Strengthening healthcare services for our community this winter

As part of the NHS’s winter preparations, senior clinicians and partners across the health and care system have been developing plans to make the best use of healthcare facilities and resources this winter.

Plans include changes to:

increase and reconfigure inpatient community rehabilitation beds that support people who need short-term bed-based rehabilitation services after a spell in hospital. This includes stroke and more generalised rehabilitation beds.
relocate the birthing unit run from St Peter’s Hospital in Maldon – which sees an average of six births a month – to the William Julien Courtauld Birthing Unit (WJC) in Braintree.

Increasing and reconfiguring inpatient rehabilitation community beds

Inpatient community beds are used to support people who are not yet well enough to go home and to care for people who need additional rehabilitation, including those who need support following a stroke.

These services need to meet the changing needs of our residents and ensure they receive the right support at the right time and in the safest place for them.

The changes will see an overall increase in the number of beds used for stroke rehabilitation meaning hospital beds will be freed up for patients who need urgent care.

Sustaining a safe and high-quality service is no longer possible at St Peter’s due to the condition of the building. It has deteriorated in recent years and is no longer the best place to deliver inpatient care. Bayman Ward at Brentwood Community Hospital will therefore provide 25 beds for stroke rehabilitation in modern, high-quality accommodation replacing the 16 beds at St Peter’s.

Outpatient services such as diagnostics and screening will still be provided from St Peter’s for the local population in Maldon.

Relocating midwife-led births

Maternity outpatient appointments will continue at St Peter’s in Maldon, but people wanting to give birth in a midwifery-led unit will use the Willian Julien Courtauld (WJC) birthing unit in Braintree or Broomfield Hospital instead.

Midwives will continue to support families to choose the best place to deliver their babies.

Deborah Goldsmith, Director of Midwifery at Mid and South Essex NHS Foundation Trust, said: “We want to provide families with the best experience when they are having their babies, and the modern, purpose-built facilities in Braintree will allow us to do exactly that. Unfortunately, we had to regularly close the facilities at St Peter’s, but using the birthing suite at WJC means we will be able to offer a safer and more reliable service.”

Local staff will be front and centre of transition plans to ensure all patients’ needs are met.

The changes are scheduled to take place in the autumn of 2023 in preparation for the winter when demand for care is expected to increase and the NHS will be under the most pressure.

Dr Matt Sweeting, Interim Medical Director at Mid and South Essex Integrated Care Board and a Consultant Geriatrician, said: “We owe it to patients and the public to get this right. This plan comes as part of comprehensive and collaborative efforts to improve healthcare facilities and resources this winter. The changes offer several advantages, including being able to accommodate a larger number of patients and ensuring that they get the care they need in the right place, at the right time.

“Our main aim is to deliver the best possible outcomes for our patients in high-quality facilities.”

Residents who would like to be included in any future conversations around the longer-term plans for stroke rehabilitation, intermediate care, and maternity services, should email [email protected]

Frequently Asked Questions (FAQ)

A: The movement of community inpatient beds is part of ongoing efforts to improve and optimise healthcare services for the community. This decision is driven by needing to make the best use of collective healthcare facilities and resources this winter.

Adjustments ahead of the winter period, will help to ensure the NHS can offer safe, efficient, and effective healthcare services.

A: For the coming winter, inpatient services for stroke rehabilitation, intermediate care, and maternity will change as outlined below:

Bayman Ward at Brentwood Community Hospital with 25 beds for stroke rehabilitation in modern, high-quality accommodation will replace the 16 beds at St Peter’s Hospital.
The Midwifery-led Birthing Unit at St Peter’s Hospital in Maldon will transfer to the William Julien Courtauld Birthing Unit (WJC), in Braintree, where there will be three beds to support midwife-led births (currently six births per month take place at St Peters in Maldon)
Beds at the CICC (Cumberledge Intermediate Care Centre) Rochford will now accommodate 14 stroke rehabilitation and eight intermediate care patients. Previously there were only eight stroke rehabilitation beds there.
Community inpatient beds at Mountnessing Court, Billericay (22 beds) will remain unchanged.
Community inpatient beds in Mayfield Unit on the Thurrock Community Hospital site (24 beds) will remain unchanged.
Community inpatient beds in Halsted Hospital (20 beds) will remain unchanged.

The changes will mean an overall increase in the number of stroke rehabilitation beds in the community, enabling more patients to be transferred from acute hospitals, helping those hospitals to accommodate more urgent cases.

We know that both local access and getting the right care at the right time matter to local people. We acknowledge and understand that these changes mean some people living in mid Essex will need to travel further to visit loved ones who require these community inpatient services this winter. We are working with our community and voluntary sector partner to understand what is available to support people who may find it difficult to visit their relatives and loved ones.

The ambition is for the new configuration of community inpatient beds (for this winter) to be completed this autumn in preparation for the winter of 2023/24, when pressure on NHS services is expected to increase.

