Locality Context
Mid Essex covers the Chelmsford, Braintree and Maldon Districts with a population of 397,900 people. In this area there are 152,320 adults aged 18 - 64; 72,200 adults are between 65 - 84 and 11,100 adults aged 85 and over. *
Mid Essex’s demographic data shows that people who are categorised ethnically as White (i.e., White British, Welsh, Scottish, Northern Irish; White Gypsy or Irish Traveller; White Roma) make up 93% of the population across Braintree, Chelmsford, and Maldon. People who are categorised ethnically as BAME account for 7% of the Mid Essex population, as shown in the graph below.
Use the “ONS Map” drop down below to view an interactive map where you can see ethnicity demographics at a local authority district level.
In August 2021, Early Intervention and Ongoing Support teams were aligned to neighbourhoods defined by the Mid Essex Health and Wellbeing Alliance Integrated Neighbourhoods programme, this has allowed the teams to work closer with the community to wrap around adults within a smaller geography.
This plan brings together ICS, Alliance and ECC strategy, in line with the Health and Care Bill (2022), which proposes to establish new statutory integrated care partnerships. This includes 6 multi-agency Integrated Neighbourhood Teams, which has a clear program of work in achieving an integrated approach in care delivery within neighbourhoods.
*Population figures taken from the Projecting Older People Population Information System (POPPI) and Projecting Adult Needs and Service Information (PANSI) databases. Ethnicity demographic figures are taken from Office for National Statistics (ONS) subnational population projections by persons, males and females, by single year of age. Figures may not sum due to rounding.
The Locality Director for Mid Essex works closely with our Social Care Teams and Health Partners as part of the Mid South Essex Integrated Care System (ICS). The director also manages the countywide regional assurance team, Quality assurance team and is the lead sponsor for Quests, and the director has a countywide workforce lead.
To support our vision of reducing inequality and ensuring we focus on the wider determinants of health, the Mid Essex Alliance works in consideration of the Live Well model. This will ensure our communities are supported and empowered at each stage of their life to be as well as possible when progressing the Mid Essex Alliance areas of priority.
Our Integration and Partnership Locality Lead's role is to work with our operational teams and NHS and other partners to design and deliver the integration of health and social care. Each quadrant has an Integration and Partnership lead in place and the role is essential to supporting the development of relationships with key partners across the local system in our four quadrant areas, (each the size of a large London borough) and identifying best practice in integration.
The Adult Social Care workforce in Mid Essex is made up of approximately 165 staff. The workforce includes Social Work, Occupational Therapists and Community Support Workers. This also includes Social Work and Occupational Therapy apprentices and newly qualified Social Work and Occupational Therapists. We recognise the importance of a diverse workforce to reflect the communities in which we work, and we monitor the makeup of our workforce, and listen to our employees through surveys, panels, and network groups.
The workforce deliver intervention under the Care Act 2014 and are responsible for undertaking Care Act Assessments, planned and unplanned Social Care reviews, Mental Capacity Assessments and Safeguarding adults.
The Adult Social Care Teams also deliver interventions under the Care Act 2014 to formal carers ensuring that formal carers are identified and offered assessments/interventions and ensuring delivery against the Essex All Age Carers Strategy 2022 -26. The strategy outlines how the County Council, along with partners, will support unpaid carers of all ages undertake the invaluable contribution they make to society.
Mid Social Care currently have 5 Integrated Neighbourhood teams covering 9 Primary Care Networks, three specialism teams, and two Discharge to Assess Teams. To meet the requirements of the Integrated Neighbourhood Team programme, a sixth social care team is in the process of being formed to ensure social care is aligned to alliance partners.
There will be 6 neighbourhood teams responsible for ward areas and have been aligned to mirror the structure of the Mid Essex Alliance Integrated Neighbourhood Team programme.
The Focused teams which are a Mid-wide service, working closely with the above Neighbourhood Teams are as follows:
Discharge to Assess
There are two ASC Discharge to Assess Teams (D2A) that work across the Mid Essex area. The team undertake assessment with adults that have been discharge from a hospital setting and are in an intermediate care service, to determine their ongoing care and support needs. The D2A teams work with partners to support discharges from hospitals as part of the Transfer of Care hubs, with the multi-disciplinary team working from Broomfield General Hospital.
There are three specialism teams that work across the Mid Essex area:
Learning Disabilities and Autism Team working with adults and their families who have a diagnosed learning disability and/ or autism that is confirmed through psychology assessment.
Physical Sensory Impairment Team working with adults and their families who have a long-term physical disability such as brain injury, stroke (under 65) and neurological condition.
Older Adults Mental Health Team working with adults and their families that have a diagnosed functional or organic mental health issue. The team also support the discharge planning of adults leaving Mental Health Hospital in partnership with the NHS mental health provider Essex Partnership University Trust (EPUT).
