I am writing to provide a response of behalf of East of England Ambulance Service NHS Trust (EEAST) in relation to the consultation on the Rochford Local Plan Spatial Strategy Options and to confirm our commitment to working in partnership with the Council and Mid and South-East Essex Sustainability and Transformation Partnership (MSE) (and any successor organization) to jointly plan the necessary infrastructure to help local community in Rochford prosper.
As part of joint health working, EEAST agree and support the points made by MSE in their separate response to the Strategic Objectives for Rochford.
As both a health partner and an emergency service, EEAST would hope to engage with the Council as the Integrated Development Plan is developed as a supporting document to the 2050 Rochford Local Plan. EEAST would request any developments adopt the jointly created emergency services Design Guide for Essex details can be found using the attached link: Engaging with the Emergency Services | Essex Design Guide (https://www.essexdesignguide.co.uk)
We welcome further discussions with the Council around how we collectively can mitigate the cumulative impact of housing and infrastructure developments across health services serving Rochford and where appropriate the surrounding area. Every effort is made to EEAST’s request for developer contribution is tailored to each individual development, or where less than 50 dwellings in each development, group of developments.

EEAST are in the process of developing an evidence-based formula to identify the impact of population growth for housing and infrastructure developments on ambulance services. This will include key projects to enable delivery of our services due to population growth on housing developments, nursing and care homes or over 55 developments. EEAST together with MSE would welcome further discussions around how the infrastructure impact of the Borough’s 2050 Local Plan can be collectively addressed and support net Carbon Zero, to deliver BREEAM Outstanding sustainability standards.

EEAST’s Estates Strategy (2020-2025) summary position is to provide cost effective and efficient premises of the right size, location, and condition to support the delivery of clinical care to the community served by the Trust. A range of national initiatives are underway aimed at improving performance and sustainability within the NHS across wider urgent and emergency system in all six counties along with Local Authorities and Councils, Universities, military establishments, and private providers of ambulance services. Addressing these changes requires the Trust to develop revised operating models and strategies for all aspects of its services, including operational support services such as the Estates Service. A key component of this process has been to establish the Trust’s future Operating Model and to commence planning for the resulting transformation of support services. Expansion to the existing Make Ready Hub and Spoke network will be required to meet the growing demographics.
Each Hub will have a network of Spokes termed Ambulance Station Response Posts (ASRP), tailored to meet service delivery and patient response specific to their local area. Other infrastructure developments such as road and rail also impact on EEAST as an emergency services provider, with requirements to meet nationally set response times.
The spoke network is determined by the changes to infrastructure and changes to local population health care needs through patient flow modelling and subsequently EEAST staffing requirements. The aim is to create demand-centric and agile spokes which are adapted to activity requirements (both permanent and temporary workforce requirements during significant infrastructure development construction periods) as these change over time.

Current East of England Ambulance Stations close to Rochford

Spokes can be made up of:
• Ambulance Station Reporting Base - 24/7 permanent reporting base for staff and primary response location for one or more vehicles
• Ambulance Station Response Post - primary response location which includes staff welfare facilities
• Standby Location - set in strategic locations where crews are placed to reach patients quickly. Facilities used by staff are provided by external organisations to EEAST.
The resulting estate configuration which consists of a network of up to 18 ambulance Hubs. Each Hub will incorporate:
• A make ready center from which the Make Ready Service is delivered
• Workshop facilities providing service, maintenance, and repair services for operations vehicles within the local spoke network, including Patient Transport Service (PTS) vehicles
• Consumable product stores, with stock-levels maintained on a just-in-time basis by direct supplier delivery
• Some Hubs will operate additionally as the bases for certain corporate, administrative and support services
• PTS facilities incorporated into the operational estate, primarily at the Hubs.
In addition, across the Trust’s region there are:
• Two Hazardous Area Response Team (HART) bases, located to best support the major airports within the Trust’s region
• A Trust HQ co-located within operational premises
• A regional training school providing staff professional training, co-located with driver training and supported by up to two satellite professional training locations plus general training facilities at each of the Hubs
• A fleet logistics center at one of the Hubs’, incorporating a 24-hour fleet logistics call-center
The Rochford area is covered by the Southend Hub which forms one of the 18 Make Ready Hubs across the region.
EEAST estates and development plans consider growth in demographics of population changes and therefore any increase in requirements to meet these changes will require modelling to account for the required increased workforce, equipment and vehicles. EEAST are currently participating in a service review to better understand what resources are needed to meet patient demand.

