l Clare Panniker, chief executive of Southend, Basildon and Chelmsford hospital trusts, writes exclusively for the Echo on the challenges ahead after announcing changes to the proposed Mid and South Essex Success Regime overhaul:

Doctors, nurses and other health service carers and leaders want to provide the very best care for people in mid and South Essex. We want to use our resources as effectively as possible for the greatest benefit for local people.

The NHS in our part of Essex faces significant challenges. We can’t attract enough specialist staff to live and work here. Demand for services is changing as people grow older and live with more long-term conditions such as diabetes, lung conditions and heart disease. Rising costs and increasing demand means we struggle to deliver with the funding we have. But even if we had more money this wouldn’t make all the challenges go away.

Within the three hospitals one of the improvements we want to make is to separate out emergency care from planned operations and treatments needing an overnight stay.

Evidence shows that keeping planned and emergency patients separate, by having wards and theatres just for planned care, means fewer cancelled operations and shorter waiting times so less pain and discomfort for those patients.

Secondly, it isn’t possible to provide very specialist services, such as cancer, heart attack and specialist surgery, everywhere.

To make sure we can have teams of specialists 24 hours a day, seven days a week we need to bring our expert workforce together so they can share expertise, access very technical and expensive equipment, and see enough patients with the same condition to keep up their levels of skill and expertise.

In considering our options, we discussed with staff and local people the benefits of one hospital, possibly Basildon, providing the most serious emergency treatment and described how each hospital would keep its A&E department, led by consultants and open 24 hours a day, seven days a week.

For some patients with serious, life-threatening conditions we talked about how we could improve chances of survival and recovery if they went straight to a very specialist emergency centre, such as Basildon, by ‘blue light’ ambulance.

In the feedback from over 100 local discussion events, we have heard very clearly that some people have significant concerns about all ‘blue light’ ambulances going straight to a single centre.

We have been thinking how we could address these concerns and still improve patient care with specialist centres and the separation of planned and emergency care.

We are now developing our options to include the possibility of the three current A&E departments receiving ‘blue light’ emergency patients with serious conditions.

Once seen by doctors in the local A&E, stabilised, diagnosed and treated, patients would then either be: discharged; referred for follow-up treatment; admitted to that hospital for further tests and treatment; or transferred if needed to a specialist centre. But the ‘norm’ would be to go to your local hospital in an emergency.

As now, a small number of people who are very seriously ill would go straight to a specialist centre to get the best treatment (for example, severe heart attack patients already go straight to Basildon, or people suffering severe burns already go to Broomfield, in Chelmsford).

We also want to develop assessment units in our hospitals for children, older and frail people and patients who may need surgery or medical treatment. Patients could stay overnight if needed, but these units would aim to help people avoid a stay in hospital unless it was necessary and ensure a faster and better response to most of the emergency needs of older people and children, linked to a range of community services for on-going support if needed.

Senior doctors are currently looking in detail at the clinical evidence to see if there are other severe conditions that may require this approach – for example for people suffering from burst blood vessels in the brain or heart, or people with very severe abdominal bleeding requiring urgent emergency surgery. This work is not yet complete but doctors are focusing on it over the next few months.

No decision on the future pattern of services has yet been taken. We are continuing to do detailed work on our options and to gather feedback from local people. We will only decide what changes to make after a full public consultation has been completed and the feedback considered. We expect the consultation to start towards the end of this year, and any changes wouldn’t happen until later next year in 2018.

We are determined to find the very best solution for delivering excellent, safe, high quality hospital care, within our available funding, into the long-term for people in mid and south Essex.