Integrated Health and Wellbeing Hub in Hornchurch

In a 12 week engagement period running from 22 November 2021 to 13 February, 2022 local people from Havering, Redbridge and Barking and Dagenham were invited to share their views on proposals for a new integrated Health and Wellbeing Hub in Havering. The report on engagement activity was submitted to the project board in March and has now been approved by the CCG’s governing body. The report is available for download below.

NEL CCG, in collaboration with North East London Foundation Trust (NELFT), ran a series of virtual Q&A “drop in” events throughout January and February where residents, local authorities, voluntary sector organisations and other public sector stakeholders could ask questions and share their views on the project. There was also an online survey available for those who couldn’t attend the events. More information about methodology of the engagement and a detailed list of stakeholders involved in the process can be found in the engagement report.

There were over 400 responses to the St George’s Hub questionnaire. Comments covering key themes from both the survey and drop in sessions and how they will be addressed by the CCG are listed in the table below:

Comments received through the engagementHow we will address the comments
A resident thought there are more GP and dental services needed in the Rainham and South Hornchurch area. A number of respondents felt GP services at the Hub should be an extension to GPs and other services offered in the area, not a replacement as there needs to be more capacity A Rainham resident said they felt ‘neglected’ due to lack of a full time GP provision at Rainham Health Centre and concerned about current care infrastructure not being sufficient with a significant number of new properties in Beam Reach.Provision of GP and primary care services at the St George’s Hub is a priority for our proposals. We have assumed an increase in population of 5,000 in the local area and have allowed space for that expansion within the St George’s hub. A list size of 5,000 would not be viable for a new provider. Therefore, the plan is for two existing practices, who are wanting to expand and take on new staff, to move into the new facility along with the Havering South Primary Care Network (PCN), who will look to provide services from the Hub too. This is just one element of our work to improve access to primary care services within South Hornchurch, Rainham and the wider Havering area, We plan to commission a new GP provider for the Rainham Health Centre practice (via a procurement process). The Beam Park development (which borders Barking and Dagenham and Havering) will have a new, large GP facility with additional GP and other services provided.
A number of residents were concerned about continuity of adequate staff, potential shortages of staff and poor residents-to-healthcare professionals/services ratio in the area.Workforce remains a priority of all partners within the North East London Integrated Care System, who are working collectively to address the national recruitment and retention of health and care staff at a NEL level. Workforce requirements are a key element of the planning of the integrated care operating model and will be closely monitored as we develop our plans. Health and care partners have established the BHR Academy which will support us in ensuring we have the right number of skilled staff in place at the right time.
There were comments about how the hub will help support the provision of health care to the growing local population: “Due to rapid increases in population in the recent years, there is more health infrastructure needed in the area, including a new hospital to increase the number of beds available, and reduce waiting times in A&E”. “The hub is a good start but there is more capacity needed with the increasing population.”The new Health and Wellbeing Hub at St George’s is a key part of wider NHS service planning, both in Havering and across north east London, and the local NHS sees it as being at the very heart of integrated health and care services in this part of the capital. The St George’s Health and Wellbeing Hub will be an integrated health and social care hub that brings care closer to home, while also helping to support delivery of health and care across Havering and North East London.
 This is the first of a number of planned new developments in north east London. In addition, the move of renal dialysis services into a more appropriate clinical location at St George’s will provide additional space at Queen’s hospital to support improvements to the A&E service. There are currently no plans for a new hospital within outer north east London (within the boroughs of Barking and Dagenham, Havering and Redbridge).
There were suggestions that some services should be kept in hospitals to reduce risks e.g. renal services. One respondent told us “I am a dialysis patient and am concerned that a new unit will be on the 2nd floor. Dialysis patients attend multiple times a week and are prone to sudden drop of blood pressure or even haemorrhage. The thought that we may have to try and stem bleeding whilst trying to get up to the 2nd floor walking or in a chair through a busy atrium and past a cafe is terrifying. I think the public and especially those with mental health issues would find it distressing. Something like the sexual health service would be a more appropriate service to move there and leave the dialysis unit at Queen’s.We have taken clinical advice from Barts Health, who provide the renal dialysis service, currently at Queen’s Hospital. Their advice is as follows: “In-centre haemodialysis has been proven to be safely delivered in nurse-led satellite units for many years. “Dialysis units therefore do not need to be co-located on acute hospital sites as common clinical issues, such as dropping blood pressure, are quickly identified and rectified without needing the support from the wider hospital services. “ The Barts Health Renal service and the national strategy is to provide dialysis closer to patients’ homes and ideally in the patient’s home where this is possible. St Georges is a fantastic opportunity for us to provide dialysis treatment in an innovative way, supporting patients to take a much greater control of their treatment or to dialyse independently.”
