Hello my name is Carol….
Primary and community care working together is the cornerstone of our plans and the programme board met this week. This includes GPs, community trust representatives, NHS England, and a number of other colleagues from organisations such as Local Medical Committee, Community Pharmacy West Yorkshire and GP Federations.
The vast majority of care and support is provided in communities. Our partnership vision depends on people being supported to stay well at home and in their communities. Primary and community care services have a critical role in making sure this happens. This is the first point of call and people’s experience of health care is usually through these services.
There is clear evidence that strong community care can offer better health for people, and more effective management of long term conditions, high levels of public satisfaction, and reduced demand on hospital services.
We need to share the good practice and learning across the area and wider to make sure we realise these ambitions. This includes making the most of our GP networks / federations and widening the programme board to include social care representation and community partners. This is especially important given that most of the work takes place in our local areas, communities and neighbourhoods and is on the whole focused on improved access to care, including GP appointments and making sure people get the right care, at the right time, in the right place.
We currently have five work streams reporting into the board, such as workforce, community services benchmarking and improving access to care. We are reviewing these to ensure they are addressing our priorities. In addition to these areas, we want to consider where we can add value to the development of primary care networks in our six local places (Bradford and District and Craven; Calderdale, Harrogate, Leeds, Kirklees and Wakefield), partly through sharing learning, and also by securing external support when we can.
It’s also important that we keep firmly in view the role of ‘healthy communities’. Communities themselves often know far better than us what keeps people well. Good housing, employment and where you live, for example access to green spaces and good air quality, also have a key role to play and this is why working with council colleagues (including public health) and our voluntary and community partners is critical. You can read more about Housing and health: Opportunities for sustainability and transformation partnerships in the recent Kings Fund report here.
Fundamental to our plans is the idea of left-shift. This includes supporting people so they can manage their own health conditions in their community when they become ill, where safe to do so. Some people who have a health condition could potentially take an increasing role in managing their illness alongside health professionals, and are often more motivated when they are given the chance to share their experience with others in the same situation. We need to clearly explain what we mean by the left-shift to staff and stakeholders, and importantly what the benefits are to people.
In order to move forward more positively we need to ensure we communicate with primary and community health care professionals , partnership employees and stakeholders, including local people and their representatives i.e. MPs, councillors, members of Health Overview Scrutiny Committees, Joint Health Overview Scrutiny Committee and Health and Wellbeing Boards. We need to provide them with clarity on what our future direction entails, so there is a common understanding of the work that takes place at a local level and how this aligns to West Yorkshire and Harrogate priorities.
This is especially important when you consider our ambition is to have a health care system that delivers good services and improves the wellbeing for everyone living across the area. This includes integrating health and social care and meeting people’s needs based on a system that operates as one.
The Secretary of State, Jeremy Hunt’s, seven key principles in the Social Care Green Paper will help guide our thinking. Although the Green Paper (published later this year) contains no commitment to action, it will be the first step towards changing the law. After publication, the Government will consult with people for their views. These discussions will feed into the next stage of the process – the production of a White Paper which allows proposed changes to be made before the Bill’s formal introduction.
The Kings Fund also highlights that priority must be given to putting in place policies to support integrated care - offering practical help to enable providers and commissioners to take integrated care forward at scale and pace. There is also an opportunity to learn from international good practice, such as Canterbury District Health Board in New Zealand who has made progress towards integrated care over several years by investing in its staff and supporting them to bring about improvements in care. You can also see good examples of care closer to home in the work of Dorset’s integrated care programme.
A key part of this work is the role of independent care providers for example cares homes and supported living for people with learning disabilities. Ian Holmes, Director for West Yorkshire and Harrogate Health and Care Partnership will be discussing this with Rachael Loftus, Head of Regional Health Partnerships – making sure we include care providers in our thinking, and importantly give them the opportunity to voice their views and get involved.
We will keep you updated as the work progresses.
Have a good weekend
What else has been happening this week?