Mid Essex Health and Wellbeing Alliance
We want to create opportunities for the benefit of local people, to support health and wellbeing, to bring care closer to home and to improve and transform services so they improve outcomes for the adults, children, and families of Mid Essex.
The aim of the Mid Alliance is to bring key partners together to provide the localism needed within the Mid & South Essex system to create opportunities for people to live well in Mid Essex.
This extends beyond the traditional boundaries of health and adults and children’s social care and incorporates wider system partners to tackle the social determinants of poor health and wellbeing with levelling-up in terms of outcomes and reduced disparities.
There is a recognition by all partners in the system that the social determinants of poor health and wellbeing need to be tackled by everyone to see the improvement in outcomes we want to achieve. Developing our local partnership will support this.
Our priorities
The duties and priorities of the Committee will be driven by the integrated care strategy of the Integrated Care Partnership (ICP), the associated strategy and delivery plans of the ICB and the associated risks. Our priorities will also align with the ambitions set out in the strategies and plans of our members such as Everyone’s Essex, the Joint Health and Wellbeing Strategy and the Essex Adult Social Care Business Plan. They will also be based on local need and citizen insight for Mid Essex, translating the system wide strategy into delivery at a more local level.
For 2023-25 our priorities are:
- Transfer of Care Hubs
- Integrated Neighbourhood Teams
- Thriving Places Index
Membership
Core Membership will include:
- The ICB Alliance Director
- The ICB Alliance Deputy Director
- A representative from each district, city, or borough council in the alliance footprint
- Representation from Essex County Council
- Healthwatch
- Hospice
- Local providers and voluntary and community sector representation across Mid Essex.
Health inequalities for Mid Essex key areas are:
- Life expectancy: Braintree has the 5th worst life expectancy at birth for both males and females
- Impact of healthy lifestyles: Maldon has the 2nd highest prevalence of patients suffering stroke; Maldon has the 4th highest prevalence of patients with cancer
- Mental health: Braintree and Maldon have the 5th and 6th highest suicide rates, respectively
- Maldon has the lowest number of local jobs
Acute Hospitals
In Mid Essex our Adult Social Care teams work closely with our acute hospitals; mainly Broomfield Hospital in Chelmsford, managed by Mid and South Essex NHS Foundation Trust. However also work with community hospitals within the MSE footprint and out of area hospitals, including Colchester Hospital, West Suffolk Hospital and Addenbrookes Hospital in Cambridge
Essex Partnership University NHS Foundation Trust (EPUT)
Our social care teams in Mid work closely with EPUT Mental Health Services providing support to people over the age of 65 and who are experiencing mental illness both as inpatients and within the community and who may require social care support.
Essex Learning Disabilities Partnership
The Social Care Teams work closely with Essex Learning Disabilities Partnership which is provided by Hertfordshire Partnership University NHS Trust and are responsible for all NHS Learning disability community and inpatient service across Essex.
The community voluntary sector
The Mid Essex Community Voluntary sector is a network which works closely with the NHS, Councils and other partners within the integrated care system. This sector consists of our main three Community and Voluntary organisations: Community 360 (Braintree), Chelmsford CVS & Maldon CVS.
Housing
Braintree District Council provides management and maintenance services to properties in the Braintree area. Chelmsford City Council for Chelmsford and Maldon District Council for Maldon area.
There is a mobilisation plan in developing the Stepping Stone Home flats which will be for adults who want to regain as much independence as possible, within a home like setting, with an enablement approach. This will then support the adult in understanding and identify their longer term needs to either return home or to an alternative housing /care setting.
From 1st July 2022, Clinical Commissioning Groups were abolished and their functions transferred to the Integrated Care System (ICS). They consist of two Boards – the Integrated Care Board (ICB) and Integrated Care Partnership (ICP)
Mid and South Essex ICB
The Mid and South Essex ICB is responsible for deciding how the NHS budget for Mid Essex is spent. It is also responsible for developing a plan to improve people’s health, deliver higher quality care, and ensure health services are of high quality.
Mid and South Essex ICP
The Mid and South Essex ICP is a statutory committee that brings together a broad alliance of organisations and representatives involved with improving the care, health, and wellbeing of the population. The ICP’s board includes members from the NHS, local authorities, care providers, the police, Healthwatch and the voluntary, community, faith and social enterprise (VCFSE) sector. The ICP will play a central role at system level in tackling health inequalities.
Better Care Fund
The Better Care Fund (BCF) programme supports local systems to successfully deliver the integration of health and social care in a way that supports person-centred care, sustainability and better outcomes for people and carers.
Launched in 2015, the programme established pooled budgets between the NHS and local authorities, aiming to reduce the barriers often created by separate funding streams. The pooled budget is a combination of contributions from the following areas:
- minimum allocation from integrated care systems (ICSs)
- disabled facilities grant – local authority grant
- social care funding (improved BCF) – local authority grant
- winter pressures grant funding– local authority grant.