There was a suggestion from some respondents to keep services in the Hub focused on the elderly as they make up a significant percentage of Hornchurch’s population and providing other services in Queen’s Hospital as the younger population tends to be more concentrated there. One respondent suggested a focus on services to support older people could include physiotherapy.   One respondent noted that St George’s Hospital historically hosted a number of geriatric services., Closure of the hospital highlighted the need for this type of service in the local area.The hub will provide a wide range of services across all ages. This will include a specialist ‘frailty’ hub and associated services, focussed on the elderly, with support from specialist elderly care consultants (Geriatricians) from BHRUT.. Supporting services will include a physiotherapy department and gym.
NHS services should be kept separate from social and community services”.There is an essential link between health and local authority services which will ensure a holistic approach to health and well-being,
Some respondents commented that there is a shortage of essential services which should be accommodated before developing additional voluntary services.This will also involve the voluntary sector who play a vital part in supporting the local population especially in terms of supporting people to stay well. The Project Board is currently working through the contribution the voluntary sector can add to the hub and local residents.
Centralisation could lead to increased travel times and other logistical issues”. Some respondents felt that current travel times are too long, especially for patients who are unwell (e.g. from the Rainham and South Hornchurch area). Some respondents expressed concern that the number of services in one building could affect the quality of provided services.By centralising some south Havering services at St George’s and delivering them through an integrated care model, we feel that we will be able to provide a much more enhanced service for patients. This will mean that patients from Rainham and south Hornchurch will be much better served, and could reduce travel times for many residents who currently travel to Queen’s Hospital and other hospital sites.
Parking spaces was a common concern. Some respondents are concerned that due to a large number of new residential developments recently built in the area and proximity of a school, it is already difficult to manage traffic. They felt sufficient parking facilities for local residents, patients and staff is key in providing patients and residents with a positive experience. Ensuring there are enough disabled parking spaces in the facility, including dedicated parking spaces for renal patients. Residents are concerned about adequate parking provision and safety considering proximity of the hub to a school.We have had a travel and transport survey undertaken that concludes that we have the right number of parking spaces, this was approved by the London Borough of Havering. We plan to give patients priority parking. Our plans for the development already includes a number of disabled spaces, as well as spaces reserved for renal dialysis patients. Parking will be free and closely monitored through ANPR to ensure that it is not used by commuters.
A resident in the West Redbridge area felt the services at the hub are focused on reducing pressures at the Queen’s Hospital, leaving Whipps Cross out.As well as the Whipps Cross Integrated Services strategy which supports the proposed new hospital at Whipps Cross Hospital, there are a number of plans in development in Redbridge which will relieve pressure on Whipps Cross. This includes more integrated working between community, mental health social care and primary care to bring care closer to home and, where appropriate, away from the hospital site. There are also plan for developments in the west of Redbridge. These are at a very early stage. .
Respondents suggested a number of outpatient and community services that could be located at the hub (see the engagement report for the full list)There will be a range of services provided including outpatient, community and mental health. The CCG has been advised by NHS England that Community Dental services are to be retained at
Dental services was noted as a priority by some respondents.South Hornchurch health centre for at least the next 5 years.
A resident felt mental health services shouldn’t be provided at the hub.Providing greater access to residents with mental health issues is a high priority and part of the NHS plan to bring services ‘closer to home’. It also supports the principle of integrated services, so people with both mental and physical health needs can be supported at the same community facility.
A number of respondents suggested the hub could include space for a play group and community centre or nursery.Unfortunately, the planned building does not have the space for this type of facility, and the main focus had to be on health and wellbeing services.
Diagnostics and walk in centres. A number of residents stated they would like to see a new walk in centre facility in the area, similar to the Harold Wood Polyclinic as well as diagnostic services including phlebotomy (blood testing), x-rays, ultrasound, MRIs, breast screening, cancer screening, ECG, allergy testing, GI endoscopy.The hub will provide blood tests, ultrasound, x-ray, CT and MRI scanning. Breast screening will remain at King George’s, providing a ‘one stop shop’ service, endoscopy will also remain at hospital sites due to the nature of the service. Consultation was undertaken on the proposals for Urgent Treatment Centres (including Harold Wood Polyclinic) in 2018, leading to agreement of four Urgent Treatment Centres only in Barking and Dagenham, Havering and Redbridge. UTCs provide walk-in and bookable community urgent care services. There are no current plans or available funding to increase the number of UTCs in Havering.
It was suggested that one of the aims of provision of services at the hub should be to reduce pressure on the Queen’s hospital, especially the Children’s A&E where some residents noted particular dissatisfaction with the current waiting times..One of the very significant benefit of relocating of the renal dialysis unit from Queen’s Hospital to a more appropriate and expanded clinical setting at St George’s is that this will provide significant additional space to support improvement and expansion of the A&E department at Queen’s Hospital.
The Havering Health Overview and Scrutiny Committee would like to see services expanded to 10.00 pmThe NHS would like to keep the building open as late as possible to maximise both health and community use.
A small number of respondents thought the public were not provided with enough information to decide whether they support or not or that the questions were not suitable.In addition to the information provided we held open sessions for the public to ask us questions about the development where they could have asked for clarification on any aspect of the Hub.