The Clinical Forum met on Tuesday. The membership includes GPs, medical directors, lead nurses, and council colleagues. It is chaired by Dr Andy Withers.Lauren Phillips, our partnership programme lead gave members an update on the recent funding allocation of £25million for four areas of work including telemedicine in care homes, pathology and scanning. You can find out more here. We are considering applications for the next funding round.
Anthony Kealy (core team) and Lauren Phillips also gave an update on the fifteen programme check and confirm sessions.The high level themes were discussed. These included financial support, programme capacity and connections to our six local places. Colleagues felt it was a useful process and discussions are underway to consider whether the meetings should take place next year.
There was also a discussion on the work of urgent care and mental health and this will be discussed at a future meeting. Primary care and nursing, workforce planning, preventing ill health and obesity were also discussed.
Shane Hayward Giles, NHS England Right Care, gave an update on the information available to prevent respiratory disease, including heart and lungs. This gives us the opportunity to reduce hospital admissions whilst ensuring people get the support they need to stay well. The impact of fuel poverty and air quality on respiratory concerns was also discussed. There is an opportunity to work with the Academic Health Science Network to share learning and spread the work across WY&H. Shane will attend a future place based planners meeting to discuss this further.
Fatima Khan-Shah (our programme lead for unpaid carers) attended the forum to discuss national quality markers set out by NHS England for carer friendly GP practices. Our carers programme includes workforce, young carers, hospital care and primary care. NHS England have highlighted that our carer programme is one of four exemplar sites across the country. An event will be held in June, supported by NHS England and aimed at GPs, practice nurses, community matrons, mental health colleagues, voluntary sector leads, representatives from community pharmacy and councils, as well as chairs from public involvement groups, including Healthwatch. Local Medical Committees, which are local representative committees of NHS GPs, will also be invited to attend.
Joint Committee of Clinical Commissioning Group
Marie Burnham chaired the Joint Committee of the 11 CCGs on Tuesday. Marie is the independent lay chair and there are also two lay members on the committee. Their role is to act as advocates for public interests. There was an update on the potential to become an integrated care system. No decision has been made. There was also an overview on the development of the Memorandum of Understanding (MoU) from Ian Holmes. There is an editorial group for this work and discussions on the draft MoU have taken place at local Health and Wellbeing Boards. Further discussions will take place once we have a final draft.
Dr Gordon Sinclair gave an update on how severe and complex obesity services were commissioned by NHS England. In April 2017 responsibility for commissioning these services, commonly known as Tier 4 bariatric surgery, was transferred to clinical commissioning groups. Michelle Turner, WY&H programme director for the bariatric surgery programme and Dr Andrew O’Shaughnessy, a public health consultant, gave an overview of the work taking place across the area including specialist weight management services required to prepare people for obesity surgery, referrals and eligibility criteria.
West Yorkshire and Harrogate Health and Care Executive Leadership Group
The leadership group met on Tuesday. This includes leaders from across the Partnership, including hospitals, councils, clinical commissioning groups and voluntary sector. The meeting is chaired by Rob Webster, CEO lead for our Partnership.
There was a presentation around strategic estates planning, namely the Naylor Review and the potential opportunities for working together. Colleagues from councils and NHS services will look at how best we move forward together.
There was also a conversation around the recent funding allocation and planning for the next phase of capital funding. The partnership has brought in over £70million to support our WY&H work so far. Financial strategies for the coming year were also discussed.
Ian Holmes, Director for WY&H HCP, gave an update on the development of the Memorandum of Understanding and the importance of mutual accountability. There is the potential to bring together in the future a strategic level board with partner members, including the West Yorkshire combined authority, and locally elected members and non-executive chairs. There was agreement from the board that this form of working would help build on our principles of meaningful engagement and added value. Being open and transparent is important to the way we work. We will keep you updated as the work progresses.
What’s happening next week?
- Local place based planners (Bradford Districts and Craven; Calderdale, Harrogate, Leeds, Kirklees, Wakefield) meet on Tuesday.
- There is a meeting with Rory Deighton, Kirklees Director for Healthwatch and public health colleagues on the work to #changetheconversation
- The carers project group meets on Thursday.
- West Yorkshire and Harrogate priority programme leads meet on Thursday. This includes maternity services, urgent care, stroke and cancer.