ECC rating of the market, assessed January 2024
Residential Care
As of January 2024, there were 94 CQC registered care homes in Mid Essex with a total of 3,293 beds. Of the 94 care homes, 71 are registered to support older people with a total of 3,123 beds which represents 95% of all beds available.
As of January 2024, 79% (74) of all Adult Social Care residential based services inspected by the CQC in Mid Essex had been rated as either Outstanding or Good.
Domiciliary Care
As of January 2024, there were 89 locations registered with the CQC to provide Adult Social Care community based services in Mid Essex. Of the 89 locations, 79 are registered to support older people which represents 89% of the market in Mid Essex.
As of January 2024, 81% (72) of all Adult Social Care community based services inspected by the CQC in Mid Essex had been rated as either Outstanding or Good.
*The above information is taken from the CQC care directory
Care Homes
- There are 94 care homes that provide residential care in Mid Essex which equates to 3,293 beds
Domiciliary Care
- There are 89 domiciliary providers located in Mid Essex, 79 of which are registered to support older people
Intermediate Care
- Essex Cares Limited (ECL) deliver the core reablement services in the Mid-Essex locality, based on a contract that commenced in May 2021
- Additional Reablement Capacity (ARC) is provided in Mid-Essex by Passion Tree Care Services
- Bridging Services for Mid-Essex are provided by Mid and South Essex NHS Acute Trust (MSE), to support hospital discharges, admission avoidance and the transition of adults into further services. MSE are contracted for a capacity of 25 service users, with a flexibility up to 35 users at one time.
- Essex County Council have commissioned no beds in Mid-Essex to support adults that require short-term residential reablement support. There are no plans to change this position at this time.
Domiciliary Care
In the main urban areas of Chelmsford and Braintree, domiciliary care supply is good. Supply in Maldon is reasonably good, although there is a reliance on the spot market to provide capacity, particularly in the Dengie peninsular. There is also a reliance upon the spot domiciliary care market in more rural areas of Mid Essex such as Writtle and South Woodham Ferrers.
In Halsted and the rural villages in North and South Braintree there is a lack of capacity due to the distance and travel time between care calls.
Residential Care
- Difficult to recruit and retain staff
- Rising costs in utilities impacting the financial viability of homes
- Affordable nursing placements and DE capacity
- Seasonal pressures increasing demand for care services
Intermediate Care
- A lack of capacity within all elements of the intermediate care services
- Increased operating costs (e.g., fuel) and the impact of inflation and interest rates.
- Geographical diversity, including the mix of urban and rural settings, and transport links
- Locality demographics and the availability of locality-based workforce
- Adults who are completing the service can experience delays due to the sourcing process or finding a suitable long-term service.
Domiciliary Care
The Council’s framework for domiciliary care services is expiring in 2025, and re-commissioning will commence during 2024.
Residential Care
The Council's framework for older people residential and nursing care expires in 2025. The contract is refreshed annually inviting existing providers to submit revised pricing and allows for new providers to make a tender submission to join.
Intermediate Care
Through the Transformation of Intermediate Care Programme, we have been working in partnership with NHS Partners and the Provider Market on a medium to long-term approach to reshape the intermediate care system. The aim is to bring together reablement services, bridging services, short-term care home provision, as well as NHS intermediate care services, to improve outcomes for people and ensure a joined up and integrated approach (and process) to service delivery.
Essex County Council plays an important and vital role helping to create social inclusive communities, this is not just within our own practises and policies but setting an example for other organisations and the Essex community as whole.
The Public Sector Equality Duty (the equality duty) was created under the Equality Act 2010 and came into force in 2011. It places a duty on local authorities to:
- consider how their policies and decisions affect people with protected characteristics.
- prevent discrimination and inequality.
- promote inclusion.
In Essex County Council we recognise that the workforce is representative of the communities we serve. Our vision is to enable the right environment and behaviour, so that individual and organisational equality, diversity, and inclusion is embedded in everything we do.
We will achieve our Equality, Diversity, and Inclusion vision by focussing on three strategic strands:
- Improving Diversity
- Building an Inclusive Culture
- Ensuring Equality
Across all the localities we have introduced a wide range of workstreams and programmes to support creating a great place for people to live and work in.
Below is list of some of our strategies and programmes:
- Equality, Diversity, and Inclusion Workforce Strategy 2023-25
- Levelling Up Strategy
- Quest programmes
- Zero Tolerance to Abuse Policy
- Care Workforce Strategy 2023-30
- Essex Disability Strategy 2023
- Meaningful Lives Matter programme
Through all these projects and plans we will look at how things are changing in different part of Essex, and how we can work more closely with our health partners and utilise new technology to bring everything together.
We want things to get better for everyone, and we want the change to be fair for all across the board.