East Coast Community Healthcare

A Message from Lord Pickles and Lord Blunkett, followed by East Coast Community Healthcare's best practice article

The ability to listen and learn from one another has always been vital in parliament, in business and in most aspects of daily life. But at this particular moment in time, as national and global events continue to reiterate, it is uncommonly crucial that we forge new channels of communication and reinforce existing ones. The following article from East Coast Community Healthcare is an attempt to do just that. We would welcome your thoughts on this or any other Parliamentary Review article.

Blunkett signature Rt Hon The Lord David Blunkett
Pickles signature Rt Hon The Lord Eric Pickles


CEO JonathanWilliams
81 per cent of ECCH
staff have chosen to be
shareholders in the social
East Coast Community Healthcare is a community interest
company that provides NHS community health services
across Norfolk and north Suffolk. Currently developing
and implementing a new primary care model, it has placed
communities and patients at its heart. Working alongside both
traditional services and those that are not usually associated
with the NHS, it aims to provide the highest level of service.
CEO Jonathan Williams tells
The Parliamentary Review
the construction of this model and how they have adapted to
financial pressures across the NHS.
Our 850 staff serve a population of around 230,000 people on the east coast. This
includes Great Yarmouth and Lowestoft, which have some of the highest levels
of deprivation in the country, and also very rural areas where social isolation and
an ageing population result in a number of challenges. We provide NHS services,
including community in-patient services, district nursing, specialist palliative care
and physiotherapy, as well as public health services such as smoking cessation and
children’s speech and language. We are coterminous with our commissioners and
are involved in the Sustainability and Transformation Partnership for our area. As
the only social enterprise in Norfolk involved in this body, with a district general
hospital, our jurisdiction falls into a neat enclave, improving the way in which we
are able to plan and deliver services.
Our accomplishments have been based on our flexibility, our emphasis on
innovation and our ability to remain prudent and to pay a great deal of attention
to our staff. Our success in recruitment, an area in which other parts of the NHS
»Chief Executive:
»Established in 2011
»Headquarters in Lowestoft
»Services: Community health
and public health services
»No. of employees: 850
East Coast Community
Highlighting best practice
have struggled, is mainly based on
the development of a positive internal
culture and the value we place on
good engagement with staff. This solid
base has meant that, with a bold and
innovative new care model, we have
secured a new community services
contract for the next five years, with an
optional two additional years. In order
to gain the new contract, we engaged
in a competitive procurement process,
competing against two NHS trusts. This
has allowed us to emerge from the
process with a forward-thinking model
for the delivery of our services.
Developing a primary care
The NHS is creating Primary Care
Networks, with each covering roughly
50,000 people. There are four of these
networks in our local area and we
have worked hard to develop multi-
disciplinary teams who will work in
and around primary care. In order to
fine-tune this development, we visited
other areas of the country to learn
from their models. Our STP has a tight
deadline to become an integrated
care system, with a target of achieving
this by 2022. Our model is standing
out as an area of excellence in this
Our model places communities and
patients at its heart. Our work with
the four Primary Care Networks, three
covering urban areas and one in a
more rural setting, involves devising
integrated health and social care
homes based around the GP practices.
The aim is to treat more patients in
their own communities. There is also
a determination to widen the scope
of services available by reducing
duplication of efforts, integrating
our approach with other agencies
and working in partnership across
Community services have been
continually adapted in the last ten
years, and multiple initiatives have
been introduced to try to alleviate the
pressure on hospitals and to support
primary care. Different models have
been commissioned alongside one
another, creating fragmented systems
that are often confusing for both staff
and the public. Our model merges
these different initiatives, focusing on
clinical leadership and contact. We
place significant emphasis on public
engagement, developing a range of
methods for communicating with
patients, listening to their views and
needs and anticipating and embracing
new technology.
We are also working closely with the
voluntary sector and with industries
that are not usually associated with
health and social care. For example,
we have a strong partnership with
a local charity that provides sports
facilities. Around 8,000 people become
members of the leisure centre each
year and we are now working with
them to provide screening for new
members for signs of major diseases
like diabetes and heart arrhythmias.
These partnerships are a central part of
our strategy.
ECCH’s Primary Care
Networks are tailored to
meet the demographic
needs of each area
Our accomplish-
ments have
been based on
our flexibility,
our emphasis
on innovation
and our ability
to remain
prudent and to
pay a great deal
of attention to
our staff
Running in tandem with the new
model is our belief in health coaching
and social prescribing. We have won
awards for our approach, which has
included training over 400 of our own
staff in health coaching skills, as well
as staff from partner organisations.
Dealing with financial
The biggest challenge we, and the
whole of the NHS, face is challenging
finances, something I feel has not been
properly addressed. Our STP in Norfolk
has a huge financial challenge and,
although we are in quite a healthy
financial position, if our partners
are locked in a cycle of deficit, it will
inevitably have a knock-on effect on
us. While NHS trusts can set deficit
budgets, we would go bust. Beyond
this, we pay VAT, which the NHS
generally doesn’t, and we fall under a
set of corporate tax systems that are
often not favourable to our growth.
The Agenda for Change, the NHS staff
pay model, places further financial
pressure upon us, and can require us
to contribute around half a million
pounds of uplift every year. All of these
financial pressures mean we have to
be very realistic when we plan for
the future. When we do have surplus
resources, in line with our status as
a social enterprise, we reinvest them
to benefit local communities, be that
in monetary terms or in the form of
staff time. We have donated funding
and equipment to good causes in
recent years, set up clinics for parents
of premature babies and training for
parents in infant resuscitation. We
have given safeguarding training to
local sports clubs and defibrillator
training to local communities and
have run three “Get into Healthcare”
courses for trainees from The
To alleviate financial pressures, we
have developed our own IT systems,
which we can sell to others, and we
have begun to offer training and
education services to external partners
as well as in-house. Finding these
avenues for growth is something we
take very seriously.
As we look to the future, we are
developing a strategic shift to propel
us forward. We have established our
own charity, The ECCH Foundation,
with independent trustees helping
young people in areas of significant
deprivation, all fuelled by our passion
to build healthy communities and to
become the support mechanism for
health and wellbeing services in the
years to come.
Our model
and patients
at its heart
ECCH values patient
engagement and uses
feedback to continually
develop services


