Locality Context
West Essex covers the Epping Forest, Harlow, and Uttlesford Districts with a population of 312,300 people. In this area there are 183,100 adults aged 18 - 64; 49,200 adults aged 65 - 84; and 8,600 adults aged 85 and over.
West 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 86% of the population across Epping Forest, Harlow and Uttlesford. People who are categorised ethnically as BAME account for 14% of the West 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.
*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.
In August 2021, Early Intervention and Ongoing Support teams were aligned to neighbourhoods defined by the West Essex Health Care Partnership and created Integrated Neighbourhood Teams, this has allowed the teams to work closer with the community to wrap around adults within a smaller geography.
This plan brings together ICS, West Essex Health Care Partnership (WEHCP) and ECC strategy, in line with the Health and Care Bill (2022), which proposes to establish new statutory integrated care partnerships. The West Essex Health Care Partnership is a partnership between NHS, Local Authority, independent and voluntary sector teams, leaders and organisations with a shared focus on working collaboratively to achieve the best possible health and wellbeing outcomes for the people of West Essex.
The Locality Director West Essex leads our Social Care Teams in this area. The Locality Director works closely with our Social Care Teams and Health Partners as part of the Hertfordshire and West Essex Integrated Care System (ICS).
The West Essex Health Care Partnership vision is: “To help everyone in our area live long and healthy lives by supporting independence and providing seamless care.” The aim is to reduce inequality and to ensure we focus on the wider determinants of health, the West Essex Alliance has adopted the Live Well model, which helps to make certain our communities are supported and empowered at each stage of their life to be as well as possible.
To support this vision the WEHCP has develop an “Out of Hospital Model of Care – Adults”, this model has two core elements:-
The first is the Care Coordination Centre which incorporates the function of the “Transfer of Care Hub functions”. This primarily is to coordinate all adults' transfer of care (Health, Social Care, and Mental Health) from the community or hospital if the intervention cannot be delivered by within the Integrated Neighbourhood Teams resource.
The second is the approach for the “Integrated Neighbourhood Team” to support our complex adults, through proactive care planning and delivery, enabling earlier intervention and prevention, and reduction in escalation of need, improving outcomes for our population.
The 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.
West Essex Adult Social Care Teams are staffed with Social Workers, Occupational Therapists, and Community Support Workers to 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 activity under S42 of the Care Act 2014.
All teams are supportive of the identification and needs of formal carers and delivering upon 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.
West Social Care have four Integrated Neighbourhood teams covering six Primary Care Networks, three specialism teams, one Discharge to Assess team, and one team working in the Care Coordination Centre at Princess Alexandra Hospital.
Integrated Neighbourhood Teams
- The Harlow (North & South) Integrated Neighbourhood Team covering postcodes CM17, CM18, CM19 and CM20
- Epping Forest North - covering Epping, Ongar, North Weald, Abridge, Waltham Abbey covering postcodes CM19, CM16, CM5. Borders of EN9 and RM4
- Uttlesford Integrated neighbourhood teams North and South covering postcodes that include CM22. CM24 CB11 and CB10
- The Epping LBC (Loughton, Buckhurst Hill and Chigwell) Integrated Neighbourhood Team covering postcodes IG4, IG5, IG7, IG8, IG9, IG10 and small section of RM4
Hospital and Discharge to Assess
The Discharge to Assess team is a team of social workers and community support workers who conduct intervention under the Care Act and Mental Capacity Act 2005 for adults that have left hospital and are in an intermediate care service.
Care coordination centre – The social care team work closely with the acute hospitals; Princess Alexandra Hospital in Harlow, Whipps Cross University Hospital in Waltham Abbey, and Addenbrookes Hospital in Cambridge to support hospital discharge.
Specialism Teams
There are three specialism teams that work across the West 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. The team work closely with Essex Partnership University Trust (EPUT) and Essex Learning Disabilities Partnership.
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. The team work closely with Essex Partnership University Trust (EPUT).
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), Mental Health Community Teams (CMHT) and the Severe Dementia and Frailty Service (SDFS).
West OT Hub is an extension of all teams in West Teams. Its purpose is to ensure all adults requiring an Occupational Therapist intervention are aligned to one place, thus ensuring that no adult was left at a disadvantage due to their location and our limited number of OTs.
The Adult Social Care workforce in West Essex is made up of approximately 135 staff. This 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.
In West Essex the Health and Care Partnership Board and Health and Care Programme Board fulfil the functions of the committee and the executive. The main purpose is to coordinate and drive place-based system work focused on the wider determinants of health drawing together the collective skills, resources, and capabilities of the Partnership and it's wider system partners. The Partnership fulfils the function of the committee, which is the decision-making group reporting to the ICB that oversees the delivery of the Alliance delivery plan and is the responsible group for the delivery of the delegated responsibilities from the ICB.
West Essex has a high population of adults living with five or more Long Term Conditions - all age and over 85 years combined with higher number of emergency admissions due to falls.
