‘Place-based care’ initiative proposed for Axminster, Seaton and Lyme Regis

Community groups in East Devon and West Dorset are proposing to formalise a joint forum to cover all the angles of health and social care for more than 42,000 people.

The aim is to continue to build on community conversations and subsequent surveys carried out by Lyme Forward, Seaton Area Health Matters and Axminster Health Needs.

A ‘triangular’ forum hopes to secure a model of place-based careto best serve communities within a triangle formed by Axminster to the north, Seaton to the south and Lyme Regis to the east, striving to improve procurement and delivery of all aspects of health and social care, including:

  • GP surgeries
  • NHS clinics and hospitals
  • Health hubs
  • Mental health services
  • Care for the elderly.

The communities served by the new forum would include: All Saints, Axminster, Axmouth, Beer, Branscombe, Charmouth, Colyford, Colyton, Combpyne & Rousdon, Dalwood, Hawkchurch, Kilmington, Lyme Regis, Marshwood, Membury, Musbury, Northleigh, Seaton, Shute, Southleigh, Stockland and Uplyme.

The intention is to ensure that residents within this ‘health triangle’ are able to access the best possible range of services without being restricted by any of the current artificial boundaries for commissioning health and social care.

Through a cross-community and multi-disciplined approach, the group want to enable people living in the Axe Valley and across the border with West Dorset to enjoy a two-way flow of information and have unlimited access to the best health and social care, based on practicality rather than postcode.

Health and social care

They also aim to influence future health and social care decisions by engaging on behalf of their residents with professional Health Service Commissioners and the Voluntary Sector to reflect the priorities of their communities and ensure that they are taken into account.

The latest move follows a series of informal background talks over the last two years or so, which has included many community conversations and surveys across the area within the triangle.

Representatives from the three groups met before Christmas at the Lyme Bay Medical Practice in Lyme Regis to discuss their vision with the chairmen of clinical commissioning groups both NHS Dorset, Forbes Watson,  and NHS Devon, Paul Johnson..

They reached agreement in principle to firm up plans to launch the forum as a channel for two-way communication and to start working together to deliver their vision.

The group includes – but is not exclusive of – elected councillors, the two CCG chairmen, the chair of Axe Valley Health Hub, a retired surgeon, community engagement connectors, a DCC /NHS social care manager and primary care providers (GPs) through ‘Health & Wellbeing engagement’.

Seaton councillor Jack Rowland, Acting Chairman of the Axe Valley and Lyme Bay Health Care Forum, said: “We want to give our communities a voice when it comes to the complex and geographically spread nature of health and social care provision in our area. We need to be able to influence policy-making so that current and future health care best suits the need of all our residents, regardless of age or postcode.

“We’re proposing a model of place-based care for the communities within the Axe Valley and Lyme Bay catchment area, rather than a town-based system. We want to see a structure which recognises that the efficient provision of services should not be restricted by the artificial boundaries currently in place for the commissioning of health and social care.

“The objective of this new forum will be to facilitate ongoing community engagement on health and social care in order to inform commissioners of the agreed prioritised needs of the community and to ensure that patients and clients can prepare for changes coming down the line”.

Patients and service users

Axminster councillor Ian Hall said: “Our aim is to act as a central point of reference for patients and service users, elected representatives, the voluntary sector and care providers to help the commissioners of services better understand local needs before formulating future decisions.

“We want to act as a conduit to inform the local population of changes to health and social care service provision to help ease the impact they may have on the local population”.

“By working together, we will simply be looking for win/win situations for all stakeholders from residents to our local GPs and the Devon and Dorset Health and Social Care Teams.

“We need resilient communities for now and the future in an ever-changing world; we must ‘future proof’ for local provision so that we do not ‘bottleneck’ our main hub hospitals. We must also ensure we are reducing our individual and collective carbon footprint in light of the recently announced Climate Emergency”.

NHS/Social Care Community Services Manager for Seaton, Axminster & Seaton (SAS) Richard Anderson added: “We intend to explore the health and social care needs of the wider community to help define, identify and promote best practice. We mean to build on our successful prevention approach and support residents at home. We also aim to identify any economies of scale that this larger place-based population can deliver over town-focused provision”.

Local health and care facilities

Axminster community connector (Light Up Axminster) Cindy Furse said: “Those economies can be reinforced by delivering care closer to the population through making use of suitable local facilities already in existence, to improve the efficiency of services provided by the primary, secondary and voluntary care sector and community services.

“We are very blessed in our corner of England to have such amazing Community Spirit and an ever-increasing voluntary sector, which I’m sure will continue to flourish. This initiative will really help us to focus on how we can grow upwards and outwards from the roots we have already put down”.

Lyme Regis resident and retired surgeon Ken Lavery said: “The place-based approach we are proposing is designed to address the collective problems of families and communities at a local level, with a focus on community strengthening and so dispensing with artificial and unnecessary County boundaries.

“Lyme and Charmouth are to the west of Dorchester whilst the Axe Valley is to east of Exeter, with Seaton to the south. Common sense says that if a triangle is drawn around the areas in question it creates a big enough demographic (42,000 population) to work for all.

“Our idea is to bring organisations together to focus on population health and not just health and care services. While there will be a strong focus on primary care (PNCs), the work of the forum will also involve local authorities and the voluntary sector as partners in this vital work”.

Mike McAlpine CEO of Arc, the Adult Mental Health charity based in Axminster, and who has been working for many a year as a community volunteer either side of the West Dorset and East Devon border added: “The Forum will allow us all, Health professionals and volunteers alike, to work effectively together to understand and prioritise the health and wellbeing needs of our communities.

“We can then communicate that with one voice to the decision makers in the CCGs who commission services on our behalf. By coming together we can help the CCGs to target services where they are most needed.

“We have also shown that we can work collectively to raise money to pay for the vital services that the NHS is currently unable to provide such as Hospice at Home and Arc. I would like to see these and other Third Sector services expand and be made available across the whole of this area.

Dr Forbes Watson, Chair of NHS Dorset CCG , said: “As a local GP this is an exciting collaboration for Lyme Bay and our friends in East Devon. Care should be delivered where people live and outside of traditional boundaries wherever possible and this is a good start in trying to achieve that.”

Dr Paul Johnson, Chair of the Devon CCG , said: “At the heart of the NHS Long Term Plan and our vision for Devon is to support people in their own communities to stay healthy, promote wellbeing and get the care they need when they become unwell or frail. The passion and drive that the community leaders in Lyme Bay and Axe Valley have to provide that care and support is really encouraging and I’m sure will benefit the local population”

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