Any longer-term proposals for permanent changes to stroke rehabilitation, intermediate care and maternity services will be developed in conjunction with local people and key stakeholders and in line with the best possible clinical advice.

Outline proposals for the future are expected to be completed by the end of the year with formal public consultation expected to take place in the early part of 2024. Residents and stakeholders that would like to be included in any future conversations around the longer-term plans for stroke rehabilitation, intermediate care and maternity services should email: [email protected]

No, the changes being made now are necessarily temporary and will only affect inpatient beds i.e., where patients need to stay overnight or where a bed is needed for an extended period. These changes are being made this winter to reflect the immediate needs of the service.

Outpatient services provided from St Peter’s in Maldon will continue to be located there. For example, blood tests, diagnostics, screening, and maternity outpatient appointments.

Work will proceed in parallel to determine proposals for long-term solutions for the configuration of stroke rehabilitation, intermediate care, and midwifery-led birthing services. This will produce proposals developed in conjunction with local people and key stakeholders in line with the best possible clinical advice. Formal plans should be drawn up by the end of the year and will take the form of a “pre-consultation business case” which can be used as the basis for formal public consultation and decision making in the early part of 2024.

Yes, the William Julien Courtauld midwifery-led Birthing Unit at Braintree site will be available in replacement of St Peter’s midwifery-led birthing unit.

Women and birthing people can discuss available options with their midwife. They can choose to birth in any hospital or opt for a home birth.

Broomfield midwife-led Birthing Unit will continue to operate as normal.

Patients, visitors, and staff using St Peter’s Hospital are safe as we have put several short-term solutions in place. But we know patients deserve much better.

We know that water sometimes leaks through the roof and that it is cleared immediately so it does not cause any further issues. To access the stroke rehabilitation services on the first floor the use of the main lift is required as it is the only lift that has the capacity to take a bed. This lift has broken down several times, but temporary measures have been put in place to keep patients safe.

As in all our buildings, we carry out regular inspections on the property and during the day there is an onsite estates team who can respond in a timelier manner than out of hours. Relocating the stroke rehabilitation services would leave the midwifery led birthing unit as an isolated unit at night, with less staff to respond at pace in case of emergency. Moving the Midwifery-led Birthing Unit at St Peter’s to the William Julien Courtauld Birthing Unit would increase the security for staff and patients.

The outpatient areas of the hospital have been carefully assessed and do not present any immediate issues, for example outpatient services provided on the second floor can be accessed via an alternative platform lift.

The temporary measures put in place to provide the safety of the services cannot be maintained permanently and in the 21st century patients rightly expect high quality accommodation to sit alongside the excellent care that St Peter’s Hospital staff strive to give.

A: The relocation of community inpatient beds will bring several benefits for patients and their families. It will result in an overall increase in the number of beds used for stroke rehabilitation meaning hospitals beds will be freed up to meet the needs of patients requiring urgent care more effectively.

It will also mean patients will have better access to modern purpose-built facilities.

A: The moves are interim and form part of plans to make the best use of collective healthcare facilities and resources this winter.

Any permanent proposals for longer term plans for stroke rehabilitation, intermediate care and maternity services must be the subject of formal consultation and will be developed in conjunction with local people and key stakeholders and in line with the best possible clinical advice.

As stated above, work will proceed in parallel to determine proposals for long-term solutions for the configuration of stroke rehabilitation, intermediate care, and midwifery-led birthing services. This will produce proposals developed in conjunction with local people and key stakeholders in line with the best possible clinical advice. Formal plans should be drawn up by the end of the year and will take the form of a “pre-consultation business case” which can be used as the basis for formal public consultation and decision making in the early part of 2024.

A: Work will now begin on planning the transition this autumn. Patients and their families who will be directly impacted will be informed through various channels, including direct communication, public announcements, our website, and local media outlets. We are committed to making the transition as smooth as possible for everyone involved.

A: One of our main aims is to minimise disruptions to patient care. The changes will be carefully planned to ensure a seamless transition. Necessary measures will be implemented to ensure that patient care continues with minimal interruptions during the move.

A. Some staff have been asked to change their usual place of work and the normal staff consultation processes have been followed in relation to such changes.

Reasonable steps are being taken to minimise the effects on the staff involved and to assist them with any transition. Further information in this regard will be provided directly to staff, including details of the steps proposed to assist and support them with the transition.

Due to the fact the Stroke Rehabilitation Ward and the Midwifery Led Birthing Unit have relocated to different sites with established Estates and Facilities functions in place, some roles have seen redundancies – suitable alternative job vacancies have been shared during the consultation process.

No clinical staff have been made redundant as a consequence of these interim changes.

A: We encourage patients and their families to speak to the healthcare professional involved in their care regarding any additional information or concerns linked to direct patient care this autumn/winter. Residents who would like to be included in any future conversations around the longer-term plans for stroke rehabilitation, intermediate care and maternity services can email [email protected].