Hertfordshire and West Essex Joint Forward Plan 2023 - 2028

Our Integrated Care System provides health and social care to 1.6 million people living in Hertfordshire and Essex.

A high proportion of our residents are in good health and life expectancy is longer than the national average.  However, although the health and wellbeing of our population is similar or better than in England as a whole, there is considerable variation within our area. In some communities, life expectancy is relatively low, with people struggling to live with the health and wellbeing impacts of deprivation. The average healthy life expectancy for our residents, which is the average number of years that a person can expect to live in full health, is 65.4 years for males and 65.7 years for females, compared with life expectancy of 81 for males and 84 for females.

Our ageing population need increased support from health and care services, with demand for mental health services, planned treatments, access to primary care, and long waiting times for urgent care among many pressing issues. Many of these challenges have been exacerbated by the COVID-19 pandemic, which worsened the inequalities that exist in our communities.

The affordability of housing poses an ongoing financial challenge to our residents and workforce and the rising cost-of-living is increasing this pressure.   

A health overview of our Integrated Care System population can be found here Health needs of the Hertfordshire and west Essex (HWE) population. Assessments of the needs of the whole of Hertfordshire and Essex can be accessed using these links: Hertfordshire Joint Strategic Needs Assessment  Essex Joint Strategic Needs Assessment

This plan has been informed by detailed information about our population and the health and social care needs of our communities.  We have used this information to assess the health of our communities in comparison with each other, and against the national average, identifying the areas where the needs are greatest.

To support our response to our population needs we have identified ten Clinical Priorities which are outlined below in Figure 3, these priorities offer a significant opportunity to improve our residents’ health and create efficiencies. We are also in the process of developing a population outcomes framework which will be implemented in 2023-24. This will enable us to hold ourselves to account for delivery, aligned with our system priorities.

Clinical Priorities

Children and young people

• Improved readiness for school in children, including an increase in the percentage of children with Free School Meal (FSM) status achieving a good level of development at the end of reception
• Reduce rates of childhood obesity, particularly in areas of higher deprivation
• Reduce unnecessary A&E attendance and admissions

Prevention and health inequalities

• Reduced premature mortality rate for cardiovascular disease (CVD)

Long term conditions (LTC) and frailty

• Reduce attendance and admissions for falls, people with frailty and people in the last year of their lives
• Development of more proactive, preventative care models for management of long-term conditions and frailty

Mental health

• Reducing suicide rates and attendances / admission rates for self-harm
• Reducing rates of A&E attendances involving substance misuse and violence

Maternity

• Reducing suicide rates and attendances / admission rates for self-harm
• Reducing rates of A&E attendances involving substance misuse and violence
• National recommendations to be implemented and linked quality issues with local providers requiring ICB transformation support
• Neonatal urgent care pathways

Learning from people and communities

The views of our residents, patients, staff and communities have informed and shaped the development of this plan.  Using an approach guided by our policy and best practice - including a wide-ranging literature review, focus groups, stakeholder engagement events and surveys - we have explored what makes healthy living tough, particularly for people facing inequalities. More than 1,100 people shared their personal experiences and recommendations for action in a survey specifically commissioned to support this plan, supported by our Healthwatch partners. You can read in detail about our learning here and see relevant extracts in Section 4 of the PDF which outlines the six priorities identified for our system, and how we will deliver on them.

Supporting our places

Our system includes most of the county of Hertfordshire, with its 10 district and borough councils (with the exception of Royston in the north of Hertfordshire) and the three district and borough councils to the west of the county of Essex. The Integrated Care System also falls under two county council areas (Essex and Hertfordshire) and is a key partner of both Essex and Hertfordshire Health and Wellbeing Boards and the delivery of their health and wellbeing strategies that cover 2022-26.

• Essex Joint Health and Wellbeing Strategy 2022 - 2026
• Hertfordshire Health and Wellbeing Strategy 2022 – 2026

Our area has a number of hospitals and in-patient units to meet people’s physical and mental health needs. Watford General Hospital,  Lister Hospital in Stevenage and Princess Alexandra Hospital in Harlow are our three biggest ‘acute’ hospitals. 

Residents in our area can also access care and support from mental and community health organisations such as the Essex Partnership University Foundation NHS Trust (EPUT), Hertfordshire Community NHS Trust (HCT), Central London Community Healthcare NHS Trust (CLCH) and Hertfordshire Partnership University NHS Foundation Trust (HPUFT). An overview of the main providers of our Healthcare services is provided below.

There are three geographically-based Health and Care Partnerships (HCPs)– in west Essex, south and west Hertfordshire and east and north Hertfordshire. These partnerships are a collaboration of NHS, local authority and voluntary and community organisations that help to design and deliver services together in a way that meets the needs of their local communities.

This joint working has led to some of our system’s most holistic and personalised patient care – with integrated teams having regard for the wider support needs of each of the people they care for, which enable them to prioritise their wellbeing and respect their independence.  Each Health and Care Partnership has its own strategy, governance arrangements and locally agreed priorities, which are informed by the health needs of the people it serves. You can find out more about these Health and Care Partnership and their plans here. 

The Hertfordshire Mental Health, Learning Disability and Autism Health and Care Partnership (HMLDA HCP) brings together the local organisations with a responsibility for supporting people living with a mental illness, autism and learning disabilities in Hertfordshire, to support them to live longer, happier and healthier lives.  Essex is served by three Integrated Care Boards, and an integrated adult mental health strategy is currently being developed to serve the greater Essex area.

The local Voluntary, Community, Faith, and Social Enterprise sector (VCFSE) consists of many thousands of organisations, from small volunteer-led charities and community-based faith groups to large social enterprises employing hundreds of staff and serving thousands of people.  Our VCFSE Alliance is a network of these organisations which works closely with the NHS, councils, and other partners within the Integrated Care System to help make sure everyone can find the right support, when and where they need it. The Alliance has recently developed a strategy to value, promote and enhance the VCFSE sector in promoting health and wellbeing and addressing the wider determinants of health across our system.