre. There is a potential to include such a provision to bring greater integration to adult and children's services.
• There are opportunities to better integrate the Towns Fund regeneration proposals with Tilbury IMC. The lack of car parking remains an unresolved issue in Tilbury.
• The current Tilbury business case would not get through the NHSEI (NHS England and NHS Improvement) process.
• The building will need to be redesigned. Unfortunately, this will delay the OBC approval process.
• The issue of car parking at Tilbury will need to be resolved before a planning application will be approved.
• Members were told there is a pause in the prject while a proposal for review and costs of the review and timescales are looked at again. And a partial redesign is taking place for the planned IMC in Purfleet.

In February last year members of Purfleet-on-Thames' Community Forum were briefed on plans for the town's new centre and assured things were on track.

After seeing detailed plans of a proposed building they were told it was hoped the new Purfleet centre will be ready to open by the end of 2023.

That is a deadline long gone.

At last week's O&S committee members were told the latest target opening date for Purfleet is 2024/5.

The project's outline business case has still not been completed, though it is hoped it may be ready for submission for 'sign' off by the end of this month.

However, that is only the beginning of the project progressing to the final stage of approval – a full business case.

Detail is scant at this stage about what the Purfleet centre will offer, though the report says it contains space for GP, PCN, out of hospital, community, mental health, council run and voluntary services.

And adds: "This space is also designed to enable use by the community to support health and wellbeing initiatives".

The fourth IMC will be located on the site of Thurrock Community Hospital on Long Lane in Grays.

Again little detail has been provided about what will happen at the site and it seems unlikely to be operational as a new and dedicated IMC for some time – though some services already offered at the hospital will be incorporated into the overall scheme.

Grays' bullet point list includes the following:

• NELFT and EPUT clinical services are already on site, some of which will split across the 4 IMCs once created. There is also EPUT corporate teams.
• Archus, a healthcare planning consultant, was appointed to review the use of existing space at TCH and this work is now complete.
• The review confirms there is adequate space and potential site layouts for those services that will need to move onto site to create the IMC. These include primary care services and Orsett service re-locations.
• A modular build approach is recommended with interconnecting buildings to ensure integrated services.
• The report highlights an opportunity to utilise existing admin space to a greater extent to reduce the need for additional admin space requirements on site.
• Work is now underway to confirm the exact space needed for these services to develop an overall site masterplan and cost of development. Expected by May 2022.

Overall, there remains considerable doubt and delay about the IMC project, summed up by Cllr Holloway.

She told Nub News: "As residents continue to wait for their Integrated Medical Centres - the promised replacement for the closure of Orsett Hospital - nwe hear of redesigns, delays and changes due to cost saving measures.

"Orsett Hospital is closing in just three years and we don't have the buildings in place to provide the health care Thurrock residents deserve."

It all seems a far cry from 2018 when Tom Abell, the then deputy chief executive of Basildon and Thurrock University Hospitals NHS Foundation Trust visited a public meeting at Thurrock Civic Hall and brushed aside residents' many concerns and predictions that things would falter because they had not been thought through.

Mr Abell, who has since left the Trust to take over as CEO of the failing East of England Ambulance Service, said to the people of Thurrock: "This decision is good news. Local residents will soon have more modern health and care services closer to where they live.

"This means more investment in the services people use the most.

"We are also absolutely clear that services will not stop at Orsett Hospital until all the new services are up and running."