Acute, Mental Health, Social and Out of Hospital Services
As Integrated Care Systems deliver hospital services reconfiguration and transformation into new models of care, this means ambulance services will be impacted by:
• Ageing population and greater number of people living with long term conditions – creates greater demand on both emergency and commissioned patient transport services.
• An increased need for emergency ambulance services to deliver more out of hospital care, such as by expanding their “hear and treat” and “see and treat” services.
• Development of centralised care Hubs, such as vascular and stroke networks, may lead to increased conveyance times, but with improved outcomes for patients.
• Changes to discharge care models are likely to increase the number of patients discharged with more complex needs and are likely to require increased levels of care during transportation as well as effective and timely handover of care.
• Focusing on improvements to acute and ambulance service diagnostic and digital connectivity.
The provision of health and social care services out of hospital care into community and social care via diagnostic hubs and community locations will require changes to patient transport services.

Assessment of Rochford Local Plan 2050 Spatial Strategy Options

This section provides further assessment of the impact of each of the proposed options on EEAST Emergency Ambulance Services across the Spatial Options Consultation Paper 2021 and the likely mitigations to be considered as part of the Infrastructure Delivery Plan next year.

STRATEGY OPTION 1: Urban Intensification

Existing planned housing developments, including sites with planning permission, existing allocated sites and urban developments, involving around 4,200 new homes of which at least 800 will be affordable. Support utilisation of existing site and urban developments with provision of at least 800 affordable homes.

In relation to ambulance services providing support to this population growth, wherever possible this would be incorporated into existing ambulance Hubs or response posts, however this may not be possible and additional response or stand by posts may be required or relocated. This may be in larger primary care premises or jointly located with fire and police or other potential solutions.

EEAST would request any developments adopt the created principles in Essex: Engaging with the Emergency Services Essex Design Guide.

Potentially a further 1,500 homes by allowing higher density developments in urban areas and on existing allocations. As above
Existing planned employment developments, including sites with planning permission and existing allocated sites, involving a minimum of 120,000 m2 of permissioned employment space, including new high quality space at Airport Business Park and Michelin Farm As above
Capacity improvements to existing schools and healthcare centres, new onsite open spaces and sports facilities Any new health/medical premises would ideally provide the opportunity to explore an ambulance response post at this location including a suitable fast charging EV connection.

Potential requirement for financial contributions from developers.
Limited opportunities to deliver transformational new infrastructure as many of the developments would fall below the 50-home threshold to contribute to new infrastructure The combination of a number of small developments (<50 dwellings) affects ambulance service provision and consideration is requested to enable financial contributions from developers is assessed on a block basis to enable expansion or introduction of new response posts to retain the nationally mandated response times
Option 1 Urban Intensification EEAST does not have any particular preference for each sub-option, as any development option requires consideration of the suitable location of ambulance response and/or standby posts in order to meet the needs of the patient population growth which will impact on our ability to achieve national response times.

Our main consideration is the ability to access financial contributions from developers to support the expansion or relocation of ambulance stations/reporting/response and/or standby posts
Total 4,200 + 1,500 dwellings

STRATEGY OPTION 2: Urban Extensions
Option 2a: Focused on main towns
Option 2b: Dispersed to all settlements based on Settlement Hierarchy

An additional 3,000 – 5,000 homes relative to Option 1 of which at least 1,000-2,000 would be affordable Support utilisation of existing site and urban developments with provision of at least 1,000 – 2,000 affordable homes.

In relation to ambulance services providing support to this population growth, wherever possible this would be incorporated into existing ambulance Hubs or response posts, however this may not be possible and additional response or stand by posts may be required or relocated. This may be in larger primary care premises or jointly located with fire and police or other potential solutions.

EEAST would request any developments adopt the created principles in Essex: Engaging with the Emergency Services Essex Design Guide.

Up to 3 new primary schools, new medical facilities, open spaces, employment areas and transport connections Any new health/medical premises would ideally provide the opportunity to explore a response post at this location including a suitable fast charging EV connection.

Potential requirement for financial contributions from developers.

Opportunities to support rural services by directing some growth to villages with rural shops, schools or community facilities We support rural growth combined with regular appropriate public transport arrangements to support people getting to work/recreation/use of community facilities

The combination of a number of small developments (<50 dwellings) affects ambulance service provision and consideration is requested to enable financial contributions from developers is assessed on a block basis to enable expansion or introduction of new response posts to retain the nationally mandated response times.
Option 2a: Focused on main towns

Option 2b: Dispersed to all settlements based on Settlement Hierarchy
EEAST does not have any particular preference for each sub-option, as any development option requires consideration of the suitable location of ambulance response and/or standby posts in order to meet the needs of the patient population growth which will impact on our ability to achieve national response times.

Our main consideration is the ability to access financial contributions from developers to support the expansion or relocation of ambulance stations/reporting/response and/or standby posts
Total between 3,000-5,000 dwelling with 1,000 – 2,000 affordable

Option 3: Concentrated growth
Option 3a: Focused west of Rayleigh
Option 3b: Focused north of Southend
Option 3c: Focused east of Rochford

An additional 3,000 – 5,000 homes relative to Option 1 of which at least 1,000-2,000 would be affordable Support utilisation of existing site and urban developments with provision of at least 1,000 – 2,000 affordable homes.