This article was sponsored by East Coast Community Healthcare. The Parliamentary Review is wholly funded by the representatives who write for it. The publication in which this article originally appeared contained the following foreword from Rt Hon Michael Gove.

Rt Hon Michael Gove's Foreword For The Parliamentary Review

By Rt Hon Michael Gove

This year's Parliamentary Review comes at a momentous time for parliament, as we collectively determine the destiny of the United Kingdom. 

On October 31, the UK will leave the European Union. The successful implementation of this process is this government's number-one priority.

Three years after a historic referendum vote, we will deliver on the decisive mandate from the British people. Trust in our democracy depends on it. Until that final hour, we will work determinedly and diligently to negotiate a deal, one that abolishes the backstop and upholds the warm and close relationship we share with our friends, allies and neighbours in the EU. But in the event that the EU refuses to meet us at the table, we must be prepared to leave without a deal.

As the Chancellor of the Duchy of Lancaster, it is my job to lead on this government's approach, should that scenario happen. Preparing for Brexit is my department's driving mission. But while I am leading this turbocharged effort, the whole of government is committed to this endeavour.

Ministers across Whitehall are working together to ensure that every possibility is considered, every plan is scrutinised and every provision is made. A daily drumbeat of meetings means that we are holding departments accountable, so that preparations are completed on time.

The chancellor has confirmed that all necessary funding will be made available. And we have mobilised thecivil service, assigning 15,000 of our most talented civil servants to manage our exit from the EU.

We will make sure that on November 1, there is as little disruption to national life as possible. Our trade relationships will continue to thrive, thanks to agreements with countries around the world worth £70 billion. Our country will remain secure, thanks to nearly 1,000 new officers posted at our borders. And the 3.2 million EU nationals now living and working among us can remain confident, with absolute certainty, of their right to remain in the UK.

Above all, our goal is to be transparent. Soon, we will launch a public information campaign so that citizens, communities and businesses are ready and reassured about what will happen in the event of “no deal”.

In my first few weeks in this role, I have travelled to ports and tarmacs, borders and bridges, all across the UK –from the seaside of Dover to the rolling green hills of County Armagh. I have heard from business owners and border officials, farmers and hauliers. They are ready to put an end to uncertainty. And they are ready to embrace the opportunities ahead.

Our departure from the EU will be a once in a lifetime chance to chart a new course for the United Kingdom. Preparing for that new course will be a herculean effort. But this country has made astounding efforts before. We can do it again.
Rt Hon Michael Gove
Chancellor of the Duchy of Lancaster