Rising to the challenge

From October 1 Southend and Castle Point and Rochford PCTs became one organisation serving the eastern tip of the county.

Basildon PCT merges with Brentwood, Billericay and Wickford and Thurrock PCTs to create the South West Essex PCT.

Overall the number of PCTs serving Essex has been reduced from 13 to just five.

The move followed demands last year from the then chief executive of the NHS Sir Nigel Crisp for a shake-up of the way local services were managed and called for the number of PCTs, strategic health authorities and ambulance trusts to be cut to save management costs.

The new strategic health authorities and ambulance trusts came into force in July and on Sunday the new primary care organisations were ushered into being.

However, according to Katherine Kirk, chairman of the new South East Essex PCT: "It is not business as usual for us, if we think we will not succeed. It is a terrific challenge to build a new PCT to serve that much larger community.

"It is a diverse community and we will have to create one PCT that is sensitive to a number of very different issues across that geographical area."

One such issue is the ranges in the levels of health and life expectancy in the patch.

Mrs Kirk says: "There are particular areas of deprivation across the geographical area in Southend and Canvey.

"For example there are some parts of Southend where the life expectancy is significantly lower up to four, five or even six years lower than some of the other wards and it is an important disparity that needs to be addressed."

Both she and Julie Garbutt the chief executive of the new PCT have a wealth of experience in primary care and were in charge at Southend before the merger.

They admit they need to get up to speed with the issues in Castle Point and Rochford, but say their six-and-a-half-years of working together will stand them in good stead.

"The benefit of working in the area for that length of time is that you get to see things start to come to fruition," says Ms Garbutt. "We both have huge ambition for the new PCT. We want it to be better than before and be recognised as a leading edge PCT providing leading services for our people as it is what they deserve."

Primary care trusts control three quarters of the budget of the NHS for the whole country and are responsible for the majority of health care provided in a community setting, rather than in a hospital.

That equates to around 90 per cent of our day to day contact with the NHS.

"A lot of what we do for patients requires us to work with colleagues in local government," explains Ms Garbutt. "Although we have good relationships with the district council we have never had to work with Essex County Council before.

"There are some complexities about how that will work but after the initial challenge I think it will work very well.

"Both PCTs were very successful in there own right. Both balanced their books, met their targets around the star ratings so we are very fortunate we are bringing two well run PCTs together."

Ms Garbutt is also proud of the record the former organisations had for involving frontline clinical staff in shaping services rather than just managers.

"As a bigger PCT that is something we see as a benefit.

"We will be able to continue and create a PCT that is fit for purpose."

Mrs Kirk agrees: "Both PCTs have been extremely successful in different areas and in different service and our view is to bring both up to the level of the best of both areas in every service."

The new organisation has a budget of £450million to meet the health needs of the population it serves.

"On a simple level we provide services you do not access in hospital, things like district nurses and therapists," Ms Garbutt explains "We hold contracts for all primary care practitioners, the GPs dentists, optometrists.

"We also a significant budget to buy services on behalf of our residents to allow them to access hospital services and mental health services."

But the remit of the primary care does not end there.

One of its biggest responsibilities is to improve the health of its population through healthy living initiatives and education.

It is something both women feel has been a success in the past and are keen to continue, particularly through involving patients and communities in helping to make decisions about services through patient forums.

"There is the whole idea of patients being more in control of their treatment," says Ms Garbutt, "particularly patients with long term conditions having more input into their own care."

For Mrs Kirk it is that ethos that motivates her to continue: "This is where I live and I want to make a contribution to make this PCT area a good place to live and a good place to remain healthy and enjoy life."