SOUTHEND and Basildon hospitals face one of the biggest overhauls in a generation – with shared services and a potential shake-up in A&E departments – because there is not enough cash.

The NHS England Essex Success Regime progress report, affecting Southend, Basildon and mid-Essex, has raised fears over the future of some services after saying Essex health care is not “financially sustainable”.

NHS bosses have made it clear hospitals will not be forced to shut, but consideration will be given to potential changes in how A&E departments are run.

The report sent to hospital trusts and clinical commissioning groups pointed out there were five hospitals in the county in contrast to other areas of a similar population size which only have one or two hospitals.

It states: “The market town nature of the county has resulted in five relatively small hospitals, where in other areas a similar sized population might be served by one or two hospitals.

“Because of the larger geographical area, there is duplication of services across each hospital.

“This is not only expensive, it requires more clinical staff, and, in some specialties, qualified professionals are in short supply.

“This creates difficulties recruiting to clinical rotas, and Essex hospitals have a higher than average use of locum staff.”

The report said there was great potential for more care in the home or in the community.

It added: “Learning from successful systems elsewhere, both nationally and internationally, there are untapped possibilities for planning care around people and communities, rather than the traditional way of planning around organisations.”

Closer working and “integration”

between hospitals and GPs and community social care was crucial, the report said.

It added: “While money continues to go into sustaining expensive hospital services, there is less available for primary, community and social care – the very place where investment is needed for better health outcomes and a better patient experience.”

The report is prompted by ongoing concerns about a cash crisis in the NHS.

It stated: “Care in Essex costs more than the money available. This is not sustainable.

“These deficits put enormous pressure on services across the health and care system, and the ability to deliver the best patient care. Because of the larger geographical area, there is duplication of services across each hospital.

This is not only expensive, it requires more staff, and, in some specialties, qualified professionals are in short supply.

“This creates difficulties recruiting to clinical rotas, and Essex hospitals have a higher than average use of locum staff.”

The report outlines plans to overhaul urgent and emergency care and change the way A&E departments operate.

The Essex Success Regime is one of three such improvement programmes being run across the country in areas where there are financial and “deep-rooted, systemic pressures”.

It is overseen by NHS England, the NHS Trust Development Authority and health watchdog Monitor, and is co-ordinated by Andrew Pike, Essex area director for NHS England.

He said: “The three hospitals involved are extremely important.

The intention is to improve the way they work together to make the most of expertise and secure the best hospital care across the three sites, including emergency services.

“We are not planning to close a hospital.”