In relation to ambulance services providing support to this population growth, wherever possible this would be incorporated into existing ambulance Hubs or response posts, however this may not be possible and additional response or stand by posts may be required or relocated. This may be in larger primary care premises or jointly located with fire and police or other potential solutions.

EEAST would request any developments adopt the created principles in Essex: Engaging with the Emergency Services Essex Design Guide.

Up to 1 new secondary school, 3 new primary schools, new medical facilities, open spaces, employment areas and new link roads Any new health/medical premises would ideally provide the opportunity to explore a response post at this location including a suitable fast charging EV connection.

Potential requirement for financial contributions from developers.
Greater opportunities to attract Government investment into existing and new infrastructure as part of the Thames Estuary Growth Area. Support growth opportunities
Greater opportunities to work with Basildon, Castle Point, Essex and Southend Councils to co-ordinate funding towards transformational transport infrastructure projects such as a new inter-urban rapid transit system or new link roads EEAST as an emergency service needs to be aware of and involved in transformational infrastructure projects as during the construction phase this may impact on our ability to achieve national response times.

Infrastructure changes also impact on any commissioned Patient Transport Services to ensure timely delivery and collection of patients for their appointments to acute hospitals/diagnostic hubs or other out of hospital services
Opportunities to deliver the eastern extent of the South Essex Estuary Park forming a new coastal country park in the east of the District Support opportunities to improve health and well -being of residents and visitors to the area
Option 3a: Focused west of Rayleigh

Option 3b: Focused north of Southend

Option 3c: Focused east of Rochford
EEAST does not have any particular preference for each sub-option, as any development option requires consideration of the suitable location of ambulance response and/or standby posts in order to meet the needs of the patient population growth which will impact on our ability to achieve national response times.

Our main consideration is the ability to access financial contributions from developers to support the expansion or relocation of ambulance stations/reporting/response and/or standby posts
Total between 3,000-5,000 dwellings with 1,000 – 2,000 affordable

Option 4: Balanced Combination
No sub-options

An additional 3,000 – 5,000 homes relative to Option 1 of which at least 1,000-2,000 would be affordable. Support utilisation of existing site and urban developments with provision of at least 1,000 – 2,000 affordable homes.

In relation to ambulance services providing support to this population growth, wherever possible this would be incorporated into existing ambulance Hubs or response posts, however this may not be possible and additional response or stand by posts may be required or relocated. This may be in larger primary care premises or jointly located with fire and police or other potential solutions.

EEAST would request any developments adopt the created principles in Essex: Engaging with the Emergency Services Essex Design Guide.

Up to 1 new secondary school, 3 new primary schools, new medical facilities, open spaces, employment areas and new link roads. Any new health/medical premises would ideally provide the opportunity to explore a response post at this location including a suitable fast charging EV connection.

Potential requirement for financial contributions from developers.
Greater opportunities to attract Government investment into existing and new infrastructure as part of the Thames Estuary Growth Area Support growth opportunities
Greater opportunities to work with Basildon, Castle Point Essex and Southend Councils to co-ordinate funding towards transformational transport infrastructure projects such as a new inter-urban rapid transit system or new link roads EEAST as an emergency service needs to be aware of and involved in transformational infrastructure projects as during the construction phase this may impact on our ability to achieve national response times.

Infrastructure changes also impact on any commissioned Patient Transport Services to ensure timely delivery and collection of patients for their appointments to acute hospitals/diagnostic hubs or other out of hospital services
Opportunities to support rural services by directing some growth to villages with rural shops, schools or community facilities. We support rural growth combined with regular appropriate public transport arrangements to support people getting to work/use of community facilities

The combination of a number of small developments (<50 dwellings) affects ambulance service provision and consideration is requested to enable financial contributions from developers is assessed on a block basis to enable expansion or introduction of new response posts to retain the nationally mandated response times
Opportunities to deliver the eastern extent of the South Essex Estuary Park forming a new country park in the east of the District Support opportunities to improve health and well-being of residents and visitors to the area
Option 4 Balanced Combination EEAST does not have any particular preference for each sub-option, as any development option requires consideration of the suitable location of ambulance response and/or standby posts in order to meet the needs of the patient population growth which will impact on our ability to achieve national response times.

Our main consideration is the ability to access financial contributions from developers to support the expansion or relocation of ambulance stations/reporting/response and/or standby posts
Total between 3,000-5,000 dwellings with 1,000 – 2,000 affordable

We hope this information provides a useful indication of the expected impact on health services for East of England Ambulance Services on the proposed Spatial Strategy Options set out in the Local Plan 2050 consultation document. We look forward to working with the Council, Mid Essex STP, police and fire colleagues throughout the development of the Local Plan 2050 and associated Infrastructure Delivery Plan.