Demand for health and care services is increasing, as a result of our ageing and growing population, with many more people now living with long-term conditions such as heart disease and diabetes and requiring additional support from local services.

It is important that we plan to meet these demands now and for the future. Health and care services need to work together in partnership to meet the needs of local people, with a focus on helping people to access a wider range of services in their local communities to support their wellbeing.

Our approach to delivering this vision is through more joined-up working across services, with integrated health and care hubs as a focal point for people accessing health and wellbeing services. People will be able to receive assessment, treatment and a wide range of support all under one roof.

The Hub is an essential part of our ambition to deliver high quality healthcare services giving patients access to primary care, community services and mental health services delivered in an integrated way.

Health and care partners across North East London have been working together for a number of years to design the Hub which will bring together a range of health, social care and community services under one roof, in a brand-new fit-for-purpose facility in the community.

In autumn 2019, the Government announced it would allocate £17 million towards funding the project. Local GPs have been working with NHS partners from our local Clinical Commissioning GroupNorth East London NHS Foundation Trust (NELFT) and Barking, Havering and Redbridge University Hospitals NHS Trust (BHRUT) to develop the plans.

Planning permission for the development was granted by Havering Council in November 2021.

This new community base aims to provide integrated primary, community, mental health and local authority care services on a single, local community site located at the former St George’s Hospital site in Suttons Lane, Hornchurch.

Local people from across Havering and its neighbouring boroughs of Redbridge and Barking and Dagenham will also benefit from health and wellbeing and early prevention services and additional capacity for some services currently based in hospitals.

The Hub design also includes community facilities such as an integrated café and education facilities, community meeting spaces, as well as a sensory, dementia friendly communal garden with a wetland area.

Havering GP and Clinical Lead for the Health and Wellbeing Hub, Dr Atul Aggarwal, said: “The Hub aims to bring together a mix of health and care professionals in a single location to promote more joined up working between the NHS, the council and voluntary and community sectors. People will be able to receive help with keeping well, assessment, treatment, diagnostics and a wide range of support. It will also be a valuable community resources with space for local organisations.

 “We want it to be an innovative, best practice model of integrated health and social care that others can learn from and that local people can be proud of. As well as a range of health, social care, diagnostic and community services available on one site, we expect the Hub to become the catalyst for bring professionals together to develop new, integrated pathways of care that are focused on meeting patients’ needs”.

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