Regarding health inequalities for West Essex key areas are: -
- Harlow: Higher proportion of population in most deprived wards with poorest outcomes
- Life expectancy and premature mortality (cardiovascular disease, drug misuse, suicide rates)
- Impact of healthy lifestyles: Highest prevalence of smokers, percentage of physically inactive
- Mental health: Highest prevalence of common mental health disorders, SMI, suicide rates, higher rate of admissions for mental health and behavioural disorders due to alcohol (females)
- Highest prevalence of obesity 10-11 years older people
- Higher proportion living in poverty income
Acute Hospitals
In West Essex our social care teams work closely with our acute hospitals; Princess Alexandra Hospital in Harlow, managed by The Princess Alexandra Hospital NHS Trust. They also work with out of county hospitals or Whipps Cross University managed by Barts Health NHS Trust, and Addenbrookes Hospital.
Essex Partnership University NHS Foundation Trust (EPUT)
The Social Care Teams work closely with EPUT Community Mental Health Teams providing support to people experiencing mental illness both as inpatients and within the community and providing social care support to people with a range of needs and predominantly under the age of 65 years.
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 Hertfordshire and West Essex Voluntary, Community, faith and social enterprise alliance is a network which works closely with the NHS, Councils, and other partners within the integrated care system.
Housing
Uttlesford District Council provides management and maintenance services to properties in the Uttlesford area. Harlow District Council provide for Harlow area and Epping Forest District Council for Epping area.
Epping Forest, Harlow, and Uttlesford District Councils when acting together agree to be known as the West Essex Councils Group.
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)
Hertfordshire and West Essex ICB
The Hertfordshire and West Essex ICB is responsible for deciding how the NHS budget for West 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.
Hertfordshire and West Essex ICP
The Hertfordshire and West 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
In residential services as of January 2024, there were 48 Care Quality Commission (CQC) registered care homes in West Essex with a total of 2,355 beds. Of the 48 care homes, 41 are registered to support older people with a total of 2,289 beds which represents 97% of all beds available.
As of January 2024, 85% (41) of all Adult Social Care residential based services inspected by the CQC in West Essex had been rated as either Outstanding or Good.
Domiciliary Care
As of January 2024, there were 76 locations registered with the CQC to provide Adult Social Care community based services in West Essex. Of the 76 Locations, 70 are registered to support older people which represents 92% of the market in West Essex.
As of January 2024, 72% (55) of all Adult Social Care community based services inspected by the CQC in West Essex had been rated as either Outstanding or Good.
*The above information is taken from the CQC care directory.
Care Homes
- There are 48 care homes that provide residential care in West Essex which equates to 2,355 beds
Domiciliary Care
- There are 76 domiciliary providers located in West Essex, 70 of which are registered to support older people
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.
Currently the Intermediate offer is as follows:
- Essex Cares Limited (ECL) deliver the core reablement services in the West-Essex locality, based on a contract that commenced in May 2021
- Additional Reablement Capacity (ARC) is provided in West Essex by De Vere Care Partners
Independent Living Schemes
- There are 3 Extra Care Schemes in the West quadrant of Essex that provide housing and onsite care these are; Honey Tree Court, Loughton; Sumners Farm, Harlow and Cornell Court, Uttlesford.
The Service is for adults primarily over the age of 55, who have a local connection to the local housing authority area that the scheme is within, and would benefit from a home environment with 24-hour on-site care and support that enables their continued independence.
- In Honey Tree Court there are 40 one-bedroom self-contained apartments, each featuring its own entrance hall, open plan lounge and dining area, kitchen, wet-rooms and a bedroom with a fitted wardrobe. The onsite care is delivered by the inhouse provider, Radis Community Care
- In Sumners Farm Close there are 42 one-bedroom self-contained apartments. The onsite care is delivered by the inhouse provider, Agincare
- In Cornell Court there are 40 Extra Care and 33 sheltered self-contained apartments, each featuring a modern kitchen, lounge and bathroom including a walk-in shower. The onsite care is delivered by the inhouse provider, Hales Group
Domiciliary Care
In recent months, supply in West Essex is generally good and has drastically improved in the more challenging areas such as Uttlesford. The majority of supply in West is being commissioned through the Live at Home framework, however there is a heavier reliance on the spot market to deliver the required capacity in more rural areas including Uttlesford and Ongar. In the Uttlesford district, historically there have been challenges with capacity due to the rurality of the area which can result in inefficient care rounds due to increased travel time and distance when compared to Essex as a whole. However, in recent months capacity in Uttlesford has improved as a result of new providers branching out into this district due to having more care workers available because of the sponsorship scheme for overseas workers. There is still occasional reliance on the spot market in the rural areas however, in particular the non-urban areas of Uttlesford. The Council have introduced a block contract in Uttlesford which has been put in place to ensure sufficient supply and the blocks have aided to eliminate unsourced care. The council is reviewing the outcomes of the pilot with the intent of learning to feed into the plan for the locality going forward.
In the remainder of West there is good supply, with the majority of care packages being commissioned through the Live at Home framework. In recent months there has been a less of a reliance on the spot market in the districts of Epping and Harlow. There are some issues with capacity in Ongar and the outskirts of Harlow at times. The feedback from Live at Home providers suggests that they are keen to grow and develop within their existing areas of operation, as well as branch out into other areas where the council may lack sufficient supply. However, the flow of available packages to build a sustainable round can be slow meaning that they do not grow further or move into certain areas.
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
- 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
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, the Provider Market and including the voice of adults with lived experience and their families 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.